CYFRA21-1、CA19-9和SCCAg检测在食管癌诊断中的价值研究
|
摘要
目的探讨血清细胞角质蛋白19片段CYFRA21-1、糖类抗原19-9(CA19-9)、鳞状细胞癌抗原(SCCAg)单独及联合检测在食管癌诊断中的价值。方法选取100例食管癌患者(观察组)和50例健康志愿者(对照组),检测两组受试者的血清CYFRA21-1、CA19-9和SCCAg水平,并按照临床分期对观察组患者进行亚组分析,采用受试者工作曲线(ROC)分析CYFRA21-1、CA19-9和SCCAg检测在食管癌诊断中的价值。结果观察组患者的血清CYFRA21-1、CA19-9和SCCAg水平均明显高于对照组,Ⅰ~Ⅱ期患者的血清CYFRA21-1、CA19-9和SCCAg水平均明显低于Ⅲ~Ⅳ期,差异均有统计学意义(P﹤0.01);血清CYFRA21-1、CA19-9、SCCAg三者联合检测诊断食管癌的灵敏度为82.26%,特异度为91.33%,阳性预测值为86.14%,阴性预测值为89.57%,AUC值为0.864,均高于其中任一项指标单独检测,差异均有统计学意义(P﹤0.05)。结论血清CYFRA21-1、CA19-9、SCCAg三者联合检测可以提高食管癌诊断的灵敏度和特异度。
Objective To investigate the value of serum cytokeratin 19 fragment(CYFRA21-1), carbohydrate antigen 19-9(CA19-9) and squamous cell carcinoma antigen(SCCAg) in the diagnosis of esophageal cancer. Method 100 cases of esophageal cancer(study group) and 50 healthy subjects(control group) were recruited in the study, the serum levels of CYFRA21-1, CA19-9 and SCCAg in these patients were detected. Subgroups analysis was performed in study group by clinical staging, and the diagnostic value of CYFRA21-1, CA19-9 and SCCAg in detecting esophageal cancer was analyzed by receiver operating characteristic curve(ROC). Result The serum levels of CYFRA21-1, CA19-9 and SCCAg in study group were significantly higher than those in control group, and those were significantly lower in patients with stage Ⅰ-Ⅱ disease than those with stage Ⅲ and Ⅳ disease, indicating statistically significant difference(P<0.01); the sensitivity of serum CYFRA21-1, CA19-9 and SCCAg in the diagnosis of esophageal cancer was 82.26%, and specificity was 91.33%, with positive predictive value being 86.14%, and negative predictive value being 89.57%, and AUC value was 0.864, the combined detection was superior to each measure utilized alone, the difference was significantly significant(P<0.05). Conclusion The combined detection of serum CYFRA21-1, CA19-9, and SCCAg can significantly improve the diagnostic sensitivity and specificity in detecting the esophageal cancer.
Objective To investigate the value of serum cytokeratin 19 fragment(CYFRA21-1), carbohydrate antigen 19-9(CA19-9) and squamous cell carcinoma antigen(SCCAg) in the diagnosis of esophageal cancer. Method 100 cases of esophageal cancer(study group) and 50 healthy subjects(control group) were recruited in the study, the serum levels of CYFRA21-1, CA19-9 and SCCAg in these patients were detected. Subgroups analysis was performed in study group by clinical staging, and the diagnostic value of CYFRA21-1, CA19-9 and SCCAg in detecting esophageal cancer was analyzed by receiver operating characteristic curve(ROC). Result The serum levels of CYFRA21-1, CA19-9 and SCCAg in study group were significantly higher than those in control group, and those were significantly lower in patients with stage Ⅰ-Ⅱ disease than those with stage Ⅲ and Ⅳ disease, indicating statistically significant difference(P<0.01); the sensitivity of serum CYFRA21-1, CA19-9 and SCCAg in the diagnosis of esophageal cancer was 82.26%, and specificity was 91.33%, with positive predictive value being 86.14%, and negative predictive value being 89.57%, and AUC value was 0.864, the combined detection was superior to each measure utilized alone, the difference was significantly significant(P<0.05). Conclusion The combined detection of serum CYFRA21-1, CA19-9, and SCCAg can significantly improve the diagnostic sensitivity and specificity in detecting the esophageal cancer.
引文
[1]Probst A,Aust D,Anthuber M,et al.Early esophageal cancer in Europe:endoscopic treatment by endoscopic submucosal dissection[J].Endoscopy,2015,47(2):113-121.
[2]付卫云,陈冬玲,卞华,等.血清CYFRA21-1、CA19-9和SCC的测定对食管癌的诊断价值研究[J].重庆医学,2017,46(12):1672-1674.
[3]陈孝平,汪建平.外科学[M].8版.北京:人民卫生出版社,2013.
[4]孙雅文,王家林.食管癌诊断中代谢组学应用进展[J].中华肿瘤防治杂志,2017,24(14):1021-1024.
[5]吕会来,张丽,李勇,等.食管鳞癌手术前后血清肿瘤标记物的变化及其临床意义[J].实用医学杂志,2015,31(23):3900-3903.
[6]Barnas C,Martel-Planche G,Furukawa Y,et al.Inactivation of the p53 protein in cell lines derived from human esophageal cancers[J].Int J Cancer,2015,71(1):79-87.
[7]王永连,赵英政,徐光翠,等.血清肿瘤标志物水平及其联合检测对食管癌的诊断意义[J].重庆医学,2016,12(3):419-420.
[8]程云杰,焦文鹏,王军,等.食管小细胞癌肿瘤标志物与淋巴结转移和预后的相关性分析[J].中华肿瘤防治杂志,2016,23(21):1426-1430.
[9]杨哲,戴洪海,冯阿磊,等.分子标志物指导同步放化疗不能手术食管癌前瞻性非随机对照临床研究[J].中华放射肿瘤学杂志,2016,25(8):807-812.
[10]段新春,崔永,龚民,等.手术前后血清CEA和CYFRA21-1水平的变化有助于预测非小细胞肺癌患者的预后[J].中国肺癌杂志,2015,29(6):358-364.
[11]杜军华,乔洪源,尹宜发.血清CEA、CA125及Cyfra21-1水平对中晚期非小细胞肺癌患者预后的影响[J].肿瘤防治研究,2016,43(2):137-140.
[12]佟威威,佟广辉,王婧,等.Cyfra21-1、NSE、SCCA和CRP在肺癌诊断中的应用[J].中国免疫学杂志,2015,27(3):396-400.
[13]张俊,王永斌,彭海林,等.血清胃蛋白酶原和CEA及CA199与CA724联合检测对胃癌诊断价值研究[J].中华肿瘤防治杂志,2015,18(22):176-178.
[14]陈舒颖,邱芳华,李秋明,等.血清DCD、CA199、CA724和CEA联合检测对大肠癌的诊断价值[J].实用医学杂志,2017,33(15):2482-2485.
[15]李群,刘淑玉,刘红丽,等.血清鳞状细胞癌抗原水平变化在诊断子宫颈鳞癌复发中的临床意义[J].中华妇产科杂志,2015,29(2):131-136.
[2]付卫云,陈冬玲,卞华,等.血清CYFRA21-1、CA19-9和SCC的测定对食管癌的诊断价值研究[J].重庆医学,2017,46(12):1672-1674.
[3]陈孝平,汪建平.外科学[M].8版.北京:人民卫生出版社,2013.
[4]孙雅文,王家林.食管癌诊断中代谢组学应用进展[J].中华肿瘤防治杂志,2017,24(14):1021-1024.
[5]吕会来,张丽,李勇,等.食管鳞癌手术前后血清肿瘤标记物的变化及其临床意义[J].实用医学杂志,2015,31(23):3900-3903.
[6]Barnas C,Martel-Planche G,Furukawa Y,et al.Inactivation of the p53 protein in cell lines derived from human esophageal cancers[J].Int J Cancer,2015,71(1):79-87.
[7]王永连,赵英政,徐光翠,等.血清肿瘤标志物水平及其联合检测对食管癌的诊断意义[J].重庆医学,2016,12(3):419-420.
[8]程云杰,焦文鹏,王军,等.食管小细胞癌肿瘤标志物与淋巴结转移和预后的相关性分析[J].中华肿瘤防治杂志,2016,23(21):1426-1430.
[9]杨哲,戴洪海,冯阿磊,等.分子标志物指导同步放化疗不能手术食管癌前瞻性非随机对照临床研究[J].中华放射肿瘤学杂志,2016,25(8):807-812.
[10]段新春,崔永,龚民,等.手术前后血清CEA和CYFRA21-1水平的变化有助于预测非小细胞肺癌患者的预后[J].中国肺癌杂志,2015,29(6):358-364.
[11]杜军华,乔洪源,尹宜发.血清CEA、CA125及Cyfra21-1水平对中晚期非小细胞肺癌患者预后的影响[J].肿瘤防治研究,2016,43(2):137-140.
[12]佟威威,佟广辉,王婧,等.Cyfra21-1、NSE、SCCA和CRP在肺癌诊断中的应用[J].中国免疫学杂志,2015,27(3):396-400.
[13]张俊,王永斌,彭海林,等.血清胃蛋白酶原和CEA及CA199与CA724联合检测对胃癌诊断价值研究[J].中华肿瘤防治杂志,2015,18(22):176-178.
[14]陈舒颖,邱芳华,李秋明,等.血清DCD、CA199、CA724和CEA联合检测对大肠癌的诊断价值[J].实用医学杂志,2017,33(15):2482-2485.
[15]李群,刘淑玉,刘红丽,等.血清鳞状细胞癌抗原水平变化在诊断子宫颈鳞癌复发中的临床意义[J].中华妇产科杂志,2015,29(2):131-136.