口腔颌面部恶性肿瘤患者血清中SCCA、Cyfra21-1、EGFR、CyclinD1含量的检测  

Serum SCCA,Cyfra21-1,EGFR and CyclinD1 levels in patients with oral and maxillofacial malignancy

作　　者：冯晓宇[1] 邢汝东[1] 鲁大鹏[1] 李建华[1] 李金忠[1] 李华[1] 韩正学[1] 

机构地区：[1]首都医科大学口腔医学院口腔颌面外科

出　　处：《北京口腔医学》2009年第6期309-313,共5页Beijing Journal of Stomatology

基　　金：首都医学发展科研基金(2005-3047)

摘　　要：目的检测口腔颌面部恶性肿瘤患者血清中鳞状细胞癌相关抗原(SCCA)、细胞角蛋白19可溶性片段(Cyfra 21-1)、表皮生长因子受体(EGFR)和细胞周期素D1(Cyclin D1)的含量,探讨它们的联合检测对口腔颌面部恶性肿瘤的诊断价值,以及与肿瘤临床分期、病理分级和淋巴结转移的关系,并观察手术前后这四种物质的含量变化。方法选择住院治疗的口腔颌面部恶性肿瘤患者92例,正常对照组72例,肿瘤患者于术前取空腹静脉血2ml,对其中20例患者于术后1周再次取空腹静脉血2ml,正常对照组于常规体检时取空腹静脉血2ml。酶联免疫吸附法测定所有标本血清中SCCA、Cyfra 21-1、EGFR、Cyclin D1的含量。结果口腔颌面部恶性肿瘤患者术前血清中SCCA、EGFR、Cyclin D1的含量明显高于正常对照组,而Cyfra21-1的含量与对照组相比无显著差异。患者术后1周血清中SCCA的含量明显降低,而Cyfra 21-1、EGFR、Cyclin D1的含量与术前相比无显著差异。肿瘤患者术前血清中SCCA、Cyfra 21-1、EGFR、Cyclin D1的含量与肿瘤的临床分期、分化及淋巴结转移无关。单独检测SCCA、EGFR、Cyclin D1时,EGFR对肿瘤诊断的灵敏度、特异性和准确性最高;SCCA、EGFR、Cyclin D1任意两种联合检测时,EGFR与Cyclin D1联合对肿瘤诊断的灵敏度、特异性和准确性最高,其次是SCCA与EGFR联合;SCCA、EGFR和Cyclin D1三者联合检测的灵敏度、特异性和准确性与EGFR、Cyclin D1联合检测相同。结论EGFR与Cyclin D1联合检测可提高对口腔颌面部恶性肿瘤诊断的灵敏度、特异性和准确性,对口腔颌面部恶性肿瘤有辅助诊断价值。SCCA可能对治疗效果的监测有参考意义。Objective To determine the levels of SCCA, Cyfra21-1, EGFR and Cyclin D1 in serum of patients with oral and maxillofacial malignancy and to investigate their relationship with clinical stage, pathological grade and lymph node metastasis. Methods Ninety-two hospitalized patients with oral and maxillofacial malignancy and seventy-two healthy individuals were included in this investigation. Venous blood was collected from these patients and the healthy controls before therapy. One week after therapy, venous blood was collected once again in 20 patients. Serum samples were detected by enzyme linked immunosorbent assay （ELISA）. Results The serum SCCA, EGFR and Cyelin D1 concentrations were significantly higher in patients with oral and maxillofaclal malignancy than in healthy controls, while there was no significant difference in the Cyfra21-1 level between patients and healthy individuals. The serum SCCA level after surgery became lower than before surgery, but there were no significant differences in the serum Cyfra21-1, EGFR and Cyclin D1 levels before and after surgery. None of the serum SCCA, Cyfra21-1 , EGFR and Cyclin D1 level was correlated with the clinical stage, pathological grade and lymph node metastasis. If SCCA, EGFR and CyclinD1 were detected independently, EGFR had the highest sensitivity,specificity and accuracy in diagnosis; if any two of the SCCA, EGFR and Cyclln D1 were detected in combination, the combined detection of EGFR and Cyclin D1 had the highest sensitivity, specificity and accuracy. Conclusion SCCA, EGFR and Cyclin D1 may prove to be useful tumor markers in oral and maxillofaeial malignancy. The combined determination of EGFR and Cyelin D1 may be of value in the diagnosis of oral and maxillofacial malignancy. Serum SCCA may be used as an adjunct in monitoring treatment response.

关 键 词：SCCA CYFRA 21—1 EGFR CYCLIN D1 口腔颌面部恶性肿瘤 

分 类 号：R739.8[医药卫生—肿瘤]