宫颈癌肿瘤标志物在新辅助化疗中的应用  

Application of Tumor Markers in Neoadjuvant Chemotherapy for Cervical Cancer

作　　者：刘星宇 黄欢[2] 李瑞[2] 余俚瑶[2] 颜琳[2] 潘光鑫 卢豪 胡轶[2] 陈宏伟[2] 李雄 张淳[2] LIU Xingyu;HUANG Huan;LI Rui;YU Liyao;YAN Lin;PAN Guangxin;LU Hao;HU Yi;CHEN Hongwei;LI Xiong;ZHANG Chun(School of Medicine,Jianghan University,Wuhan 430056,Hubei,China;Department of Obstetrics and Gynecology,TheCentral Hospital of Wuhan,Wuhan 430014,Hubei,China)

机构地区：[1]江汉大学医学院,湖北武汉430056 [2]武汉市中心医院妇产科,湖北武汉430014

出　　处：《江汉大学学报（自然科学版）》2019年第1期87-91,共5页Journal of Jianghan University：Natural Science Edition

基　　金：国家自然科学基金项目(91529102;81572571);武汉市卫生和计划生育委员会青年基金项目(WX18Q16)

摘　　要：目的了解新辅助化疗对宫颈癌肿瘤标志物水平的影响,探讨肿瘤标志物在新辅助化疗效果评估中的作用。方法回顾在武汉市中心医院妇产科接受化疗和宫颈癌根治术的40例患者的临床资料,通过腹部超声和磁共振检查确定在新辅助化疗前后肿块的大小;通过淋巴细胞的病理结果判断子宫周围淋巴结转移情况。比较两轮新辅助化疗及宫颈癌根治术前后肿瘤标志物水平(癌胚抗原、血清糖类抗原125、鳞状细胞癌抗原),评估新辅助化疗疗效和宫颈癌肿瘤标志物水平的相关性。结果宫颈癌肿瘤标志物水平在化疗和手术后都明显降低,差异有统计学意义(CEA:F=11. 07,P <0. 05;SCC-Ag:F=8. 84,P <0. 05;CA125:F=10. 18,P <0. 05)。新辅助化疗能减少局部晚期子宫颈癌患者的比例(χ2=7. 17,P <0. 05)。新辅助化疗后肿瘤缩小≥1 cm的的患者,其血清肿瘤标志物水平均低于肿瘤直径缩小<1 cm的患者,其中鳞状细胞癌抗原水平差异有统计学意义(t=2. 4,P <0. 05)。但是化疗后肿瘤标志物水平不能明显反映患者淋巴转移情况。结论新辅助化疗可显著降低肿瘤标志物水平,血清肿瘤标志物水平的变化是反映新辅助化疗有效性的指标。Objective To investigate the effect of neoadjuvant chemotherapy on tumor markers levels in cervical cancer and to explore the role of tumor markers in the evaluation of neoadjuvant chemotherapy.Methods The clinical data of 40 patients received chemotherapy and radical surgery of cervical cancer in Wuhan Central Hospital were retrospectively analyzed.The size of the masses before and after neoadjuvant chemotherapy was determined with abdominal ultrasound and magnetic resonance imaging,and the lymph node metastasis around the uterus was determined with the pathological results of lymphocyte.Tumor markers levels(carcino-embryonic antigen(CEA),carbohydrate antigen 125(CA125),squamous cell carcinoma antigen(SCC-Ag))before and after two rounds of neoadjuvant chemotherapy and radical cervical cancer surgery were compared to evaluate the correlation between the efficacy of neoadjuvant chemotherapy and the levels of tumor markers of cervical cancer.Results The levels of tumor markers in cervical cancer decreased significantly after chemotherapy and surgery,the differences were statistically significant(CEA:F=11.07,P<0.05;SCC-Ag:F=8.84,P<0.05;CA125:F=10.18,P<0.05).Neoadjuvant chemotherapy reduced the ratio of locally advanced cervical cancer(χ^2=7.17,P<0.05).After neoadjuvant chemotherapy,the tumor markers levels in the patients whose tumor diameter shrunk≥1 cm were lower than those shrunk<1cm,and the difference of the level of squamous cell carcinoma antigen was statistically significant(t=2.4,P<0.05).However,the levels of tumor markers after chemotherapy could not reflect the lymphatic metastasis of patients.Conclusion Neoadjuvant chemotherapy can significantly reduce the levels of tumor markers,the serum tumor markers are indicators for the effectiveness of neoadjuvant chemotherapy.

关 键 词：宫颈癌 血清肿瘤标志物 新辅助化疗 CEA CA125 SCC-AG 

分 类 号：R737.330.5[医药卫生—肿瘤]