tumorsMalignant tumoursMalignant tumours2224-50572587-6813Rosoncoweb10.18027/2224-5057-2020-10-2-2tumors-738Research ArticleОБЗОРЫ И АНАЛИТИКАREVIEWS AND ANALYSISЗначение циркулирующих опухолевых маркеров при раке легкого в клинической практикеThe importance of circulating tumor markers in lung cancer in clinical practiceРыковИ. В.RykovI. V.

Иван В. Рыков, к. м. н., заведующий отделением онкологии

Санкт-Петербург

Ivan V. Rykov, MD, PhD, Head of the Department of Oncology

ФГБУЗ «Санкт-Петербургская клиническая больница РАН»РоссияSt. Petersburg Clinical Hospital of the Russian Academy of SciencesRussian Federation2020311220201023135Copyright © Рыков И.В., 20202020Рыков И.В.Rykov I.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.malignanttumors.org/jour/article/view/738

В статье рассмотрены циркулирующие опухолевые маркеры (ЦОМ), используемые при немелкоклеточном и мелкоклеточном раке легкого — CYFRA 21-1, РЭА, SCC, NSE и proGRP. При немелкоклеточном раке легкого, учитывая возможную неспецифичность, ЦОМ должны оцениваться комплексно. При комбинации трех маркеров — РЭА, CYFRA 21-1 и SCC, повышение хотя бы одного из 3 маркеров наблюдалось у 100% пациентов с НМРЛ III–IV ст. CYFRA 21-1, РЭА и SCC также обладают предиктивным и прогностическим значением. В нескольких исследованиях было показана зависимость от уровня снижения маркеров и выживаемостью пациентов на фоне лекарственного лечения (химиотерапии и иммунотерапии). Для мелкоклеточного рака легкого наиболее изученными ЦОМ являются NSE и proGRP. В комбинации с ЦОМ для НМРЛ они позволяют верно предположить гистологический вариант опухоли легкого у 79–97% пациентов. Кроме того, мониторинг ProGRP после 1, 2 и 3 циклов терапии хорошо коррелировал с динамикой опухолевого процесса и имел прогностическое значение для пациентов с МРЛ. Это позволяет использовать ЦОМ как дополнительный критерий ответа, при невозможности оценки результатов лечения, например при наличии только неизмеряемых очагов. Циркулирующие опухолевые маркеры представляют собой простой и удобный инструмент, позволяющий дополнить информацию о гистологическом подтипе, прогнозе и ответе на лечение при раке легкого.

We have reviewed the available publications about circulating tumor markers (CTM) — CYFRA 21‑1, CEА, SCC, NSE and proGRP, in patients with small‑cell (SCLC) and non‑small cell lung cancer (NSCLC). Elevated levels of at least one of them (CEA, CYFRA 21‑1 и SCC) were seen in 100 % of patients with stage III–IV NSCLC. CEA, CYFRA 21‑1 and SCC could have prognostic and predictive value. Their decrease during chemotherapy or immunotherapy correlates with better overall survival. For SCLC the main CTM are NSE and proGRP. Together with CTM for NSCLC these markers could predict correctly histological subtype of lung cancer in 79–97 % of patients. Levels of proGRP after 1, 2 and 3 cycles of chemotherapy in SCLC correlated with response to treatment and were associated with prognosis. Thus, it can be used as an additional response criterion, for example in patients with non‑measurable disease. CTM provide additional easy‑to‑use predictive and prognostic data for patients with lung cancer.

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The authors declare that there are no conflicts of interest present.