肿瘤研究与临床
腫瘤研究與臨床
종류연구여림상
CANCER RESEARCH AND CLINIC
2011年
4期
216-219
,共4页
食管肿瘤%肿瘤,鳞状细胞%肿瘤标志物%抗肿瘤联合化疗方案
食管腫瘤%腫瘤,鱗狀細胞%腫瘤標誌物%抗腫瘤聯閤化療方案
식관종류%종류,린상세포%종류표지물%항종류연합화료방안
Esophageal neoplasms%Neoplasms,squamous cell%Tumor marker%Antineoplastic combined chemotherapy protocols
目的 探讨血清肿瘤标志物在晚期食管鳞状细胞癌(简称:鳞癌)中的表达及其在化疗疗效评价和预后判断中的意义.方法 测定50例晚期食管鳞癌患者一线化疗前后血清标志物的水平.按照实体瘤的疗效评价标准(RECIST标准)评效.通过建立受试者工作特性曲线(ROC曲线)求最佳临界值.用Kaplan-Meier法行生存分析.结果 50例患者治疗前的血清肿瘤标志物阳性率以细胞角蛋白19片段(CYFRA21-1)最高(44.0%,22/50);癌胚抗原(CEA)最低(22.0%,11/50).配对样本Wilcoxon秩和检验示部分缓解(PR)组化疗后CYFRA21-1、鳞状上皮细胞癌抗原(SCC-Ag)下降,差异有统计学意义(Z=3.181、2.389,P=0.001、0.017),进展(PD)组化疗后CYFRA21-1、SCC-Ag升高,差异有统计学意义(Z=2.701、2.250,P=0.007、0.024),稳定(SD)组化疗前后SCC-Ag、CYFRA21-1差异无统计学意义(Z=0.414、1.114,P=0.679、0.265).提示SCC-Ag、CYFRA21-1与影像学疗效评价具有一致性.ROC曲线显示化疗后CYFRA21-1较化疗前升高32%,SCC-Ag升高38%,可作为预测化疗疗效的最佳临界值,并与影像学评效具有较好的一致性.化疗后CYFRA21-1较化疗前升高＞32%和SCC-Ag较化疗前升高＞38%为晚期食管鳞癌预后不良因素.结论 CYFRA21-1和SCC-Ag对晚期食管鳞癌的诊断、预测化疗疗效和预后有重要意义.
目的 探討血清腫瘤標誌物在晚期食管鱗狀細胞癌(簡稱:鱗癌)中的錶達及其在化療療效評價和預後判斷中的意義.方法 測定50例晚期食管鱗癌患者一線化療前後血清標誌物的水平.按照實體瘤的療效評價標準(RECIST標準)評效.通過建立受試者工作特性麯線(ROC麯線)求最佳臨界值.用Kaplan-Meier法行生存分析.結果 50例患者治療前的血清腫瘤標誌物暘性率以細胞角蛋白19片段(CYFRA21-1)最高(44.0%,22/50);癌胚抗原(CEA)最低(22.0%,11/50).配對樣本Wilcoxon秩和檢驗示部分緩解(PR)組化療後CYFRA21-1、鱗狀上皮細胞癌抗原(SCC-Ag)下降,差異有統計學意義(Z=3.181、2.389,P=0.001、0.017),進展(PD)組化療後CYFRA21-1、SCC-Ag升高,差異有統計學意義(Z=2.701、2.250,P=0.007、0.024),穩定(SD)組化療前後SCC-Ag、CYFRA21-1差異無統計學意義(Z=0.414、1.114,P=0.679、0.265).提示SCC-Ag、CYFRA21-1與影像學療效評價具有一緻性.ROC麯線顯示化療後CYFRA21-1較化療前升高32%,SCC-Ag升高38%,可作為預測化療療效的最佳臨界值,併與影像學評效具有較好的一緻性.化療後CYFRA21-1較化療前升高＞32%和SCC-Ag較化療前升高＞38%為晚期食管鱗癌預後不良因素.結論 CYFRA21-1和SCC-Ag對晚期食管鱗癌的診斷、預測化療療效和預後有重要意義.
목적 탐토혈청종류표지물재만기식관린상세포암(간칭:린암)중적표체급기재화료료효평개화예후판단중적의의.방법 측정50례만기식관린암환자일선화료전후혈청표지물적수평.안조실체류적료효평개표준(RECIST표준)평효.통과건립수시자공작특성곡선(ROC곡선)구최가림계치.용Kaplan-Meier법행생존분석.결과 50례환자치료전적혈청종류표지물양성솔이세포각단백19편단(CYFRA21-1)최고(44.0%,22/50);암배항원(CEA)최저(22.0%,11/50).배대양본Wilcoxon질화검험시부분완해(PR)조화료후CYFRA21-1、린상상피세포암항원(SCC-Ag)하강,차이유통계학의의(Z=3.181、2.389,P=0.001、0.017),진전(PD)조화료후CYFRA21-1、SCC-Ag승고,차이유통계학의의(Z=2.701、2.250,P=0.007、0.024),은정(SD)조화료전후SCC-Ag、CYFRA21-1차이무통계학의의(Z=0.414、1.114,P=0.679、0.265).제시SCC-Ag、CYFRA21-1여영상학료효평개구유일치성.ROC곡선현시화료후CYFRA21-1교화료전승고32%,SCC-Ag승고38%,가작위예측화료료효적최가림계치,병여영상학평효구유교호적일치성.화료후CYFRA21-1교화료전승고＞32%화SCC-Ag교화료전승고＞38%위만기식관린암예후불량인소.결론 CYFRA21-1화SCC-Ag대만기식관린암적진단、예측화료료효화예후유중요의의.
Objective To assess the predictive and prognostic role of the alteration of serum carcinoembryonic antigen (CEA),squamous cell carcinoma antigen (SCC-Ag) and cytokeratin 19 fragment (CYFRA21-1) during chemotherapy in patients with advanced esophageal squamous cell carcinoma (ESCC).Methods The serum levels of CEA,CYFRA21-1 and SCC-Ag were measured in 50 patients with advanced ESCC at baseline and after first line chemotherapy.The data was correlated with objective efficacy and overall survival.To evaluate the role of tumor marker change in predicting response to therapy,receiver operating characteristic (ROC) curves were constructed.Results CEA,SCC-Ag and CYFRA21-1 increased higher than the cutoffs in 22.0 %,34.0 %,and 44.0 % of tested patients,respectively.Statistically significant correlations were observed between CYFRA21-1 and SCC responses and objective efficacy evaluated by RECIST criteria (Z =3.181,2.389; P = 0.001,0.017).Based on the ROG curve analysis,a post treatment 32 % and 38 % increase in serum concentration was used as cut-off level for defining CYFRA21-1 and SCC-Ag change,respectively.When the cut-off levels were used to predict chemotherapy efficacy,the accuracy for CYFRA21-1 and SCC-Ag were 76 % and 70 %.In the univariate survival analysis,a statistically significant prognostic impact on survival from the change of CYFRA21-1 and SCC-Ag was observed.Conclusion CYFRA21-1 and SCC-Ag are useful for diagnosis,predicting chemotherapy objective efficacy and prognosis in advanced ESCC.
