目的 研究肺鳞癌患者化疗前后外周血CYFRA21-1和SCCA的表达水平以及与临床疗效的关系。方法 采用电化学发光法测定肺癌患者化疗前后血浆CYFRA21-1和SCCA含量。参照2009年实体瘤疗效评价标准RECIST，以SPECT 99Tcm-MDP影像的病灶大小、数目在治疗前后的变化为评判依据，在化疗4周期后，疗效按完全缓解（CR）、部分缓解（PR）、稳定（SD）和进展（PD）分类。按临床获益（CB）=CR+PR，治疗无效（NR）=PD+SD分组。结果 CYFRA21-1水平在肺癌治疗无效组与临床获益组比较，差异有统计学意义（P＜0.01）。SCCA水平在肺癌治疗无效组与临床获益组比较，差异有统计学意义（P ＜0.01）。治疗后SPECT病灶消失或缩小或数目减少的17例，无变化或有进展的23例。治疗后在CYFRA21-1水平高值组16例中，临床获益（CB）为18.75%，治疗无效（NR）为81.25%；在CYFRA21-1水平低值组24例中，CB为58.33%，NR为41.67%。两组比较，差异有统计学意义（χ2=6.155，P ＜0.05）。治疗后在SCCA水平高值组14例中，CB为21.43%，NR为78.57%；在SCCA水平低值组26例中，CB为53.85%，NR为46.15%。两组比较，差异有统计学意义（χ2=3.913，P ＜ 0.05）。结论 对比SPECT骨转移病灶大小、数目的变化，化疗前后血浆CYFRA21-1和SCCA水平变化对肺癌化疗效果评估具有较高的临床应用价值。与实体瘤疗效评价标准RECIST评估有一致性。

Objective To explore the relationship between the curative effect and peripheral blood CYFRA21-1 and SCCA expression level in lung squamous carcinoma patients before and after chemotherapy. Methods The plasma CYFRA21-1 and SCCA levels in lung cancer patients before and after chemotherapy were evaluated by electrochemical luminescence method. 99mTc-MDP SPECT bone imaging was used to detect the tumor lesion size and number before and after therapy. The curative effect was classified as complete remission (CR), partial response (PR), stable classification (SD) and development (PD) based on SPECT imaging. The treatment was classified clinical benefit (CB) group including CR and PR, the invalid treatment (NR) group including PD and SD. Results There were significant difference on CYFRA21-1 and SCCA levels in lung cancer between CB group and NR group (P < 0.01). The SPECT imaging showed that 17 cases had lesions disappeared or reduced and 23 cases had no change or progress after treatment. Among 16 cases of high CYFRA21-1 level group after treatment, the clinical benefit (CB) was 18.75%; In 24 cases of low CYFRA21-1 level group, the CB and NR were 58.33% and 41.67% respectively. Among 14 cases of high SCCA level group after treatment, the clinical benefit (CB) was 21.43%; In 26 cases of low SCCA level group, the CB and NR were 53.85% and 46.15% respectively. Conclusion The detection of plasma CYFRA21-1 and SCCA levels in lung cancer patients before and after chemotherapy could have an important value in evaluation of treatment effect.