CYFRA21—1检测在食管鳞癌中的临床应用价值

目的 研究细胞角蛋白19可溶性片段（CYFRA21－1）在食管鳞癌中的浓度变化及临床意义。方法 采用免疫放射法（IRMA）检测35例食管鳞癌患者血浆中的CYFRA21－1、SCC抗原及CEA的浓度,研究其浓度与其临床病理因素的相关性;比较27例手术治疗患者术前、术后第1天和术后第7天的浓度变化。结果 在35例食管鳞癌患者中,20例CYFRA21－1阳性（＞3.5ng/ml）,其特异性、敏感性及正确性分别为100.0%,57.1%,66.7%,联合检测CYFRA21－1及SCC抗原,其敏感性可达77.1%;术前与术后相比,CYFRA21－1血浆浓度有非常显著性差异（P＜0.01）,术后CYFRA21－1血浆浓度呈梯度下降;CYFRA21－1血浆浓度与食管鳞癌的临床病理因素相关（肿瘤大小、肿瘤侵犯程度、淋巴结转移及切除率）。结论 CYFRA21－1是食管鳞癌的有效肿瘤标志物,联合检测CYFRA21－1和SCC抗原对于判断肿瘤的复发和转移具有重要的临床意义,CYFRA21－1可作为判断食管鳞癌患者预后的重要指标之一。     

CYFRA 21-1 determination in patients with esophageal squamous cell carcinoma: clinical utility for detection of recurrences

BACKGROUND: While there are reports that CYFRA 21-1 is a useful tumor marker, to our knowledge the clinical utility of this marker to detect recurrences for squamous cell carcinoma of the esophagus has not been addressed. METHODS: By immunoradiometric assay, human serum levels of CYFRA 21-1, SCC antigen and CEA were measured in esophageal squamous cell carcinoma patients prior to their initial treatment. Monthly follow-ups of these tumor markers was done after surgery. RESULTS: The diagnostic sensitivity of CYFRA 21-1 was 43.9% (18 of 41), a value superior to that for SCC antigen (26.8%) and CEA (17.0%) (P < 0.05). The positive rates of CYFRA 21-1 increased with progression of the disease, 22.2% of pTNM Stage 0-IIA and 77.8% of pTNM Stage IIB/III (P = 0.013), whereas SCC antigen and CEA rates were not related to pTNM stage. Among 13 patients with clinical evidence of a recurrence, 76.9% (10 of 13) exhibited an increase in CYFRA 21-1, and this increase was evident before clinical detection of the recurrence in 9 of these 13 patients (69.2%). Consequently, postoperative elevations of serum CYFRA 21-1 levels were indicative of a tumor recurrence 1-13 months before acquisition of clinical and radiological data. CONCLUSIONS: The assay of CYFRA 21-1 is useful not only for diagnosis but also for close monitoring of patients with esophageal squamous cell carcinoma.     

联合检测食管鳞癌放疗前后血清SCC、VEGF、CYFRA21-1的临床意义

目的：探讨联合检测食管鳞癌患者血清鳞状上皮细胞癌相关抗原（SCC）、血管内皮生长因子（VEGF）、细胞角化素蛋白片段19（CYFRA21-1）对放疗效果评估的价值。方法：采用酶联免疫吸附法（ELISA）或电化学发光免疫分析法（ECLIA）测定80例食管鳞癌患者放疗前、后血清SCC、VEGF、CYFRA21-1水平,并以20例健康者为对照。结果：食管鳞癌组血清SCC、VEGF、CYFRA21-1水平明显高于对照组,食管鳞癌组血清SCC、VEGF、CYFRA21-1对放疗后有效者（CR＋PR）均明显低于放疗前（P〈0.05）。结论：血清SCC、VEGF、CYFRA21-1联合检测食管鳞癌放疗疗效和预后判断有较好的临床应用价值。     

Increased serum midkine concentration as a possible tumor marker in patients with superficial esophageal cancer

Midkine, a heparin-binding growth factor, is expressed in numerous cancer tissues and is reportedly elevated in patients with various neoplasms. The aim of this study was to evaluate the clinicopathological significance of serum midkine concentration (S-MK) in patients with superficial esophageal squamous cell carcinoma (SCC). Pretreatment S-MK was measured by enzyme-linked immunosorbent assay in 135 healthy controls, 16 patients with benign esophageal disease, and 60 patients with primary superficial esophageal squamous cell cancer (SESCC). All patients with SESCC underwent curative resection. The disease was staged according to TNM/UICC guidelines. Serum concentrations of carcinoembryonic antigen (CEA), squamous cell carcinoma antigen (SCC-Ag), and cytokeratin 19 fragment (CYFRA21-1) were also evaluated in the same populations. S-MK in patients with SESCC (388+/-411 pg/ml) was significantly higher than in benign esophageal disease or healthy controls (183+/-73 and 154+/-76 pg/ml, respectively). Using the mean + 2 standard deviations of healthy control S-MK (300 pg/ml) as the cut-off level, 50% of patients with esophageal SESCC were deemed positive. This S-MK positivity rate for detecting SESCC was significantly higher than for other tumor markers. Thus, S-MK may be useful as a tumor marker to detect SESCC.     

肿瘤分子标志物联合动态检测在肺癌中的临床应用

目的 研究肿瘤分子标忐物癌胚抗原（CEA）、糖类抗原（CA125）、细胞角蛋白19片段抗原21-1（CYFRA21-1）、鳞状上皮癌抗原（Scc-Ag）、神经元特异性烯醇化酶（NSE）、胃泌素释放肽前体31-98（Pro-GRP31-98）联合动态检测在肺癌诊断、临床分期、组织学分型及治疗监控中的临床应用价值.方法 对198例肺癌患者（肺癌组）、50例肺部良性病变患者（良性对照组）及50名健康体检者（健康对照组）采用电化学发光法检测血清CEA、CA 125、CYFRA21-1、Scc-Ag、NSE,酶联免疫法检测Pro-GRP31-98水平,分析肿瘤分子标志物与肺部良恶性疾患的相关性.结果 肺癌组患者血清CEA、CA125、CYFRA21-1、Scc-Ag、NSE、Pro-GRP31-98水平与肺部良性病变组及健康对照组比较差异有统计学意义,P＜ 0.01;肺癌高分期（Ⅲ、Ⅳ期）组血清肿瘤分子标志物水平明显高于肺癌低分期（Ⅰ、Ⅱ期）组,治疗前、淋巴结转移组、复发组与治疗后、无转移组、无复发组比较血清肿瘤标志物水平明显增高,组间分别比较差异有统计学意义,均P＜ 0.01;CEA、CA125分别对肺腺癌的阳性榆出率与鳞状细胞癌、小细胞癌比较差异有统计学意义,P＜ 0.01;CYFRA21-1、Scc-Ag分别对肺鳞状细胞癌的阳性检出率与腺癌、小细胞癌比较差异有统计学意义,P＜ 0.01;NSE、Pro-GRP31-98分别对肺小细胞癌的阳性检出率与腺癌、鳞状细胞癌比较差异有统计学意义,P＜ 0.01;CEA联合CA125、CYFRA21-1联合Scc-Ag、NSE联合Pro-GRP31-98检测分别对肺腺癌、鳞状细胞癌、小细胞癌阳性检出率较单项检测比较明显提高,均P＜ 0.01;CEA、CA125、CYFRA21-1、Scc-Ag、NSE、Pro-GRP31-98诊断肺癌的敏感性分别为52.52％、51.01％、48.99％、53.03％、49.49％、50.50％,六项肿瘤标志物联合检测诊断肺癌的敏感性高达96.46％,与各单项检测比较差异有统计学意义（P＜0.01）.结论 肿瘤分子标志物CEA、CA125、CYF     

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

 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。     

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

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.     

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

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.     

肺鳞癌患者血清CYFRA21-1和SCC检测及ROC曲线和截断点的理论分析

目的:探讨血清细胞角蛋白19片段(CYFRA21-1)抗原和鳞癌抗原(SCC)对肺鳞癌的临床意义.方法:将研究对象分组,试验组为102例肺鳞癌患者,对照组为53例良性肺病患者.分别采用电化学发光法和酶联免疫法检测血清CYFRA21-1及SCC,测定值用t检验,率比较用x2检验.接受者工作特征(ROC)曲线及截断点选择理论评估CYFRA21-1及SCC的临床价值.结果:肺鳞癌组与良性肺病组CYFRA21-1和SCC水平差异有统计学意义;CYFRA21-1以3.3 ng/mL、SCC以1.5 ng/mL为诊断临界点,CYFRA21-1诊断肺鳞癌敏感性为57.84％,特异性为92.45％,准确性为69.68％,ROC曲线下面积为0.788;SCC诊断肺鳞癌敏感性为33.33％,特异性为92.45％,准确性为53.55％,ROC曲线下面积为0.691;CYFRA21-1诊断肺鳞癌最佳截断点为2.485或2.365 ng/mL,对应敏感性和特异性分别为65.7％、92.5％和67.6％、90.6％;SCC诊断肺鳞癌最佳截断点为0.55 ng/mL,对应敏感性和特异性分别为72.5％和62.3％.随肺鳞癌分期增高,CYFRA21-1和SCC浓度增高差异有统计学意义,CYFRA21-1敏感性增高差异有统计学意义,SCC敏感性无明显变化.结论:CYFRA21-1对肺鳞癌的诊断具有较高的临床价值,而SCC对肺鳞癌的诊断价值较低.     

Serum CYFRA 21-1 is one of the most reliable tumor markers for breast carcinoma

BACKGROUND: The search for new tumor markers for breast carcinoma has been an area of vigorous study; nonetheless, to the authors' knowledge little new information has emerged beyond the clinical usefulness of CA 15-3. The authors studied serum CYFRA 21-1 in breast carcinoma based on evidence that breast carcinoma expresses cytokeratin 19 fragments and that CYFRA 21-1 is a specific antigen for cytokeratin 19 fragments. METHODS: The serum samples of 86 patients with primary breast carcinoma, 14 patients with recurrent breast carcinoma, 22 patients with benign mammary disease, and 25 healthy controls were provided for measurements of CYFRA 21-1, carcinoembryonic antigen (CEA), and CA 15-3. The relation between clinicopathologic features, prognosis, and disease free survival with serum CYFRA 21-1 titers was studied. RESULTS: There was no difference between the serum CYFRA 21-1 titers from patients with benign mammary disease and those from healthy controls. The sensitivities of CYFRA 21-1 for patients with International Union Against Cancer Stage IV and recurrent tumors were 60% and 64.2%, respectively, which were as high as those for CA 15-3 and superior to those for CEA. The hematogenous recurrence showed a very high sensitivity of 89%. According to the increments of T, N, and M factor numbers, the serum CYFRA 21-1 titers were elevated. No correlation between CYFRA 21-1 and CEA was observed and the correlation between CYFRA 21-1 and CA 15-3 was weak. The univariate and multivariate analyses for survival revealed that serum CYFRA 21-1 levels were an independent indicator of prognosis. CONCLUSIONS: The measurement of the serum CYFRA 21-1 titer in patients with breast carcinoma may be useful in monitoring for recurrence and evaluating the therapeutic effect in patients with advanced disease.     

血清肿瘤标志物在肺癌诊断中的应用价值*

目的:探讨SCC 、NSE、CEA 、CYFRA21-1 四项肿瘤标志物联合检测对肺癌的诊断价值。方法:采用化学发光法对肺癌组132 例、肺良性疾病组48例和正常对照组92例的血清SCC 、NSE 、CEA 、CYFRA21-1 四项肿瘤标志物进行检测及统计学分析。结果:NSE 、CEA 、CYFRA21-1 在肺癌组显著高于肺良性疾病组和正常对照组,SCC 肺癌组高于正常对照组,CEA 和CYFRA21-1肺良性疾病组显著高于正常对照组。CEA 在肺腺癌中的水平较高,NSE 在小细胞肺癌中的水平较高,而SCC 、CYFRA21-1 在肺鳞癌中的水平较高。单项肿瘤标志物在肺癌诊断中敏感性:NSE>CEA>CYFRA 21-1>SCC;在腺癌中CEA 敏感性最高（58.8%）,鳞癌中CYFRA21-1 敏感性最高（71.4%）,小细胞肺癌中NSE 敏感性最高（50.0%）。 NSE 、CEA 、CYFRA21-1 的ROC 曲线下面积分别为0.928 ± 0.034、0.957 ± 0.026、0.964 ± 0.023,显示诊断准确性较高。SCC 曲线下面积虽然大于0.5,但差异无统计学意义。肿瘤标志物联合检测,可以提高诊断试验的敏感性,在肺癌诊断中NSE 、CEA 、CYFRA21-1 组合敏感性最高（75.6%）,特异性也较好（90.7%）;腺癌诊断中SCC 、NSE 、CEA 组合敏感性最高（73.5%）,鳞癌诊断中NSE 、CEA 、CYFRA21-1 组合敏感性最高（75.8%）,小细胞肺癌中SCC 、NSE 、CYFRA21-1 组合敏感性最高（75.0%）。 结论:SCC 、NSE 、CEA 、CYFRA21-1 对肺癌的诊断均有一定意义,不同病理类型各有特点,选择合适的组合有利于对肺癌的鉴别诊断。      

Serum p53 antibody is a useful tumor marker in superficial esophageal squamous cell carcinoma

BACKGROUND: Patients with superficial (mucosal or submucosal) esophageal carcinoma (SEC) have significantly better survival rates than patients with advanced carcinoma. Some patients with advanced esophageal carcinoma have been reported to test positive for serum p53 antibodies (Abs). Because very few patients with superficial carcinoma have been examined, the aim of this study was to evaluate the clinical significance of serum p53-Abs in patients with superficial esophageal squamous cell carcinoma (SESCC). METHODS: Thirty-five consecutive patients with SESCC were studied for serum p53-Abs by enzyme-linked immunoabsorbent assay before and after treatment. The clinicopathologic features of p53 seropositive and p53 negative patients were compared. The relation between the presence of serum p53-Abs and p53 immunoreactivity of the resected specimens was examined. Three tumor markers (squamous cell carcinoma antigen [SCC-Ag], CYFRA21-1, and carcinoembryonic antigen [CEA]) were assessed to compare their sensitivities with serum p53-Abs. RESULTS: Fourteen of 35 patients (40%) were p53 seropositive. Relatively few patients tested positive for the other tumor markers: CEA, 11.4%; SCC-Ag, 14.3%; CYFRA21-1, 5.7%. There were no significant correlations between clinicopathologic features and p53 seropositivity except for tumor location. A strong correlation between p53 immunostaining and the presence of serum p53-Abs was observed (P = 0.003). Of the 14 patients with seropositive results, 12 turned seronegative after resection, and the other 2 experienced disease recurrence. CONCLUSIONS: Surveillance of serum p53-Abs is superior to the three tumor markers for detecting SESCC. This serum marker is also useful for the detection of p53 protein overexpression and for the monitoring of residual tumor cells.     

血清NSE TSGF CA125 CYFRA21-1联合检测对肺癌的诊断价值

目的探讨血清NSE，CYFRA21-1，CA125，和TSGF联合检测对肺癌的诊断价值。方法应用ELISA技术，测定74例肺癌患者、40例肺良性疾病患者和20例体检正常者血清NSE、CYFRA21-1、CA125、TSGF的水平。结果肺癌组的4种标志物NSE、CYFRA21-1、CA125、TSGF的水平及检测阳性率均明显高于良性肺病及正常对照组（P〈0．01）。鳞癌、腺癌和小细胞肺癌分别以NSE、CYFRA21-1、CA125、TSGF升幅较为明显。NSE、CYFRA21-1、CA125、TSGF的灵敏度分别为47．3％、54．0％、59．46％、55．4％。但4种联合检测的灵敏度为91．89％，明显优于1种血清肿瘤标志物的单项测定。结论血清NSE、CYFRA21-1、CA125、TSGF联合检测提高肺癌的阳性检出率和检测特异性，对肺癌的早期诊断、疗效监测、预后判断有重要意义。     

Prognostic significance of CYFRA21-1, CEA and hemoglobin in patients with esophageal squamous cancer undergoing concurrent chemoradiotherapy

Purpose: To evaluate the prognostic value of serum CYFRA21-1, CEA and hemoglobin levels regardinglong-term survival of patients with esophageal squamous cell carcinoma (ESCC) treated with concurrentchemoradiotherapy (CRT). Methods: Age, gender, Karnofsky Performance Status (KPS), tumor location,tumor length, T stage, N stage and serum hemoglobin, and CYFRA21-1 and CEA levels before concurrent CRTwere retrospectively investigated and related to outcome in 113 patients receiving 5-fluorouracil and cisplatincombined with radiotherapy for ESCC. The Kaplan-Meier method was used to analyze prognosis, the log-rankto compare groups, the Cox proportional hazards model for multivariate analysis, and ROC curve analysis forassessment of predictive performance of biologic markers. Results: The median survival time was 20.1 monthsand the 1-, 2-, 3-, 5- year overall survival rates were 66.4%, 43.4%, 31.9% and 15.0%, respectively. Univariateanalysis showed that factors associated with prognosis were KPS, tumor length, T-stage, N-stage, hemoglobin,CYFRA21-1 and CEA level. Multivariate analysis showed T-stage, N-stage, hemoglobin, CYFRA21-1 and CEAlevel were independent predictors of prognosis. By ROC curve, CYFRA21-1 and hemoglobin showed betterpredictive performance for OS than CEA (AUC= 0.791, 0.704, 0.545; P=0.000, 0.000, 0.409). Conclusions: Ofall clinicopathological and molecular factors, T stage, N stage, hemoglobin, CYFRA21-1 and CEA level wereindependent predictors of prognosis for patients with ESCC treated with concurrent CRT. Among biomarkers,CYFRA21-1 and hemoglobin may have a better predictive potential than CEA for long-term outcomes.     

CEA、NSE、CYFRA21-1联合检测在肺癌诊断中的价值

[目的]了解血清肿瘤标志物癌胚抗原(CEA)、神经元特异性烯醇化酶(NSE)和细胞角蛋白19片段(CYFRA21-1)在肺癌诊断中的应用价值.[方法]应用电化学发光技术测定58例肺癌患者,34例肺良性疾病患者和31例正常对照者血清CEA、NSE、CYFRA21-1水平.[结果]肺癌组CEA、NSE、CYFRA21-1水平明显高于肺良性疾病组和对照组(P<0.01).CEA、NSE、CYFRA21-1对肺癌的敏感度分别为51.7%、56.9%、55.2%.NSE对小细胞肺癌敏感度为82.6%,CYFRA21-1对肺鳞癌敏感度为83.3%.三者联合检测对肺癌敏感度为93.1%.[结论]血清CEA、NSE、CYFRA21-1联合检测对肺癌的诊断及分型有价值.     

CYFRA21-1、CA19-9和SCCAg检测在食管癌诊断中的价值研究

目的 探讨血清细胞角质蛋白19片段CYFRA21-1、糖类抗原19-9(CA19-9)、鳞状细胞癌抗原(SC-CAg)单独及联合检测在食管癌诊断中的价值.方法 选取100例食管癌患者(观察组)和50例健康志愿者(对照组),检测两组受试者的血清CYFRA21-1、CA19-9和SCCAg水平,并按照临床分期对观察组患者进行亚组分析,采用受试者工作曲线(ROC)分析CYFRA21-1、CA19-9和SCCAg检测在食管癌诊断中的价值.结果 观察组患者的血清CYFRA21-1、CA19-9和SCCAg水平均明显高于对照组,Ⅰ~Ⅱ期患者的血清CYFRA21-1、CA19-9和SCCAg水平均明显低于Ⅲ~Ⅳ期,差异均有统计学意义(P﹤0.01);血清CYFRA21-1、CA19-9、SCCAg三者联合检测诊断食管癌的灵敏度为82.26%,特异度为91.33%,阳性预测值为86.14%,阴性预测值为89.57%,AUC值为0.864,均高于其中任一项指标单独检测,差异均有统计学意义(P﹤0.05).结论 血清CYFRA21-1、CA19-9、SC-CAg三者联合检测可以提高食管癌诊断的灵敏度和特异度.     

Clinical Utility of Haptoglobin in Combination with CEA,NSE and CYFRA21-1 for Diagnosis of Lung Cancer

Purpose: To investigate the clinical value in lung cancer of a combination of four serum tumor markers,haptoglobin (Hp), carcinoembryonic antigen (CEA), neuron specific enolase (NSE) as well as the cytokeratin 19fragment (CYFRA21-1). Materials and Methods: Serum Hp (with immune-turbidimetric method), CEA, NSE,CYFRA21-1 (with chemiluminescence method) level were assessed in 193 patients with lung cancer, 87 patientswith benign lung disease and 150 healthy controls. Differences of expression were compared among groups,and joint effects of these tumor markers for the diagnosis of lung cancer were analyzed. Results: Serum tumormarker levels in patients with lung cancer were obviously higher than those with benign lung disease and normalcontrols (p<0.01). The sensitivities of Hp, CEA, NSE and CYFRA21-1 were 43.5%, 40.9%, 23.3% and 41.5%,with specificities of 90.7%, 99.2%, 97.9% and 97.9%. Four tumor markers combined together could produce apositive detection rate of 85.0%, significantly higher than that of any single test. With squamous carcinomas, thepositive detection rates with Hp and CYFRA21-1 were higher than that of other markers. In the adenocarcinomacase , the positive detection rate of CEA was higher than that of other markers. For small cell carcinomas, thepositive detection rate of NSE was highest. The area under receiver operating characteristic curve (AUCROC) ofHp in squamous carcinoma (0.805) was higher than in adenocarcinoma (0.664) and small cell carcinoma (0.665).Conclusions: Hp can be used as a new serum tumor marker for lung cancer. Combination detection of Hp, CEA,NSE and CYFRA21-1 could significantly improve the sensitivity and specificity in diagnosis of lung cancer, andcould be useful for pathological typing.     

血清CYFRA21-1、SCC-Ag、LDH联合检测对肺鳞癌与肺部感染鉴别诊断的价值初探

目的:探讨血清SCC-Ag、CYFRA21-1、LDH联合检测对肺鳞癌与肺部感染鉴别诊断的价值。方法:回顾性分析2017年1月至2018年3月北京市和平里医院消化科及呼吸科住院或门诊就诊的110例患者,其中肺鳞癌患者55例,肺部感染患者55例,使用化学发光法和速率法分别检测血清CYFRA21-1、SCC-Ag、LDH表达水平,以及肺鳞癌患者Ⅰ-Ⅳ期CYFRA21-1、SCC-Ag表达水平,经统计学处理后对比分析。结果:肺鳞癌组患者血清CYFRA21-1高于肺部感染组患者,差异有统计学意义(P<0.05);同时肺部感染组患者血清SCC-Ag表达高于肺鳞癌组,有统计学差异(P<0.05);Ⅰ期、Ⅱ期肺鳞癌组患者血清CYFRA21-1较Ⅳ期患者相比差异显著,随着肿瘤的进展,血清CYFRA21-1、SCC-Ag均有上升的趋势;肺鳞癌组患者血清LDH表达水平显著高于肺部感染组患者(P<0.01)。结论:独立的每个肿瘤标志物因其自身的特异性和敏感性,可能导致诊断的局限性,血清CYFRA21-1、SCC-Ag、LDH联合检测对肺鳞癌与肺部感染辅助鉴别诊断可能具有一定临床价值。     

CYFRA 21-1 serum levels in women with adnexal masses and inflammatory diseases.

The aim of the present study was to evaluate the clinical usefulness of the cytokeratin marker CYFRA 21-1 as a screening marker for ovarian cancer, as a predictive marker in patients with adnexal masses and as a prognostic marker in women suffering from ovarian cancer. In order to determine the specificity of the CYFRA 21-1 test, we have investigated CYFRA 21-1 serum levels in several benign conditions. This retrospective study comprises 37 patients suffering from ovarian cancer FIGO stages Ia-III. Sera from patients with benign ovarian cysts, endometriosis, pelvic inflammatory disease, inflammatory bowel disease and liver cirrhosis were evaluated in 90, 10, 38, 10 and 20 cases respectively. With a sensitivity of 41% and a specificity of 95%, CYFRA 21-1 was not suitable as a screening marker for ovarian cancer. Although CYFRA 21-1 was able to discriminate between ovarian cancer and benign adnexal tumours (univariate regression model, P = 0.0001), CYFRA 21-1 did not reveal additional information to CA 125 in a multivariate regression analysis (P = 0.06). CYFRA 21-1 serum levels were elevated in benign conditions such as liver cirrhosis, but not in endometriosis and inflammatory diseases. In ovarian cancer patients, elevated CYFRA 21-1 serum levels before therapy were associated with a poor overall and disease-free survival (log-rank test, P = 0.02 and log-rank test, P = 0.005 respectively). CYFRA 21-1, while obviously not suitable for screening or differential diagnosis of adnexal masses, could be useful as an additional prognostic factor in ovarian cancer patients.     

血清肿瘤标志物联合检测对肺癌的诊断价值

目的：探讨血清中神经元特异性烯醇化酶（NSE）、细胞角蛋白19片段（CYFRA21-1）和糖类抗原19-9（CA19-9）的水平变化对肺癌的诊断价值。方法：采用化学发光法对125例肺癌患者、80例肺良性疾病患者和80例健康人血清中的NSE、CYFRA21-1和CA19-9含量进行检测及比较。结果：肺癌组的三种血清肿瘤标志物水平均明显高于肺良性疾病患者组和正常对照组,差异均有统计学意义（P〈0.05）,其中NSE在小细胞肺癌中呈高表达,明显高于鳞癌与腺癌（P〈0.01）,CYFRA21-1在鳞癌中水平明显高于腺癌与小细胞肺癌（P〈0.01）,CA19-9在腺癌中水平明显高于其他类型肺癌（P〈0.01）。三种肿瘤标志物联合检测阳性率高达84.8%,高于单项检测。结论：三项肿瘤标志物联合检测可提高肺癌诊断的灵敏度和准确度,同时为肺癌病理分型的鉴别诊断提供依据。