Cyfra21-1和鳞状细胞癌抗原对食管鳞状细胞癌的诊断和临床意义  

Clinical significance of serum Cyfra21-1 and squamous cell carcinoma antigen levels in esophageal squamous cell carcinoma

作　　者：贾坤[1] 李薇[1] 蔡梦[1] 周兰萍[1] 刘芳[1] 赵晓航[1] 

机构地区：[1]北京协和医学院中国医学科学院肿瘤医院分子肿瘤学国家重点实验室,北京市100021

出　　处：《世界华人消化杂志》2015年第27期4342-4349,共8页World Chinese Journal of Digestology

基　　金：国家高技术发展计划"863"基金资助项目;No.2012AA020206~~

摘　　要：目的:探讨血清肿瘤标志物角化素蛋白片段19(Cyfra21-1)和鳞状细胞癌抗原(squamous cell carcinoma antigen,SCC)对食管鳞状细胞癌(esophageal squamous cell carcinoma,ESCC)早期诊断和临床意义的影响.方法:应用酶联免疫吸附法(enzymelinked immunosorbent assay,ELISA)检测了食管鳞癌、不典型增生和健康对照血清中Cyfra21-1及SCC水平;应用电发光免疫测定法(electrochemiluminescence immunoassay,ECLIA)和微粒酶联免疫测定法(microparticle enzyme immunoassay,MEIA)检测了50例食管鳞癌和139例健康对照血清中SCC水平.结果:与健康对照组相比,Cyfra21-1在食管不典型增生和食管癌患者血清中高表达(P<0.05).SCC在食管不典型增生和食管癌患者血清中表达升高,与健康对照相比差异具有显著性(P<0.05).伴有淋巴结转移的食管癌患者血清Cyfra21-1水平显著高于无转移组(P=0.005).而血清Cyfra21-1和SCC水平与患者年龄、性别、肿瘤部位、分化程度、肿瘤大小和TNM分期等特征无关.化学发光法定量检测Cyfra21-1和SCC表达水平并计算曲线下面积(area under curve,AUC),结果提示联合检测Cyfra21-1和SCC血清标志诊断食管癌效果(AUC=0.777)优于单独检测Cyfra21-1(AUC=0.757)或SCC(AUC=0.661)的效果.化学发光与ELISA法检测血清Cyfra21-1和SCC表达水平结果一致.结论:血清Cyfra21-1和SCC定量检测可用于食管鳞癌的辅助诊断,联合检测可提高诊断的敏感性.AIM：To measure serum levels of Cyfra21-1and squamous cell carcinoma antigen（SCC）in patients with esophageal squamous cell carcinoma（ESCC） and to analyze their significance in ESCC diagnosis and their correlations with clinicopathological parameters.METHODS：Serum levels of Cyfra21-1 were measured by enzyme-linked immunosorbent assay（ELISA） in 48 ESCC patients,30 atypical hyperplasia patients,and 31 healthy individuals.Serum levels of SCC were measured by ELISA in 22 ESCC patients,30 atypical hyperplasia patients,and 31 healthy individuals.Serum levels of Cyfra21-1 and SCC were also measured by electrochemiluminescence immunoassay（ECLIA） and microparticle enzyme immunoassay（MEIA） in another 50 patients with ESCC and139 healthy individuals.RESULTS：Serum levels of Cyfra21-1 and SCC in ESCC and atypical hyperplasia patients were both significantly higher than those in healthy controls.Serum levels of Cyfra21-1were higher in patients with lymph node metastasis than in those without（P=0.005）.Serum Cyfra21-1 levels had no significant correlation with other histopathological features such as age,gender,tumor location,pathological grade,tumor size and TNM stage.Serum SCC levels showed no correlation with histopathological features.According to receiver operating characteristic（ROC） curve,combined detection of Cyfra21-1 and SCC in serum was much better than detection of either of them alone.The results of ECLIA and MEIA were similar to the ELISA results.CONCLUSION：Measurement of serum Cyfra21-1 and SCC is helpful in the diagnosis of ESCC,and joint detection of multiple tumor markers can improve the sensitivity of clinical diagnosis.

关 键 词：CYFRA21-1 鳞状细胞癌抗原 食管鳞状细胞癌 

分 类 号：R735.1[医药卫生—肿瘤]