胸腔镜食管癌切除术患者血清CYFRA21-1、CEA水平变化及临床意义
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摘要
目的探讨胸腔镜食管癌切除术患者血清细胞角蛋白19片段抗原(CYFRA21-1)、癌胚抗原(CEA)水平变化及临床意义。方法选取2014年1月至2017年1月胸腔镜食管癌切除术患者100例为癌症组,同期选取健康人员100例为健康组,检测所有人员血清CYFRA21-1、CEA水平,分析血清CYFRA21-1、CEA水平变化及与食管癌复发转移的关系。结果癌症组血清CYFRA21-1、CEA水平明显高于健康组,癌症组术后(出院日)血清CYFRA21-1、CEA水平明显低于术前,差异有统计学意义(P<0.05);癌症组随访12个月,复发转移22例(22.00%),在血清CYFRA21-1、CEA水平及下降比方面,复发转移者术后3、6、9、12个月明显高于无复发转移者,复发转移者术后呈持续升高的趋势,复发转移者术后呈持续下降的趋势,差异有统计学意义(P<0.05)。结论血清CYFRA21-1、CEA水平与食管癌发生及其胸腔镜切除术后复发转移有关,术后监测CYFRA21-1、CEA对患者预后转归的评估具有重要的指导意义,值得临床进一步推广。
Objective To investigate the changes of serum cytokeratin 19 fragment antigen(CYFRA21-1) and carcinoembryonic antigen(CEA) levels in patients undergoing thoracoscopic esophagectomy for esophageal cancer and its clinical significance.Methods One hundred patients with esophageal cancer who underwent thoracoscopic esophagectomy in our hospital from January 2014 to January 2017 were enrolled as cancer group,and the other 100 healthy people at the same period were enrolled as healthy group. The serum levels of CYFRA21-1 and CEA were detected,moreover,the correlation between the changes of serum levels of CYFRA21-1,CEA and the relapse as well as metastasis of esophageal cancer was analyzed.Results The serum levels of CYFRA21-1 and CEA in the cancer group were significantly higher than those in the healthy group. The serum levels of CYFRA21-1 and CEA in the cancer group after surgery(on the day of discharge) were significantly lower than those before surgery, and there were significant differences(P<0.05). The patients were followed up for 12 months, and 22 patients(22.00%) had recurrence and metastasis. The levels of serum CYFRA21-1 and CEA as well as the decrease ratio in patients with recurrence and metastasis were significantly higher than those without recurrence and metastasis at 3, 6, 9 and 12 months after surgery. The indicators in patients with recurrence and metastasis continued to increase after surgery, and those in patients without recurrence and metastasis showed a continuous decline after surgery. The difference was statistically significant(P<0.05).Conclusion The levels of serum CYFRA21-1 and CEA are associated with the occurrence of esophageal cancer and recurrence and metastasis after thoracoscopic esophagectomy. Postoperative monitoring of CYFRA21-1 and CEA is of important guiding significance for the evaluation of prognosis and outcome of patients, which is worthy of further clinical popularization.
Objective To investigate the changes of serum cytokeratin 19 fragment antigen(CYFRA21-1) and carcinoembryonic antigen(CEA) levels in patients undergoing thoracoscopic esophagectomy for esophageal cancer and its clinical significance.Methods One hundred patients with esophageal cancer who underwent thoracoscopic esophagectomy in our hospital from January 2014 to January 2017 were enrolled as cancer group,and the other 100 healthy people at the same period were enrolled as healthy group. The serum levels of CYFRA21-1 and CEA were detected,moreover,the correlation between the changes of serum levels of CYFRA21-1,CEA and the relapse as well as metastasis of esophageal cancer was analyzed.Results The serum levels of CYFRA21-1 and CEA in the cancer group were significantly higher than those in the healthy group. The serum levels of CYFRA21-1 and CEA in the cancer group after surgery(on the day of discharge) were significantly lower than those before surgery, and there were significant differences(P<0.05). The patients were followed up for 12 months, and 22 patients(22.00%) had recurrence and metastasis. The levels of serum CYFRA21-1 and CEA as well as the decrease ratio in patients with recurrence and metastasis were significantly higher than those without recurrence and metastasis at 3, 6, 9 and 12 months after surgery. The indicators in patients with recurrence and metastasis continued to increase after surgery, and those in patients without recurrence and metastasis showed a continuous decline after surgery. The difference was statistically significant(P<0.05).Conclusion The levels of serum CYFRA21-1 and CEA are associated with the occurrence of esophageal cancer and recurrence and metastasis after thoracoscopic esophagectomy. Postoperative monitoring of CYFRA21-1 and CEA is of important guiding significance for the evaluation of prognosis and outcome of patients, which is worthy of further clinical popularization.
引文
1 王祥,李强,庄翔,等.侧俯卧位胸腔镜食管癌根治术与开胸食管癌根治术的围手术期结果及淋巴结清扫的比较.中华肿瘤杂志,2014,36:863-866.
2 Zhou JH,Rosen D,Andreou A,et al.Residual tumor thickness at the tumor-normal tissue interface predicts the recurrence-free survival in patients with liver metastasis of breast cancer.Ann Diagn Pathol,2014,18:266-270.
3 陆志斌,熊磊,丛壮壮,等.早期食管癌患者外周血DKK-1、CEA、CYFRA21-1和NSE的检测及临床意义.现代肿瘤医学,2017,25:2415-2417.
4 Bagaria B,Sood S,Sharma R,et al.Comparative study of CEA and CA19-9 in esophageal,gastric and colon cancers individually and in combination (ROC curve analysis).Cancer Biol Med,2013,10:148-157.
5 郑勇,姚元波,蔡彦力,等.胸腔镜食管癌根治术与开放食管癌根治术对患者围手术期免疫功能、应激反应的影响.海南医学院学报,2016,22:2434-2436.
6 Ohashi S,Miyamoto S,Kikuchi O,et al.Recent advances from basic and clinical studies of esophageal squamous cell carcinoma.Gastroenterology,2015,149:1700-1715.
7 智玲玲,原园,李志英.新辅助化疗联合手术对老年食管癌患者CEA、CA199和CA125的影响.实用癌症杂志,2017,32:224-226.
8 Miny J,Bertaut A,Bosset JF,et al.Exclusive chemoradiation with carboplatin-paclitaxel versus FOLFOX-4 in locally advanced esophageal cancer:A matched-pair analysis.Journal of Clinical Oncology,2017,35:145.
9 周敏杰,李少民,夏焘,等.食管癌患者术前术后血清Hcy、TSGF、IGF-Ⅱ的改变及临床意义.海南医学,2017,28:1278-1280.
10 Naito M,Yamamoto T,Shimamoto C,et al.Retrospective analysis of the risk factors for grade IV neutropenia in oesophageal cancer patients treated with a docetaxel,cisplatin,and 5-fluorouracil regimen.Chemotherapy,2017,62:215-224.
11 吴冬,胡旭军,林言.不同血清肿瘤标志物对食管癌的诊断价值分析.中国卫生检验杂志,2017,27:531-533.
12 Wallin U,Rothenberger D,Lowry A,et al.CEA-a predictor for patholo- gic complete response after neoadjuvant therapy for rectal cancer.Dis Colon Rectum,2015,56:859-868.
13 黄国福,冷晓玲.血清CYFRA21-1、CA125及CA72-4对食管癌的诊断价值.标记免疫分析与临床,2014,21:229-231.
14 Chappuis G,Soltermann B.Number and cost of claims linked to minor cervical trauma in Europe:results from the comparative study by CEA,AREDOC and CEREDOC.Eur Spine J,2013,17:1350-1357.
15 杜春然,王彦明,侯申岩.CYFRA21-1、CA19-9和SCCAg检测在食管癌诊断中的价值研究.癌症进展,2018,16:186-188.
2 Zhou JH,Rosen D,Andreou A,et al.Residual tumor thickness at the tumor-normal tissue interface predicts the recurrence-free survival in patients with liver metastasis of breast cancer.Ann Diagn Pathol,2014,18:266-270.
3 陆志斌,熊磊,丛壮壮,等.早期食管癌患者外周血DKK-1、CEA、CYFRA21-1和NSE的检测及临床意义.现代肿瘤医学,2017,25:2415-2417.
4 Bagaria B,Sood S,Sharma R,et al.Comparative study of CEA and CA19-9 in esophageal,gastric and colon cancers individually and in combination (ROC curve analysis).Cancer Biol Med,2013,10:148-157.
5 郑勇,姚元波,蔡彦力,等.胸腔镜食管癌根治术与开放食管癌根治术对患者围手术期免疫功能、应激反应的影响.海南医学院学报,2016,22:2434-2436.
6 Ohashi S,Miyamoto S,Kikuchi O,et al.Recent advances from basic and clinical studies of esophageal squamous cell carcinoma.Gastroenterology,2015,149:1700-1715.
7 智玲玲,原园,李志英.新辅助化疗联合手术对老年食管癌患者CEA、CA199和CA125的影响.实用癌症杂志,2017,32:224-226.
8 Miny J,Bertaut A,Bosset JF,et al.Exclusive chemoradiation with carboplatin-paclitaxel versus FOLFOX-4 in locally advanced esophageal cancer:A matched-pair analysis.Journal of Clinical Oncology,2017,35:145.
9 周敏杰,李少民,夏焘,等.食管癌患者术前术后血清Hcy、TSGF、IGF-Ⅱ的改变及临床意义.海南医学,2017,28:1278-1280.
10 Naito M,Yamamoto T,Shimamoto C,et al.Retrospective analysis of the risk factors for grade IV neutropenia in oesophageal cancer patients treated with a docetaxel,cisplatin,and 5-fluorouracil regimen.Chemotherapy,2017,62:215-224.
11 吴冬,胡旭军,林言.不同血清肿瘤标志物对食管癌的诊断价值分析.中国卫生检验杂志,2017,27:531-533.
12 Wallin U,Rothenberger D,Lowry A,et al.CEA-a predictor for patholo- gic complete response after neoadjuvant therapy for rectal cancer.Dis Colon Rectum,2015,56:859-868.
13 黄国福,冷晓玲.血清CYFRA21-1、CA125及CA72-4对食管癌的诊断价值.标记免疫分析与临床,2014,21:229-231.
14 Chappuis G,Soltermann B.Number and cost of claims linked to minor cervical trauma in Europe:results from the comparative study by CEA,AREDOC and CEREDOC.Eur Spine J,2013,17:1350-1357.
15 杜春然,王彦明,侯申岩.CYFRA21-1、CA19-9和SCCAg检测在食管癌诊断中的价值研究.癌症进展,2018,16:186-188.