| 血清肿瘤标志物在晚期食管鳞状细胞癌疗效评价和预后判定中的作用 |
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| 引用本文： | 龚磊,龚继芳,张晓东.血清肿瘤标志物在晚期食管鳞状细胞癌疗效评价和预后判定中的作用[J].肿瘤研究与临床,2010,23(11):216-219. |
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| 作者姓名： | 龚磊 龚继芳 张晓东 |
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| 作者单位： | 浙江省肿瘤医院肿瘤内科;北京肿瘤医院暨北京市肿瘤防治研究所消化内科,北京大学临床肿瘤学院,100142; |
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| 摘 要： | 目的 探讨血清肿瘤标志物在晚期食管鳞状细胞癌(简称:鳞癌)中的表达及其在化疗疗效评价和预后判断中的意义.方法 测定50例晚期食管鳞癌患者一线化疗前后血清标志物的水平.按照实体瘤的疗效评价标准(RECIST标准)评效.通过建立受试者工作特性曲线(ROC曲线)求最佳临界值.用Kaplan-Meier法行生存分析.结果 50例患者治疗前的血清肿瘤标志物阳性率以细胞角蛋白19片段(CYFRA21-1)最高(44.0%,22/50);癌胚抗原(CEA)最低(22.0%,11/50).配对样本Wilcoxon秩和检验示部分缓解(PR)组化疗后CYFRA21-1、鳞状上皮细胞癌抗原(SCC-Ag)下降,差异有统计学意义(Z=3.181、2.389,P=0.001、0.017),进展(PD)组化疗后CYFRA21-1、SCC-Ag升高,差异有统计学意义(Z=2.701、2.250,P=0.007、0.024),稳定(SD)组化疗前后SCC-Ag、CYFRA21-1差异无统计学意义(Z=0.414、1.114,P=0.679、0.265).提示SCC-Ag、CYFRA21-1与影像学疗效评价具有一致性.ROC曲线显示化疗后CYFRA21-1较化疗前升高32%,SCC-Ag升高38%,可作为预测化疗疗效的最佳临界值,并与影像学评效具有较好的一致性.化疗后CYFRA21-1较化疗前升高＞32%和SCC-Ag较化疗前升高＞38%为晚期食管鳞癌预后不良因素.结论 CYFRA21-1和SCC-Ag对晚期食管鳞癌的诊断、预测化疗疗效和预后有重要意义.
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| 关 键 词： | 食管肿瘤 肿瘤 鳞状细胞 肿瘤标志物 抗肿瘤联合化疗方案 |
Application of serum tumor markers for predicting chemotherapy efficacy and prognosis in advanced esophageal squamous cell carcinoma |
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| GONG Lei,GONG Ji-fang,ZHANG Xiao-dong.Application of serum tumor markers for predicting chemotherapy efficacy and prognosis in advanced esophageal squamous cell carcinoma[J].Cancer Research and Clinic,2010,23(11):216-219. |
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| Authors: | GONG Lei GONG Ji-fang ZHANG Xiao-dong |
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| Abstract: | Objective To assess the predictive and prognostic role of the alteration of serum carcinoembryonic antigen (CEA),squamous cell carcinoma antigen (SCC-Ag) and cytokeratin 19 fragment (CYFRA21-1) during chemotherapy in patients with advanced esophageal squamous cell carcinoma (ESCC).Methods The serum levels of CEA,CYFRA21-1 and SCC-Ag were measured in 50 patients with advanced ESCC at baseline and after first line chemotherapy.The data was correlated with objective efficacy and overall survival.To evaluate the role of tumor marker change in predicting response to therapy,receiver operating characteristic (ROC) curves were constructed.Results CEA,SCC-Ag and CYFRA21-1 increased higher than the cutoffs in 22.0 %,34.0 %,and 44.0 % of tested patients,respectively.Statistically significant correlations were observed between CYFRA21-1 and SCC responses and objective efficacy evaluated by RECIST criteria (Z =3.181,2.389; P = 0.001,0.017).Based on the ROG curve analysis,a post treatment 32 % and 38 % increase in serum concentration was used as cut-off level for defining CYFRA21-1 and SCC-Ag change,respectively.When the cut-off levels were used to predict chemotherapy efficacy,the accuracy for CYFRA21-1 and SCC-Ag were 76 % and 70 %.In the univariate survival analysis,a statistically significant prognostic impact on survival from the change of CYFRA21-1 and SCC-Ag was observed.Conclusion CYFRA21-1 and SCC-Ag are useful for diagnosis,predicting chemotherapy objective efficacy and prognosis in advanced ESCC. |
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| Keywords: | Esophageal neoplasmsNeoplasms squamous cellTumor markerAntineoplastic combined chemotherapy protocols |
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