血清学指标CK19-2G2、CyFra21-1及EBVVCA-IgA/EA-IgA与鼻咽鳞癌诊断和近期疗效的价值分析  

Evaluation of Serum CK19-2G2, CyFra21-1, EBV VCA-IgA and EA-IgA as Markers of Diagnosis and Prognosis in Nasopharyngeal Squamous Cell Carcinoma

作　　者：林月好[1] 陈巧伦[1] 吴兴平[1] 

机构地区：[1]中山大学肿瘤防治中心检验科,广东广州510060

出　　处：《临床医学工程》2014年第10期1305-1308,共4页Clinical Medicine & Engineering

摘　　要：目的观察鼻咽癌患者血清中细胞角蛋白片段CK19-2G2、CyFra21-1浓度及EB病毒抗体VCA-IgA、EA-IgA滴度水平,评价以上四项肿瘤标志物对鼻咽癌诊断和预后的应用价值。方法分别检测72例正常健康人和47例放疗前后的未分化型非角化性鼻咽癌患者血清CK19-2G2、CyFra21-1浓度和VCA-IgA/EA-IgA滴度,CK19-2G2应用北京同生时代公司的仪器及试剂盒(化学发光法)检测;CyFra21-1应用罗氏电化学发光法检测;VCA-IgA应用免疫酶法检测。结果未分化型非角化性鼻咽癌患者血清CK19-2G2、CyFra21-1和VCA-IgA/EA-IgA的阳性率分别为:32.69%、46.15%、98.08%和71.15%,健康人群以上四项指标的阳性率分别为:9.32%、9.72%、16.67%和0,P<0.01;与病理诊断的一致性检验显示以上四项指标的Kappa值分别为:0.355、0.418、0.78和0.76;四项指标与临床分期有统计学意义(χ2分别为:69.04、28.21、90.36和70.49,P<0.01);未分化型鼻咽鳞癌患者放疗前后CK19-2G2和CyFra21-1阳性率呈下降趋势。结论血清CK19-2G2、CyFra21-1水平在鼻咽鳞癌患者和健康人群中有显著性差异,EBV VCA-IgA/EA-IgA滴度检测对鼻咽癌的诊断有较高准确率;鼻咽鳞癌患者血清CK19-2G2、CyFra21-1水平与病理分期相关;血清CK19-2G2、CyFra21-1的水平可能对鼻咽鳞癌患者的预后评价有一定的价值。Objective To evaluate the diagnostic and prognostic utility of serum cytokeratin fragment：CK19-2G2, CyFra21-1 level and EBV VCA-IgA, EA-IgA titers in patients with nasopharyngeal squamous cell carcinoma. Methods 72 cases of normal volunteers and 47 cases of patients with undifferentiated nasopharyngeal squamous cell carcinoma before radiotherapy （pre-RT） were detected by serum CK19-2G2 （Tongsheng Shidai, Beijing）, CyFra21-1 （Roche diagnosis） level and EBV VCA-IgA/EA-IgA titers （immunoenzyme technique）. Results The positive rate of CK19-2G2, CyFra21-1 and EBV VCA-IgA/EA-IgA in undifferentiated nasopharyngeal squamous cell carcinoma patients were：32.69%, 46.15%, 98.08%and 71.15%, respectively;The positive rate of the above four tests in normal volunteers was： 9.32%, 9.72%, 16.67% and 0, respectively, P 〈0.01. The correlation of the four tests and pathological staging were statistically analyzed, Kappa value was： 0.355, 0.418, 0.78 and 0.76, χ2： 69.04, 28.21, 90.36 and 70.49, respectively, P 〈0.01. The positive rate of undifferentiated nasopharyngeal squamous cell carcinoma patients reduced after radiotherapy （post-RT）, followed by the mass reduced. Conclusions Serum CK19-2G2 and CyFra21-1 level have significant difference between undifferentiated nasopharyngeal squamous cell carcinoma patients and the normal control. EBV VCA-IgA/EA-IgA titer detection have higher accuracy in serological diagnosis of nasopharyngeal carcinoma. Serum CK19-2G2 and CyFra21-1 level will be the valuable prognostic prediction factors of undifferentiated nasopharyngeal squamous cell carcinoma.

关 键 词：鼻咽癌 细胞角蛋白 EB病毒VCA-IgA/EA—IgA 

分 类 号：R739.6[医药卫生—肿瘤]