Changes of postoperative serum tumor markers levels in patients with lung cancer and their relationship with recurrence within 1 year

Zhu Bei; Fang Liang; Song Ruiqing

doi:10.3969/j.issn.1674-7151.2025.04.006

Abstract：Objective To explore the changes of postoperative serum cytokeratin 19 fragment antigen(CYF21-1),neuron-specific enolase(NSE)and carbohydrate antigen 125(CA125)levels in patients with lung cancer and analyze their relationship with recurrence within 1 year.Methods A total of 137 patients with lung cancer who received radical resection admitted in Shandong Yiyang Healthcare Group Xinwen Central Hospital from April 2021 to February 2024 were included as study subjects.The changes of serum CYF21-1,NSE and CA125 levels were compared before surgery and at 1,2 and 3 weeks after surgery.According to the cancer recurrence status within 1 year of follow-up,the patients were divided into recurrence group(31 cases)and non-recurrence group(106 cases).The levels of serum CYF21-1,NSE and CA125 at 3 weeks after surgery were compared between two groups.The influencing factors of recurrence within 1 year after surgery in patients with lung cancer were analyzed by binary Logistics regression.Receiver operator characteristic curve(ROC curve)was drawn and area under ROC curve(AUC)was calculated to analyze the predictive values of serum CYF21-1,NSE and CA125 at 3 weeks after surgery on recurrence within 1 year after surgery in patients with lung cancer.Results The proportion of patients with TNM stage ⅢA in recurrent group was higher than that in non-recurrent group(61.29%vs.34.91%,P<0.05).Within 3 weeks after surgery,the serum levels of CYF21-1,NSE and CA125 were decreased significantly and continuously.The levels of serum CYF21-1,NSE and CA125 before surgery and at 3 weeks after surgery were significantly higher than those in non-recurrence group[before surgery:CYF21-1(μg/L):19.47±4.06 vs.17.12±3.76,NSE(μg/L):29.67±4.56 vs.27.69±4.15,CA125(kU/L):228.54±47.12 vs.207.23±40.57;at 3 weeks after surgery:CYF21-1(μg/L):4.87±0.95 vs.4.25±0.78,NSE(μg/L):16.93±3.24 vs.14.94±2.95,CA125(kU/L):65.07±14.65 vs.53.74±12.04;all P<0.05].Logistic regression analysis showed that proportion of TNM stage ⅢA and CYF21-1,NSE and CA125 before surgery and at 3 weeks after surgery were associated with recurrence of lung cancer patients within 1 year after surgery[odds ratios(OR)were 5.697,2.662,10.892,1.112,1.879,8.837,1.706,P values were 0.039,0.026,0.024,0.042,0.008,0.008,<0.001].The AUCs of CYF21-1,NSE and CA125 at 3 weeks after surgery in predicting recurrence within 1 year after surgery were 0.676,0.631 and 0.653,respectively.The AUC,sensitivity and specificity of combined diagnosis were 0.766,80.65%and 55.66%,respectively,and the combined diagnostic value was higher.Conclusion The levels of serum CYF21-1,NSE and CA125 in patients with lung cancer after surgery will decrease significantly,and serum CYF21-1,NSE and CA125 at 3 weeks after surgery have certain predictive value on recurrence of lung cancer within 1 year.