口腔鳞癌患者血清和唾液Cyfra 21-1的检测及其临床意义

Cyfra 21-1是近年来发现的一种新的肿瘤标志物，在口腔鳞癌组织中有表达，我们探讨口腔鳞癌患者血清和唾液Cyfra 21-1的检测及其临床价值。     

口腔颌面部恶性肿瘤患者血清中透明质酸含量的检测

目的　检测口腔颌面部恶性肿瘤患者血清中透明质酸(HA)的含量,探讨HA对口腔颌面部恶性肿瘤辅助诊断和治疗效果监测的价值。方法　选择住院治疗的口腔颌面部恶性肿瘤患者44例,健康人24例。肿瘤患者于手术前或化疗开始前采血,其中20例患者于手术后或化疗结束后再次采血;24例健康人于常规体检时采血。用放射免疫试验测定所有标本血清中的HA浓度。结果　治疗前口腔颌面部恶性肿瘤患者血清中HA含量显著高于健康人(P<0·05),口腔颌面部鳞癌患者血清中HA含量显著高于健康人(P<0·05),涎腺腺样囊性癌患者血清中HA 含量与健康人无显著差异(P>0·05)。口腔颌面部恶性肿瘤Ⅲ、Ⅳ期患者血清中HA含量显著高于Ⅰ、Ⅱ期患者和健康人(P<0·05)。口腔颌面部恶性肿瘤患者治疗后血清中HA含量低于治疗前,但差异不显著(P>0·05)。结论　HA含量测定对口腔颌面部恶性肿瘤可能有辅助诊断价值。血清中HA的含量变化可作为肿瘤分期和判断肿瘤预后的参考,但不能用于治疗效果的监测。     

口腔颌面部恶性肿瘤患者血浆PT、APTT、TT及Fib检测

目的探讨口腔颌面部恶性肿瘤患者出、凝血功能变化,为临床诊疗提供有价值的检测指标。方法采用日本SysmexCA-50四通道自动血凝仪及DadeBehring公司生产的相应试剂和质控物,检测93例口腔颌面部恶性肿瘤患者血浆凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)及纤维蛋白原(Fib),与健康对照组,口腔颌面部良性肿瘤组进行对比分析。结果口腔颌面部恶性肿瘤患者与健康对照组及口腔颌面部良性肿瘤组相比血浆APTT缩短,经统计学处理P<0.01;而血浆PT、TT和Fib3组之间无显著性变化,经统计学处理P>0.05。结论口腔颌面部恶性肿瘤患者血浆APTT缩短,而PT、TT和Fib无显著变化。     

TGF-β1在口腔颌面部恶性肿瘤中的表达

目的 探讨转化生长因子β1（TGF－β1）在人口腔颌面部恶性肿瘤细胞中的表达水平与其生物学行为的关系。方法 以ELISA法分别检测人口腔颌面部手术切除恶性肿瘤组织细胞，人舌鳞状细胞癌细胞系Tca8113，人涎腺腺样囊性癌细胞系ACC－2和人高转移性涎腺腺样囊性癌细胞系ACC－M，及正常口腔黏膜与黏膜下组织细胞各样本的TGF－β1的表达水平。结果 口腔合面部恶性肿瘤组织TGF－β1的表达水平与正常对照组有非常显著差异（P＜0．01）。Tca8113,ACC-2细胞TGF－β1的表达水平增高正常对照组细胞（P＜0．05）；舌鳞癌系Tca8113与腺要囊性癌细胞系ACC－2的TGF－β1的表达水平无显著差异；高转移腺样囊性癌细胞系ACC－M的TGF－β1的表达水平与ACC－2相比，有非常显著的降低（P＜0．01）；高转移腺样囊性癌细胞系ACC－M无血清培养液中TGF－β1的分泌量亦低于任何其它细胞。结论 TGF－β1的表达水平可能与恶性肿瘤细胞的增殖，侵袭和转移有密切关系。     

口腔颌面部恶性肿瘤外周血循环肿瘤细胞检测及其临床意义

目的:探讨口腔颌面部恶性肿瘤患者外周血中循环肿瘤细胞(circulating tumor cells,CTCs)的水平及其临床意义.方法:选择2019年5月—2020年5月于郑州大学第一附属医院就诊并被确诊为口腔颌面部恶性肿瘤的119例患者为实验组,20例健康人为对照组.应用循环肿瘤细胞检测技术检测外周血的CTCs值,分析其相关临床意义.结果:实验组的CTCs值高于对照组,且差异有统计学意义(P<0.001);实验组CTCs值与患者的性别、年龄、发病部位等临床特征无关(P>0.05);与肿瘤负荷(P=0.00052)、T分期(P=0.0041)、N分期(P=0.0019)、远处转移(P=0.0023)、临床分期(P=0.0022)、肿瘤周围组织浸润(P=0.016)、淋巴结转移(P=0.0018)等临床病理指标相关.CTCs诊断口腔颌面部恶性肿瘤的AUC值为0.932,检验能效性具有统计学意义(P<0.001,95％CI为0.916～0.950),当血CTCs值是8.45 FU/3 mL时,约登指数最大为0.866,诊断灵敏度为91.6％,特异度95.0％;CTCs诊断淋巴结转移的AUC值为0.693,检验能效性有统计学意义(P=0.003,95％CI为0.690～0.744),当CTCs值为12.25 FU/3 mL时,约登指数最大为0.434,诊断灵敏度69.0％,特异度74.4％.结论:外周血循环肿瘤细胞(CTCs)的检测,对口腔颌面部恶性肿瘤的早期筛查、辅助诊断、评估肿瘤的负荷大小,进展情况及肿瘤转移等均有重要的临床参考价值.     

老年患者口腔颌面部恶性肿瘤联合根治术的麻醉

作者总结258例老年患者口腔颌面部恶性肿瘤联合根治术,全部采用气管插管普鲁卡因复合液静脉点滴麻醉。经初步观察,认为普鲁卡因静脉复合全麻安全可靠、副作用少,用于老年患者有许多优点,特报告如下。 1 材料和方法 1.1 临床资料 本组病例为河南医科大学口腔医学系1958～1990年收治的258例口腔颌面部恶性肿瘤老年患者,全部在普鲁卡因静脉复合全麻下施行联合根治术,其中初老期40～49岁84例,50～59岁107例,老年期60～69岁61例,高龄期70岁以上6例。     

口腔颌面部恶性肿瘤的淋巴结转移

颈淋巴清扫术是治疗口腔颌面部恶性肿瘤的重要手段。但是,由于口腔颌面部恶性肿瘤的颈淋巴结转移的早期诊断问题目前仍未解决,以至选择性淋巴清扫术的误选率仍较高。因此,努力提高诊断颈淋巴结转移的准确率仍然是摆在我们面前的重要课题。关于口腔磷癌淋巴结转移的预测问题,Shear于1976年就提出了“转移机率”预测法,并根据转移机率再决定是否应作预防性清扫术。本文就我科25年     

口腔颌面部恶性肿瘤患者血清铁蛋白测定的临床意义

本文采用放射免疫分析法对75名正常人,30例口腔颌面部恶性肿瘤和26例良性肿瘤患者进行血清铁蛋白测定。结果表明,恶性肿瘤患者血清铁蛋白含量明显高于正常人和良性肿瘤患者(P<0.01),后二者无显著性差异(P>0.05)。指出血清铁蛋白测定对口腔颌面部癌有辅助诊断价值,对肿瘤复发,转移的监测和预后判断也可能有意义。但尚待进一步研究。     

口腔颌面部恶性肿瘤免疫治疗的护理

目的探讨免疫治疗口腔颌面部恶性肿瘤患者的护理操作原则。方法对中山大学附属口腔医院收治的63例免疫治疗口腔颌面部恶性肿瘤患者进行回顾性分析,评价其免疫治疗的护理特点。结果 2009年1月至2011年12月,63例患者进行免疫治疗共413例次。其中静脉回输405例次、动脉灌注8例次,同期进行瘤体注射65例次。出现低度发热29例、中度发热11例、高度发热5例、短暂性寒颤7例、恶心呕吐11例、轻度皮疹3例,经积极治疗和护理后好转,未出现严重不良反应。全部患者均顺利安全完成免疫治疗。结论在临床医疗护理中应根据免疫治疗方案给予患者个性化的对症护理,加强患者的心理指导。口腔颌面部恶性肿瘤多途径免疫治疗是安全可靠的方法。     

口腔鳞癌首诊患者血清Cyfra 21-1检测的预后评价价值

目的探讨在口腔鳞癌首诊患者中检测血清Cyfra 21-1含量的预后价值.方法收集56例正常人和107例口腔鳞癌首诊患者的治疗前血清样本,采用ELISA方法检测血清中Cyfra 21-1的含量,跟踪随访12～57个月,采用SPSS10.0统计软件包进行相关分析.结果口腔鳞癌首诊患者治疗前血清Cyfra 21-1含量为(1.14±1.19)μg/L,显著高于对照组的(0.40±0.16)μg/L(P=0.001);其检测敏感度和特异度分别为55.1%和96.4%.结合跟踪随访,肿瘤复发和死亡的患者,治疗前血清Cyfra 21-1含量显著高于肿瘤不复发(P=0.026)和存活(P=0.001)的患者,血清Cyfra 21-1含量越高,患者生存率越低,生存时间越短(P=0.003).结论口腔鳞癌患者血清Cyfra 21-1含量显著升高,并且与预后相关.检测血清Cyfra 21-1含量对口腔鳞癌患者具有一定的临床应用价值.     

Increased Cyfra 21-1 concentration in saliva from primary oral squamous cell carcinoma patients

BACKGROUND: Saliva is the body fluid in the oral cavity and contacts directly with oral mucosa. As a detective media, it is acceptable and non-traumatic. Cyfra 21-1, being the soluble fragment of cytokeratin 19(CK19), correlates well with oral squamous cell carcinoma (OSCC). OBJECTIVE: To investigate the saliva Cyfra 21-1 concentrations in OSCC patients and healthy persons, and the correlation between the Cyfra 21-1 concentration in saliva and the CK19 expression in tissue from OSCC patients. DESIGN: Saliva Cyfra 21-1 concentration was detected by ELISA in 30 OSCC patients and 30 healthy persons; CK19 protein expression and CK19 mRNA level were, respectively, detected by immunohistochemistry and fluorescent real-time RT-PCR in cancerous and paracancerous tissues from 33 OSCC patients. RESULTS: Saliva Cyfra 21-1 concentration in OSCC patients (85.95+/-78.00 microg/L) was significantly higher than that in healthy persons (42.27+/-40.84 microg/L) (P=0.009); it was also significantly higher in the patients suffering later tumour recurrence (130.95+/-66.38 microg/L) than that in the patients without tumour recurrence (74.84+/-63.45 microg/L) (P=0.023). CK19 protein expression increased significantly in OSCC tissues (P<0.001) with positive rate of 90.9%, CK19 mRNA level in cancerous tissues was 2.21 folds higher than that in paracancerous tissues (P=0.020); significant correlation was found between tissue CK19 protein expression and tissue CK19 mRNA level (P=0.003), and great correlation was found between tissue CK19 protein expression and saliva Cyfra 21-1 concentration (P=0.051). CONCLUSIONS: The increased CK19 expression in OSCC tissues plays an important role in the increase of saliva Cyfra 21-1 concentration. Potential clinical value of saliva Cyfra 21-1 detection is suggested for OSCC. Further studies are encouraged to reveal the real diagnostic and prognostic value of detecting saliva Cyfra 21-1 concentration for OSCC.     

Cyfra 21-1肿瘤标志物在头颈鳞癌诊断和预后评价中的作用

Cyfra 21-1是近年来发现的一种细胞角蛋白19的可溶性片段，随着细胞发生癌变，癌细胞可以释放Cyfra 21-1进入循环系统而被检测出来，因此越来越被广大临床医师所重视，包括头颈部外科医师也越来越重视Cyfra 21-1在头颈部鳞状细胞癌中的临床应用价值。目前Cyfra 21-1被认为可作为判断头颈鳞癌患者预后的肿瘤标志物之一，但对头颈鳞癌的早期诊断价值尚存在争议。本文就Cyfra 21-1的特点以及在头颈部鳞状细胞癌中的临床应用新进展进行综述。     

口腔鳞癌患者唾液cyfra 21-1含量与癌组织CK19表达的相关性研究

目的：检测口腔鳞癌患者唾液中cyfra21-1含量、组织中CK19蛋白质表达和基因转录水平,探讨其相互关系。方法：对30例口腔鳞癌患者和30例正常人的唾液采用ELISA法检测cyfra21-1含量,其中6例口腔鳞癌患者的癌组织和癌旁组织分别采用免疫组织化学和实时定量RT-PCR法检测CK19蛋白质表达强度和CK19mRNA水平,采用SPSS10.0软件包进行统计学分析。结果：口腔鳞癌患者唾液cyfra21-1含量为（85.95±78.00）μg/L,显著高于对照组的（42.27±40.84）μg/L;口腔鳞癌癌组织CK19蛋白质表达强度和CK19mRNA水平显著高于癌旁组织。CK19mRNA水平与CK19蛋白质表达强度呈显著正相关,癌组织CK19蛋白质与唾液cyfra21-1含量也显著相关。结论：口腔鳞癌患者唾液cyfra21-1含量和组织CK19蛋白表达及基因转录水平显著升高,组织CK19表达升高,对唾液cyfra21-1含量的上升起着重要作用。     

Serum sialic acid levels in patients with oral and maxillofacial malignancy

Serum sialic acid levels were measured using the thiobarbituric acid method in 80 healthy subjects and in 40 patients with benign and 61 with malignant tumors in the oral and maxillofacial region. It was shown that the cancer group had statistically higher sialic acid levels than control group and the group with benign disease (P less than .05), but no significant difference was noted between the normal control group and the patients with benign tumor (P greater than .05). Serum sialic acid levels were significantly higher in the patients with stages III and IV cancer than in those individuals with stage I and II cancer, but no differences were seen between stages I and II, and between stages III and IV cancer patients (P greater than .05). There was also no difference when considering the anatomic site of the malignant lesion. Furthermore, during the serial sialic acid determination in cancer patients before and following treatment, the sialic acid levels usually declined with remission of the disease and increased with recurrence, metastasis, or a poor prognosis. We conclude from this study that the sequential measurement of sialic acid level is particularly useful in monitoring patients with oral cancer, and sialic acid may prove to be a valuable tumor marker in oral and maxillofacial malignancy.     

Serum soluble CD44v6 levels in patients with oral and maxillofacial malignancy

Objective:  To determine the levels of serum sCD44v6 in patients with oral cancer and evaluate the value of serum sCD44v6 in adjuvant diagnosis, staging and monitoring treatment response in these patients.
Materials and Methods:  A total of 112 hospitalized patients with oral and maxillofacial malignancy and 28 healthy individuals were examined for serum sCD44v6 levels. Venous blood was collected from these patients and the healthy individuals. One week after treatment, venous blood was collected once again in 60 patients with oral and maxillofacial squamous cell carcinoma (OSCC).
Results:  The sCD44v6 concentration was not significantly different between patients with oral and maxillofacial malignancy and control group ( P  > 0.05). The levels of serum sCD44v6 in patients with OSCC and salivary carcinoma showed no difference with those in control group ( P  > 0.05). The sCD44v6 level in patients with stage III and IV disease was higher than that of patients with stage I and II and that of the control group, but the difference was not significant ( P  > 0.05).  Serum sCD44v6 levels in patients with OSCC after treatment became lower than that prevailed during pretreatment ( P  < 0.05).
Conclusion:  The possible roles of CD44v6 in the diagnosis of oral and maxillofacial malignancy deserve further elucidation and evaluation. Serum sCD44v6 may be a valuable marker in monitoring treatment response in patients with OSCC.     

Detection of serum Cyfra 21-1 in patients with primary oral squamous cell carcinoma

Oral squamous cell carcinoma (OSCC) is the most common malignant tumour in the oral and maxillofacial region, and has a poor prognosis. Cyfra 21-1 is a useful tumour marker for squamous cell carcinoma, but the clinical value of Cyfra 21-1 in OSCC has not been confirmed. In order to investigate the diagnostic and prognostic value of serum Cyfra 21-1 in primary OSCC patients, the preoperative serum Cyfra 21-1 concentration of 100 OSCC patients and 56 healthy subjects was detected by enzyme-linked immunosorbent assay (ELISA). The cut-off value was calculated with a receiver operating characteristic (ROC) curve, and prognostic analysis was performed using the Kaplan-Meier method and Cox regression models. The preoperative serum Cyfra 21-1 concentration in OSCC patients (1.18+/-1.20 microg/L) was significantly higher (t=6.585, P<0.001) than that in healthy subjects (0.40+/-0.16 microg/L). With a cut-off value of 0.65 microg/L, the diagnostic sensitivity and specificity was 0.570 and 0.964, respectively. There was significant correlation with tumour recurrence and survival rate: the higher the serum Cyfra 21-1; the higher the tumour recurrence rate and lower the survival rate. Serum Cyfra 21-1 was an independent prognostic factor for OSCC using univariate and multivariate Cox models.     

口腔鳞状细胞癌患者血清Cyfra21-1的含量检测

目的:探讨口腔鳞癌患者血清Cyfra21-1的含量及潜在的临床应用价值.方法:采用ELISA技术检测31 例口腔鳞癌患者和28 例正常健康人血清中Cyfra21-1含量.结果:口腔鳞癌组血清Cyfra21-1含量为(1.12±0.61) ng/ml,高于正常组(0.34±0.20) ng/ml和良性肿瘤组(0.50±0.27) ng/ml(P<0.01);检测的敏感度、特异度分别为83.9%和89.3%;10 例口腔鳞癌患者血清Cyfra21-1含量由术前的(1.31±0.25) ng/ml降至术后的 (0.65±0.14) ng/ml,差异具显著性(P<0.01).结论:血清Cyfra21-1含量可作为口腔鳞癌的辅助诊断指标.     

β淀粉样蛋白1-40与老年患者颌面外科手术后并发谵妄的关系

目的观察老年颌面外科手术患者全身麻醉后术后谵妄（PD）的患病率,研究血浆β淀粉样蛋白1-40（Aβ1-40）与PD的关系。方法选择50例颌面外科手术患者,按照年龄分为T组（30例,年龄62~78岁）和C组（20例,年龄20~60岁）,2组均采用静吸复合麻醉,以谵妄评定量表1998年修订版（DRS-R-98）来诊断和评估PD发生状况,记录术前（T0）,术后24 h（T1）、48 h（T2）、72 h（T3）、96 h（T4）的DRS-R-98评分;并测定Aβ1-40质量浓度。结果T组患者PD的患病率为20.0%。T组Aβ1-40质量浓度在T0、T1、T2、T3时段明显高于C组（P＜0.01）,T组和C组Aβ1-40质量浓度在T1和T2时段明显高于同组T0时段（P＜0.05）。T组在T3和T4时段的DRS-R-98评分明显高于同组T1时段和C组（P＜0.01）。结论Aβ1-40在全身麻醉后持续升高可能是老年患者发生PD的重要原因之一。     

血清VEGF、TSGF、SCCA及CEA联合检测在口腔癌诊断中的价值

检测52例口腔癌患者、40例口腔良性肿瘤患者和22例正常人血清中内皮生长因子(VEGF)、肿瘤相关物质群(TSGF)、鳞癌抗原(SCCA)及癌胚抗原(CEA)的含量,发现口腔癌患者血清中的VEGF、TSGF的表达水平高于其他两组(P<0.05)。SCCA和CEA在口腔癌中的检测结果与另两组差异无显著性(P>0.05)。VEGF、TSGF两项标志在口腔癌患者中有较高的阳性率,联合检测有助于提高口腔癌诊断的敏感性和准确性。