细胞角蛋白18在胃癌化疗疗效评价中临床意义  

Clinical significance of cytokeratin 18 in evaluating the chemotherapy effect on gastric cancer

作　　者：韩彬彬[1] 魏葆珺[1] 冯莎娜[1] 李学祥[1] 王慜杰[1] 齐军[1] 

机构地区：[1]中国医学科学院肿瘤医院检验科,北京100021

出　　处：《中华实用诊断与治疗杂志》2014年第2期119-121,共3页Journal of Chinese Practical Diagnosis and Therapy

基　　金：首都医学发展基金资助项目(2009-3008)

摘　　要：目的探讨细胞角蛋白18(cytokeratin 18,CK18)在胃癌化疗疗效评价中的临床意义。方法胃癌患者96例,根据化疗后是否出现转移分为转移组13例与未转移组83例,检测2组化疗前、后血清癌胚抗原(carcinoembryonic antigen,CEA)、糖链抗原(carbohydrate antigen,CA)19-9、CA72-4和CK18水平,比较2组肿瘤标志物水平,分析CK18疗效评价与客观疗效评价的一致性。结果未转移组化疗后CEA、CA72-4和CK18水平及阳性率均较化疗前明显降低(P<0.05);转移组化疗前、后CEA、CA19-9、CA72-4与CK18水平及阳性率比较差异均无统计学意义(P>0.05);化疗前、后2组CEA、CA19-9和CK18水平比较差异均有统计学意义(P<0.05);CK18高于参考值的35例患者CK18疗效评价与客观疗效评价符合率为71.43%,有较高一致性(Kappa=0.559)。结论化疗前、后血清CK18水平可作为胃癌化疗疗效的辅助评价指标。Objective To explore the clinical significance of cytokeratin 18 （CK18） in evaluating the chemotherapy effect on gastric cancer. Methods Ninety-six patients were divided into metastasis group （n-~ 13） and non-metastasis group （n：83） after chemotherapy. The serum carcinoembryonic antigen （CEA）, carbohydrate antigen （CA） 19-9, CA72-4 and CK18 were detected before and after chemotherapy. The levels of tumor markers were compared between two groups, and the consistency of CK18 effect and objective effect was analyzed. Results The levels of CEA, CA72-4 and CK18 and their positive rates were all significantly lower after chemotherapy in non-metastasis group （P^0.05）, and the levels of CEA, CA19-9, CA72-4 and CK18 and their positive rates showed no significant differences before and after chemotherapy in metastasis group （P^0.05）. There were significant differences in the levels of CEA, CA19-9 and CK18 between two groups before and after chemotherapy （P^0.05）. In 35 patients with CK18 level higher than the cut-off value, the coincidence rate of CK18 effect and objective effect was 71. 430//oo, with a higher consistency （Kappa = 0. 559）. Conclusions The serum CK18 level before and after chemotherapy can be the referent index for evaluating the chemotherapy effect on gastric cancer.

关 键 词：细胞角蛋白18 胃癌 化疗 疗效评价 

分 类 号：R735.2[医药卫生—肿瘤]