血清肿瘤标志物在宫颈鳞癌诊断及预后预测中的价值  

The value of SCCAg, CYFRA21-1 and TPS in the diagnosis and prognostic evaluation of vatients with squamous cell cervical cancer

作　　者：粱卫江[1] 李文超[1] 杨叶青 苏桂栋[3] 刘斐烨[1] 罗荣城[1] 

机构地区：[1]南方医科大学南方医院肿瘤科,广州510515 [2]湖南省邵阳市中心医院血液肿瘤科 [3]南方医科大学南方医院妇产科,广州510515

出　　处：《中国综合临床》2012年第4期353-356,共4页Clinical Medicine of China

基　　金：广东省科技计划项目（20078030703004）;南方医科大学南方医院院长基金项目

摘　　要：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0．43μg/L、0．43μg／L、26U／L；宫颈癌组中位数分别为1．96μg/L、2．29μg／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69．25％、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在两者问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。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, CYFRA21-1 and TPS in SCC were significantly higher than those of normal group （ P 〈 0. 001 ）. The median values of normal group ：0. 43 p.g/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%o . 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, CYF

关 键 词：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 

分 类 号：R734.2[医药卫生—肿瘤]