中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2012年
4期
353-356
,共4页
梁卫江%李文超%杨叶青%苏桂栋%刘斐烨%罗荣城
樑衛江%李文超%楊葉青%囌桂棟%劉斐燁%囉榮城
량위강%리문초%양협청%소계동%류비엽%라영성
宫颈鳞癌%鳞状细胞癌抗原%细胞角蛋白19片段抗原21-1%组织多肽特异性抗原
宮頸鱗癌%鱗狀細胞癌抗原%細胞角蛋白19片段抗原21-1%組織多肽特異性抗原
궁경린암%린상세포암항원%세포각단백19편단항원21-1%조직다태특이성항원
squamous cell cervical cancer%Squamous cell carcinoma antigen%Cytokeratin 19 fragments-1%Tissue polypeptide specific antigen
目的 研究血清鳞状细胞癌抗原(SCCAg)、细胞角蛋白19片段抗原21-1( CYFRA21-1)、组织多肽特异性抗原(TPS)在宫颈鳞癌的诊断及预后预测中的价值.方法 选取宫颈鳞癌患者160例,正常妇女60例,采用酶联免疫吸附法检测血清SCCAg、CYFRA21-1、TPS浓度.结果 (1)宫颈癌组血清SCCAg、CYFRA21-1、TPS浓度明显高于正常组(P＜0.001),正常组中位数分别为0.43 μg/L、0.43μ g/L、26 U/L；宫颈癌组中位数分别为1.96 μg/L、2.29 μg/L、149.1 U/L.(2)单项血清SCCAg、CYFRA21-1、TPS对宫颈鳞癌患者的诊断敏感性分别为53.42％、40.68％、83.95％,特异性均为100％.TPS诊断敏感性明显高于SCCAg、CYFRA21-1 (P ＜0.001).SCCAg和CYFRA21-1联合及三种肿瘤标志物联合检测诊断敏感性分别为69.23％、92.31％.(3)SCCAg、CYFRA21-1及TPS在Ⅲ+Ⅳ期表达明显高于Ⅰ+Ⅱ期(P＜0.05),均与肿瘤分化程度无关(P＞0.05)；SCCAg与肿瘤大小、生长类型及有无淋巴结转移相关(P＜0.05),在≥55岁组表达明显高于＜ 55岁组(P＜0.05)；CYFRA21-1与肿瘤大小、生长类型、有无淋巴结转移及年龄无关(P＞0.05)；TPS与肿瘤大小、有无淋巴结转移相关(P＜0.05),与生长类型及年龄无关(P＜0.05).(4)随访78例宫颈鳞癌患者,已经复发转移者治疗前血清SCCAg、CYFRA21-1、TPS浓度均明显高于无复发转移者,且SCCAg、CYFRA21-1在两者间的差异有统计学意义(P＜0.05).治疗前血清SCCAg升高者中位复发转移及生存时间较正常者明显缩短(P＜0.05).结论 血清SCCAg、CYFRA21-1、TPS对宫颈鳞癌的诊断均具有较高临床参考价值,SCCAg及CYFRA21-1在预后预测方面有重要意义.
目的 研究血清鱗狀細胞癌抗原(SCCAg)、細胞角蛋白19片段抗原21-1( CYFRA21-1)、組織多肽特異性抗原(TPS)在宮頸鱗癌的診斷及預後預測中的價值.方法 選取宮頸鱗癌患者160例,正常婦女60例,採用酶聯免疫吸附法檢測血清SCCAg、CYFRA21-1、TPS濃度.結果 (1)宮頸癌組血清SCCAg、CYFRA21-1、TPS濃度明顯高于正常組(P＜0.001),正常組中位數分彆為0.43 μg/L、0.43μ g/L、26 U/L；宮頸癌組中位數分彆為1.96 μg/L、2.29 μg/L、149.1 U/L.(2)單項血清SCCAg、CYFRA21-1、TPS對宮頸鱗癌患者的診斷敏感性分彆為53.42％、40.68％、83.95％,特異性均為100％.TPS診斷敏感性明顯高于SCCAg、CYFRA21-1 (P ＜0.001).SCCAg和CYFRA21-1聯閤及三種腫瘤標誌物聯閤檢測診斷敏感性分彆為69.23％、92.31％.(3)SCCAg、CYFRA21-1及TPS在Ⅲ+Ⅳ期錶達明顯高于Ⅰ+Ⅱ期(P＜0.05),均與腫瘤分化程度無關(P＞0.05)；SCCAg與腫瘤大小、生長類型及有無淋巴結轉移相關(P＜0.05),在≥55歲組錶達明顯高于＜ 55歲組(P＜0.05)；CYFRA21-1與腫瘤大小、生長類型、有無淋巴結轉移及年齡無關(P＞0.05)；TPS與腫瘤大小、有無淋巴結轉移相關(P＜0.05),與生長類型及年齡無關(P＜0.05).(4)隨訪78例宮頸鱗癌患者,已經複髮轉移者治療前血清SCCAg、CYFRA21-1、TPS濃度均明顯高于無複髮轉移者,且SCCAg、CYFRA21-1在兩者間的差異有統計學意義(P＜0.05).治療前血清SCCAg升高者中位複髮轉移及生存時間較正常者明顯縮短(P＜0.05).結論 血清SCCAg、CYFRA21-1、TPS對宮頸鱗癌的診斷均具有較高臨床參攷價值,SCCAg及CYFRA21-1在預後預測方麵有重要意義.
목적 연구혈청린상세포암항원(SCCAg)、세포각단백19편단항원21-1( CYFRA21-1)、조직다태특이성항원(TPS)재궁경린암적진단급예후예측중적개치.방법 선취궁경린암환자160례,정상부녀60례,채용매련면역흡부법검측혈청SCCAg、CYFRA21-1、TPS농도.결과 (1)궁경암조혈청SCCAg、CYFRA21-1、TPS농도명현고우정상조(P＜0.001),정상조중위수분별위0.43 μg/L、0.43μ g/L、26 U/L；궁경암조중위수분별위1.96 μg/L、2.29 μg/L、149.1 U/L.(2)단항혈청SCCAg、CYFRA21-1、TPS대궁경린암환자적진단민감성분별위53.42％、40.68％、83.95％,특이성균위100％.TPS진단민감성명현고우SCCAg、CYFRA21-1 (P ＜0.001).SCCAg화CYFRA21-1연합급삼충종류표지물연합검측진단민감성분별위69.23％、92.31％.(3)SCCAg、CYFRA21-1급TPS재Ⅲ+Ⅳ기표체명현고우Ⅰ+Ⅱ기(P＜0.05),균여종류분화정도무관(P＞0.05)；SCCAg여종류대소、생장류형급유무림파결전이상관(P＜0.05),재≥55세조표체명현고우＜ 55세조(P＜0.05)；CYFRA21-1여종류대소、생장류형、유무림파결전이급년령무관(P＞0.05)；TPS여종류대소、유무림파결전이상관(P＜0.05),여생장류형급년령무관(P＜0.05).(4)수방78례궁경린암환자,이경복발전이자치료전혈청SCCAg、CYFRA21-1、TPS농도균명현고우무복발전이자,차SCCAg、CYFRA21-1재량자간적차이유통계학의의(P＜0.05).치료전혈청SCCAg승고자중위복발전이급생존시간교정상자명현축단(P＜0.05).결론 혈청SCCAg、CYFRA21-1、TPS대궁경린암적진단균구유교고림상삼고개치,SCCAg급CYFRA21-1재예후예측방면유중요의의.
Objective To study the value of SCCAg,CYFRA21-1 and TPS in the diagnosis and prognostic evaluation of patients with cell cervical cancer (SCC).Methods The levels of serum SCCAg,CYFRA21-1and TPS from 160 SCC patients and 60 health women were detected by means of ELISA.Results ( 1 ) The levels of serum SCCAg,CYFRA21-1and TPS in SCC were significantly higher than those of normal group ( P ＜0.001 ).The median values of normal group:0.43 μg/L,0.43 μg/L,26 U/L,the median values of cervical cancer group:1.96 μg/L,2.29 μg/L,149.1 U/L ( 2 ) The specificity of SCCAg,CYFRA21-1 and TPS in diagnosing SCC were both 100％.The sensitivity of SCCAg,CYFRA21-1 and TPS in diagnosing SCC was 53.42％,40.68％ and 83.95％,respectively.The sensitivity of TPS was obviously different from SCCAg and CYFRA21-1 ( P ＜0.001 ).The sensitivity of SCCAg plus CYFRA21-1 and three markers together were 69.23％and 92.31％,respectively.(3)The expressing of SCCAg,CYFRA21 -1 and TPS in FIGO stages Ⅲ plus Ⅳ was significantly higher than in stages Ⅰ plus Ⅱ (P ＜ 0.05 ),and all markers were not related to the degree of histological differentiation.SCCAg was correlated strongly with tumor size,growth type,lymph node metastasis and age( P ＜ 0.05 ),but CYFRA21-1 was not correlated with all these factors.TPS level was significantly associated with tumor size and lymph node metastasis( P ＜0.05 ),but not with growth type and age.(4)A total of 78 patients were followed up.The pretreatmental serum levels of SCCAg and CYFRA21-1 in patients with recurrence were significantly higher than those without recurrence( P ＜0.05 ).The same trend was not found for TPS.Compared with the normal control,the patients with elevated SCCAg before treatment has shorter intervals before recurrence and metastasis occurred.Also,the survival of patients with elevated SCCAg before treatment was shorter than the normal control ( P ＜ 0.05 ).Conclusion SCCAg,CYFRA21-1 and TPS serum levels are valuable markers for the diagnosis of SCC.Meanwhile,SCCAg and CYFRA21-1 are chnically significant pridictors for the prognosis of SCC.
