血清CT、CEA检测在甲状腺髓样癌临床评估中的价值  

Significance of serum calcitonin and carcinoembryonic antigen in clinical evaluation of medullary thyroid carcinoma

作　　者：叶柳青[1] 徐笑红[1] 丁金旺[2] 周国明[1] 沈俊娅[2] 周荣璟 

机构地区：[1]浙江省肿瘤医院,浙江杭州310022 [2]杭州市第一人民医院(南京医科大学附属杭州医院),浙江杭州310006 [3]杭州市肿瘤医院,浙江杭州310002

出　　处：《中国卫生检验杂志》2017年第2期201-204,共4页Chinese Journal of Health Laboratory Technology

摘　　要：目的探讨血清降钙素(CT)和癌胚抗原(CEA)联合检测在甲状腺髓样癌(MTC)临床评估中的价值。方法分析101例MTC、117例非甲状腺髓样癌(NMTC)及91例良性患者血清中的CT和CEA水平,分析两者与MTC临床病理特征的相关性及手术前后的变化趋势。结果 MTC组的CT和CEA水平、阳性率显著高于其他2组,差异有统计学意义(P<0.05),而NMTC组与良性组之间差异无统计学意义(P>0.05)。血清CT和CEA诊断MTC的敏感度分别为96.04%、81.19%,特异性>95%。两者均与MTC的病灶数目、肿瘤最大径、淋巴结转移、腺外侵犯及TNM分期相关,血清CT还与性别相关(P=0.044)。MTC手术后的血清CT和CEA均低于术前,差异有统计学意义(P<0.05),且随时间延长逐渐下降,病情进展时再度升高。结论血清CT和CEA是MTC的理想标记物,在MTC的临床评估中具有重要价值。Objective To investigate the significance of the combined detection of serum calcitonin（ CT） and carcinoembryonic antigen（ CEA） in the clinical evaluation of medullary thyroid carcinoma（ MTC）. Methods The expression levels of serum CT and CEA were analyzed in 101 patients of MTC,117 cases of non- MTC and 91 individuals with benign thyroid diseases. The correlation analysis was performed between the two biomarkers and clinical pathological characteristics in MTC. The expression levels of the two serum biomarkers were compared preoperatively and postoperatively. Results The levels of serum CT and CEA in MTC were significantly elevated compared to the non- MTC group and benign group,with the differences statistically significant（ P〈0. 05）,whereas there was no statistical significance on the difference between non- MTC group and benign group（ P〉0. 05）. The diagnostic sensitivities of serum CT and CEA were 96. 04% and 81. 19%,respectively,and the specifility was greater than 95%. The expressions of serum CT and CEA were associated with tumor number and size,lymph node metastasis,extra- gland invasion and TNM stage in MTC. In addition,the expression of serum CT was also associated with gender（ P = 0. 044）. Furthermore,the postoperative levels of serum CT and CEA in MTC were significantly lower than the preoperative level,with the differences statistically significant（ all P〈0. 05）,and they would be elevated as the illness progress.Conclusion Serum CT and CEA are ideal biomarkers for the evaluation of MTC.

关 键 词：甲状腺髓样癌 癌胚抗原 降钙素 生物标记物 

分 类 号：R736.1[医药卫生—肿瘤]