CAJ | 학술논문

目的：观察血清CA724、CA242及甲胎蛋白(AFP)在原发性肝癌患者肝动脉化疗栓塞术（TACE）治疗前后的变化及临床意义。方法选取原发性肝癌患者（原发性肝癌组）45例及健康对照者（健康对照组）40例，应用电化学发光免疫分析法检测健康对照组及肝癌患者在TACE术前2 d、术后1周和1个月时血清CA724、CA242及AFP，分析3个指标的相关性及与临床资料间的关系，观察肝癌患者AFP＜400μg/L与AFP≥400μg/L组中血清CA724、CA242在手术前后的变化。结果原发性肝癌组术前血清CA724、CA242及AFP含量均高于健康对照组（P<0.05），血清CA724、AFP阳性率高于健康对照组（P<0.01）。原发性肝癌组AFP在TACE治疗后1周及1个月均较治疗前2 d降低（P<0.01），CA724在治疗后1个月低于治疗前（P<0.05），而CA242差异无统计学意义（P>0.05）。原发性肝癌患者血清CA724及AFP的表达与肿瘤大小有关（P<0.05）。术后1个月，AFP＜400μg/L与AFP≥400μg/L组CA724均较术前下降（P<0.05）。CA724与AFP的表达呈正相关（r=0.754，P<0.05）。结论血清CA724可作为协助评价肝癌TACE术后疗效的肿瘤标志物之一。
목적：관찰혈청CA724、CA242급갑태단백(AFP)재원발성간암환자간동맥화료전새술（TACE）치료전후적변화급림상의의。방법선취원발성간암환자（원발성간암조）45례급건강대조자（건강대조조）40례，응용전화학발광면역분석법검측건강대조조급간암환자재TACE술전2 d、술후1주화1개월시혈청CA724、CA242급AFP，분석3개지표적상관성급여림상자료간적관계，관찰간암환자AFP＜400μg/L여AFP≥400μg/L조중혈청CA724、CA242재수술전후적변화。결과원발성간암조술전혈청CA724、CA242급AFP함량균고우건강대조조（P<0.05），혈청CA724、AFP양성솔고우건강대조조（P<0.01）。원발성간암조AFP재TACE치료후1주급1개월균교치료전2 d강저（P<0.01），CA724재치료후1개월저우치료전（P<0.05），이CA242차이무통계학의의（P>0.05）。원발성간암환자혈청CA724급AFP적표체여종류대소유관（P<0.05）。술후1개월，AFP＜400μg/L여AFP≥400μg/L조CA724균교술전하강（P<0.05）。CA724여AFP적표체정정상관（r=0.754，P<0.05）。결론혈청CA724가작위협조평개간암TACE술후료효적종류표지물지일。
Objective To investigate the change of serum CA724, CA242 and AFP levels before and after transcatheter artery chemoembolization (TACE) treatment of primary hepatic carcinoma(PHC)patients as well as its clinic significance. Methods Patients of PHC (n=45) and healthy adults (n=40) were enrolled. Serum samples were collected from each healthy people and PHC patients 2 days before TACE,l week and 1 month after TACE. Electrochemiluminescence Immunoassay (ECLI) was used to determine serum CA724, CA242 and AFP levels, and correlations among three indexes as well as their relationships with clinical data were also analysed., Change of serum CA724 and CA242 levels before and after TACE were compared in AFP<400μg/L group and AFP≥400μg/L group. Results Serum levels of CA724, CA242 and AFP in PHC group were significantly higher than that in healthy control groups before TACE therapy(P<0.05). Positive rates of serum CA724 and AFP were higher in PHC group(P<0.01)than that in healthy control group. AFP decreased significantly at both 1 week and 1 month upon TACE treatment compared with that at before teratment(P<0.01). CA724 was significantly lower at one month after treatment than that at before treatment(P<0.05). But there was no significant difference in CA242 before and after treatment(P>0.05). CA724 and AFP expressions are associated with tumor size(P<0.05). After one month of therapy, serum CA724 level was obviously decreased in both AFP<400μg/L and AFP≥400μg/L groups. Before and after TACE therapy, there was a positive correlation between the expression of AFP and CA724(r=0.754,P<0.05). Conclusion Serum CA724 can be used as one of the tumor markers to assist the evaluation of curative effect of TACE on PHC.