Preoperative serum midkine concentration is a prognostic marker for esophageal squamous cell carcinoma

High preoperative serum midkine concentration is associated with poor survival in patients with esophageal cancer, even after radical surgery, and thus may have prognostic value. Midkine (MK), a heparin-binding growth factor, is expressed in numerous cancer tissues, and serum MK (S-MK) concentrations are increased in patients with various neoplasms. The aim of this study is to evaluate the clinical significance of S-MK in patients with esophageal squamous cell cancer (SCC). S-MK was measured by enzyme-linked immunosorbent assay in 135 healthy controls, 16 patients with benign esophageal disease, and 93 patients with primary esophageal SCC before surgery. The serum concentrations of carcinoembryonic antigen (CEA), SCC antigen (SCC-Ag), and cytokeratin 19 fragment (CYFRA21–1) were also evaluated. All patients with esophageal SCC underwent radical esophagec-tomy. Tumor MK expression was assessed by immunohistochemistry in 14 fresh tumor specimens. To determine whether S-MK is of value as a prognostic factor, the authors conducted a survival analysis using Cox's proportional hazards model. S-MK values in patients with esophageal SCC were significantly higher than those in healthy controls (417±342 pg/ml vs. 154±76 pg/ml, P <0.001). Using 300 pg/ml as the cut-off value (representing the mean +2 standard deviations of the S-MK of healthy controls), 61% of patients with esophageal SCC were classified as positive. MK expression by the tumor was significantly associated with high level of S-MK. High S-MK (≥300 pg/ml) was associated with tumor size, immunoreactivity and poor survival. Multivariate analysis indicated that S-MK was an independent prognostic factor. S-MK may be a useful tumor marker for esophageal SCC. Increased preoperative S-MK in patients with esophageal SCC is associated with poor survival.     

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.     

CYFRA 21-1 serum analysis in patients with esophageal cancer.

This study was conducted to determine a potential use of CYFRA 21-1 in patients suffering from carcinoma of the esophagus. CYFRA 21-1 serum concentrations of 50 patients with histologically proven malignant lesion of the esophagus were compared with 50 healthy persons, 50 patients with benign esophageal disease, and 50 patients with benign lung disease. Additional analysis of serum carcinoembryonic antigen, CA 72-4, and squamous cell carcinoma-antigen serum concentrations were performed. The patients with esophageal carcinoma underwent follow-up tumor marker examinations every three months for 1 year. Analysis to detect statistically significant differences was conducted to estimate a cutoff and to evaluate tumor entity, tumor stage, survival, and tumor-free survival. CYFRA 21-1 at a cutoff of 1.40 ng/ml showed an overall sensitivity to esophageal carcinoma of 36% (45.5% to squamous cell carcinoma, 17.6% to adenocarcinoma) at a specificity of 97.3%. CYFRA 21-1 concentrations showed a tendency to higher serum levels depending on local tumor burden. A correlation of CYFRA 21-1 with various N- or M-stage disease was not observed. Postoperative development in terms of survival and tumor-free survival showed significant correlation to preoperative CYFRA 21-1 concentrations. Clinical tumor recurrence was preceded by CY-FRA 21-1 elevation by 3.4 months. For prognosis and follow-up, this marker is justified for additional analysis in a larger series of patients suffering from carcinoma of the esophagus.     

晚期恶性肿瘤血清VEGF含量测定的临床意义

目的：探讨血清血管内皮生长因子（VEGF）浓度在晚期恶性肿瘤中的临床意义。方法：应用酶联免疫吸附试验（ELISA）测定40例晚期恶性肿瘤（非小细胞肺癌、鼻咽癌、食管癌）患者血清的VEGF浓度，10名健康成人作为对照。结果：40例晚期恶性肿瘤患者血清VEGF浓度为（477．07±374．10）pg／ml，显著高于健康成人（139．09±133．41）pg／ml，差异有统计学意义（P=0．016），其中治疗前血清VEGF浓度在非小细胞肺癌为（518．53±378．99）pg／ml，食管癌为（399．21±393．69）pg／ml，鼻咽癌为（500．68±348．48）pg／ml，与健康成人比较差异有统计学意义（P值分别为0．011、0．044和0．019）。化疗有效患者的血清VEGF浓度（400．41±332．84）pg／ml显著低于化疗前浓度（777．10±666．01）pg／ml，差异有统计学意义（P=0．034）。结论：血清VEGF可作为晚期恶性肿瘤监测病情、判断放疗和预后一个有用的指标。     

The significance of Tenascin-C serum level as tumor marker in squamous cell carcinoma of the head and neck

BACKGROUND: Tenascin, an extracellular matrix glycoprotein, is transiently present in embryonic tissue, in benign granulation tissue, but also in several highly anaplastic tumors like fibrosarcoma, melanoma and squamous cell carcinoma of the skin. This study was performed to validate elevated Tenascin serum levels as a possible marker for head and neck squamous cell carcinomas (HNSCC). PATIENTS AND METHODS: Tenascin serum levels were evaluated in patients with primary (n = 92) and with recurrent (n = 28) HNSCC. Patients with benign, non inflammatory ear, nose and throat diseases (n = 16) served as the control. The Tenascin serum levels were measured by ELISA (Aventis). RESULTS: Serum Tenascin concentrations of patients with benign ENT diseases ranged between 0.37 and 2.19 micrograms/ml (n = 16, mean +/- SD: 1.23 +/- 0.59 micrograms/ml), of patients with HNSCC (primary diagnosis) between 0.05 and 8.75 micrograms/ml (n = 92, mean +/- SD: 1.81 (1.36 micrograms/ml) and of patients with recurrent HNSCC between 0.53 and 10.0 micrograms/ml (n = 28, mean +/- SD: 2.78 +/- 2.2 micrograms/ml). CONCLUSION: We found a significant elevation of Tenascin serum levels only in patients with higher tumor stages (T4/UICC4) (p < 0.01/p < 0.1) or recurrent disease compared to Tenascin serum levels in healthy controls. Thereby Tenascin serum levels cannot be used clinically as a routine serum marker for the control of head and neck cancer. Further investigations are necessary to evaluate whether the measurement of Tenascin levels as tumor markers could offer additional information to the clinical outcome of patients with HNSCC.     

Proteomics-based identification of autoantibody against heat shock protein 70 as a diagnostic marker in esophageal squamous cell carcinoma

Detection of novel tumor-related antigens and autoantibodies in cancer patients is expected to facilitate the diagnosis of early-stage malignant tumor and establish effective new immunotherapies. The purpose of this study was to identify novel tumor antigens in an esophageal squamous cell carcinoma (ESCC) cell line (TE-2) and related autoantibodies in sera from patients with ESCC using a proteomics-based approach. TE-2 proteins were separated by two-dimensional polyacrylamide gel electrophoresis, followed by Western blot analysis in which sera from patients with ESCC, healthy controls and patients with other cancers were tested for primary antibodies. Positive spots were excised from silver-stained gels and analyzed by matrix-assisted laser disorption/ionization time-of-flight mass spectrometry (MALDI-TOF/TOF-MS). Sera from patients with ESCC yielded multiple spots, one of which was identified as heat shock protein 70 (Hsp70) by MALDI-TOF/TOF-MS. Concentrations of serum Hsp70 autoantibody were significantly higher for patients with ESCC (mean, 0.412+/-0.096 mg/ml) than for patients with gastric (0.236+/-0.112 mg/ml, P<0.001) or colon cancer (0.231+/-0.120 mg/ml, P<0.001) or healthy individuals (0.207+/-0.055 mg/ml, P<0.001) by enzyme-linked immunosorbent assay. We have identified an autoantibody against Hsp70 in ESCC patients. The proteomic approach implemented herein offers a powerful tool for identifying novel serum markers that may display clinical utility against cancer.     

Immunochemical assay of MIC A production by tumor cells in vitro and in vivo as a component of antitumor vaccine development

Due to immunological monitoring, most of aggressive tumor cells are selected capable of producing soluble factors of immunosuppression in their microenvironment. A ligand for NK- and T-cells receptor (MICA/B) activation is one of them. We investigated MICA concentrations in serum of 10 healthy volunteers and 114 patients with solid tumors (breast cancer - 24, gastrointestinal tumors - 27, renal cell carcinoma - 15, lung cancer - 9, ovarian carcinoma - 13, cutaneous melanoma - 18, primary multiple tumors - 2, prostate cancer - 6). The lowest level of MICA was reported in ovarian carcinoma (91.19 +/- 29.42 pg/ml), the highest - in rectal cancer (311.13 +/- 50.11 pg/ml) while mean concentration in healthy volunteers was (19.38 +/- 5.91 pg/ml). Cells of melanoma, renal cell carcinoma and prostate cancer became capable of producing MICA during cultivation and antitumor vaccine preparation. It is suggested that culture supernatants be tested for MICA contents as well as patients screened for vaccination. Selection of patients should be carried out on the basis of MICA molecules detection in blood flow.     

Clinical investigation of plasma prostaglandin levels in patients with digestive cancers

Plasma PGE2 level of 45 patients with digestive cancers, 10 patients with digestive benign diseases and 10 healthy controls were examined. Some patients were also examined plasma levels of TXB2, 6-keto-PGF1 alpha and PGF2 alpha. Plasma PGE2 level of digestive cancer patients (53.5 +/- 69.1 pg/ml, mean +/- SD) were about 10 times higher compared to healthy controls (5.2 +/- 3.8 pg/ml, p less than 0.01). Patients with digestive benign diseases also revealed elevated level of plasma PGE2, but the change of value were smaller than those of digestive cancer patients. Furthermore, in the case of digestive cancer patients, significantly elevated levels of TXB2 (49.7 +/- 60.3 pg/ml, p less than 0.05) and 6-keto-PGF1 alpha (33.9 +/- 31.5 pg/ml, p less than 0.01), and significantly reduced levels of PGF2 alpha (246 +/- 63 pg/ml, p less than 0.01) were noted. The changes in plasma prostaglandin levels of digestive cancer patients may reflect, even though prostaglandins are present in normal human body and are inactivated rapidly, the biological characteristics of tumors and in vivo reactions of the host.     

糖抗原CA19—9测定对消化系统恶性肿瘤的诊断意义

Serum carbohydrate antigen CA 19-9 level was measured by radioimmunoassay in 55 patients with malignant digestive disease (14 esophageal cancers, 11 gastric cancers, 5 colorectal cancers, 14 primary liver cancers and 11 pancreatic cancers). The mean value of serum CA 19-9 levels was 22.11 +/- 24.79 u/ml in esophageal cancer, 99.91 +/- 100.12 u/ml in gastric cancer, 64.5 +/- 53.43 u/ml in colorectal carcinoma, 47.81 +/- 68.62 u/ml in primary hepatic cancer and 459.55 +/- 696.76 u/ml in pancreatic cancer (CA 19-9 greater than 37 mu/ml as positive). There were significant differences (P less than 0.05) between the mean serum CA 19-9 levels of pancreatic cancer and esophageal cancer, primary hepatic cancer. An increased CA 19-9 synthesis and excretion by tumor cells or increased pressure on pancreatic duct by the tumor may cause the elevation of serum CA 19-9 level in cancer patients. The authors conclude that CA19-9 is a valuable tumor marker in the diagnosis of pancreatic cancer and, probably, other gastrointestinal tumors.     

Prognostic significance of serum thymidine phosphorylase concentration in esophageal squamous cell carcinoma

BACKGROUND: Thymidine phosphorylase (dThdPase), which also is referred to as platelet-derived endothelial cell growth factor, is a potent inducer of angiogenesis in malignant tumors. Increased dThdPase expression and activity have been found to be associated with poor prognosis in various solid tumor tissues. Because very little was known about the significance of serum dThdPase concentration (S-dThdPase), the objective of this study was to analyze the clinicopathologic significance of S-dThdPase in the patients with esophageal squamous cell carcinoma. METHODS: The S-dThdPase was measured by enzyme-linked immunosorbent assay in 77 healthy controls and 153 patients with primary esophageal squamous cell carcinoma. A total of 80 patients underwent surgery alone; 46 patients received chemoradiotherapy alone; 17 patients received chemoradiotherapy followed by surgery; and 10 patients did not receive any treatment. Thymidine phosphorylase expression in esophageal carcinoma tissues was examined by immunohistochemistry. The clinicopathologic value and prognostic value of S-dThdPase was determined in 80 patients treated by surgery alone. RESULTS: The S-dThdPase is significantly higher in patients with esophageal carcinoma than in healthy controls (30.8 +/- 31.8 ng/mL vs. 13.8 +/- 7.6 ng/mL; P < 0.001). Statistically significant differences in S-dThdPases were observed depending on tumor size (P < 0.01) and tumor depth (P < 0.01). A S-dThdPase of more than 29.0 ng/mL (which represented the mean plus 2 standard deviation of the concentration in healthy controls) was associated with dThdPase expression (P = 0.022), poor response (P = 0.022), and poor survival (P < 0.01). Because S-dThdPase was associated with tumor depth, S-dThdPase was not an independent prognostic factor (P = 0.095). CONCLUSIONS: A high S-dThdPase is associated with depth of tumor invasion and poor response to treatment.     

Clinical significance of serum angiocidin levels in hepatocellular carcinoma

Angiocidin, a tumor-secreted protein, was measured in serum of 27 healthy volunteers and 33 hepatocellular carcinoma (HCC) patients. Healthy controls either hepatitis B surface antigen (HBsAg) positive or negative showed undetectable levels. Patients had levels of angiocidin ranging from 15.09 to 195.73 pg/ml. Patients with stages III-IV had higher levels of angiocidin (97+/-13 pg/ml, n=17) compared to those with stages I-II (63+/-37 pg/ml, n=16), p<0.043. Patients with microsatellite tumor nodules had higher average levels (98+/-55 pg/ml, n=17) compared to those without microsatellite nodules (51+/-27 pg/ml, n=20), p<0.032. Our studies suggest that angiocidin predicts advanced stage and intra-hepatic metastasis.     

Tnp-alpha determination in serum and pleural effusion in patients with lung-cancer

The relationship between Tumor Necrosis Factor-alpha (TNF-alpha) in the serum and pleural fluid of lung cancer patients and the extent and the histological cell type was studied. TNF-(a)lpha level was determined in the serum of 68 patients with lung cancer [51 non-small cell lung cancer (NSCLC) and 17 small cell lung cancer (SCLC)] and in pleural fluid of 30 patients with lung cancer (22 NSCLC, 11 of them positive for neoplastic cells and 8 SCLC, 7 of them positive). Sera of 31 healthy subjects and the pleural fluid of 15 non-malignant pleural effusions were tested as controls. TNF-alpha serum level was increased in patients with lung cancer (healthy subjects 7.8+/-3.3 pg/ml; lung cancer 16.2+/-9.1 pg/ml), in NSCLC as well as SCLC and a relationship with the extent of the disease was found in both the histological types. In pleural fluid, no differences of TNF-alpha level were observed between neoplastic and benign inflammatory effusion, between SCLC and NSCLC or between cases positive and negative for the presence of neoplastic cells. Serum TNF-alpha may be an indicator of tumour burden; conversely, TNF-alpha in pleural fluid, was unable to discriminate between neoplastic and benign effusion.     

Monocyte chemoattractant protein-1 serum levels in patients with breast cancer.

The chemokine monocyte chemoattractant protein (MCP)-1 is thought to be involved in breast carcinogenesis. We evaluated MCP-1 serum levels in patients with breast cancer (n = 135), ductal carcinoma in situ (DCIS) I-III (n = 30), benign breast lesions (n = 143) and in healthy women (n = 27). We determined the value of MCP-1 serum levels as a differentiation marker between malignant, preinvasive and benign breast diseases and as a predictive marker for the biological phenotype of breast carcinoma. Median (range) MCP-1 serum levels in patients with breast cancer, DCIS I-III, benign breast lesions and healthy women were 200 (57-692) pg/ml, 194 (58-525) pg/ml, 174 (39-529) pg/ml and 175 (67-425) pg/ml, respectively. No differences were ascertained between the patient groups. In patients with breast cancer, increased MCP-1 serum levels were correlated with advanced tumor stage (p = 0.04) and lymph node involvement (p = 0.04). We were not able to establish MCP-1 as a differentiation marker between malignant and benign breast diseases. Our data might indicate that MCP-1 influences breast carcinogenesis by facilitating tumor growth and metastatic spread, thus altering the biological phenotype of the disease.     

血管内皮生长因子在肝细胞癌血清中的表达意义

目的研究血管内皮生长因子(vascularendothelialgrowthfactor,VEGF)在肝细胞癌(HCC)患者周围血血清中的表达水平与肝癌临床病理特征及肝癌转移复发之间的关系.方法运用sandwich酶联免疫吸附测定法定量检测115例HCC、40例肝脏良性疾病患者和30例健康人血清中VEGF的含量.结果HCC组血清VEGF表达水平[(465.62±336.24)pg/ml]与肝脏良性疾病组[(159.54±120.58)pg/ml]、与健康人组[(123.53±51.84)pg/ml]比较,差异均有显著性(P值均=0.0001);VEGF表达阳性率分别为77.4%、25.0%和3.3%.HCC转移组患者血清VEGF表达水平与未转移组相比,差异有显著性(P=0.001).血清VEGF表达水平还与HCC合并门静脉瘤栓、肿瘤大小和TNM分期密切相关,VEGF含量随TNM分期升高而逐步升高.结论疗前HCC患者的血清VEGF表达水平,是反映HCC侵袭生长及转移潜能的有效生物学指标.     

Elevated salivary endothelin levels in oral cancer patients--a pilot study

The analysis of saliva has been proposed as a potentially rapid, non-invasive method to monitor and diagnose patients with oral disease. In this study we measured salivary endothelin-1 (ET-1) levels in patients diagnosed with oral squamous cell carcinoma (SCC) prior to treatment. We demonstrate significantly elevated salivary ET-1 levels in the oral SCC group (4.37+/-1.35pg/ml), relative to the control group (1.16+/-0.29pg/ml). ET-1 and ET-1 mRNA were also measured in oral SCC tissue specimens and compared to normal oral epithelial controls. The concentration of ET-1 in the oral SCC specimens was 17.87+/-4.0pg/ml and in the normal epithelial controls the concentration of ET-1 was 5.43+/-2.5pg/ml. ET-1 mRNA was significantly overexpressed in 80% (8/10) of the oral SCC specimens. Our results demonstrate the potential utility of salivary analysis for ET-1 levels to monitor patients at risk for oral SCC.     

Pro-gastrin-releasing peptide in patients with benign and malignant diseases.

The specificity and sensitivity of pro-gastrin-releasing peptide (ProGRP) was evaluated in 37 healthy subjects, 197 patients with benign diseases and 310 patients with malignant diseases of different origins. Abnormal ProGRP serum levels (>50 pg/ml) were found in 10% of the patients with benign diseases and in 26.1% of the patients with active cancer. None of the healthy subjects had abnormal ProGRP levels. The benign disease with the highest ProGRP concentration was renal failure, with abnormal values in 51.6% of the patients studied. Excluding patients with renal failure or patients with creatinine levels greater than 1.5 mg/dl, raised ProGRP values (<80 ng/ml) were found in 2.5% (4/160) of patients with benign diseases and in 4.9% of patients with active malignancies other than lung cancer or neuroendocrine tumors (<110 ng/ml). Abnormal ProGRP serum levels were found in 26.2% of patients with non-small cell lung cancer (NSCLC) (mean 40.5 +/- 35.4 pg/ml) and in 76.8% of patients with small cell lung cancer (SCLC) (mean 694 +/- 1,776 pg/ml) (p < 0.001). ProGRP serum levels >300 pg/ml were only found in SCLC patients (41.4%). ProGRP results were related to tumor extension in SCLC (sensitivity in limited disease 58.3%, in extensive disease 95.5%) but not in NSCLC. In summary, renal failure is the most frequent source of false-positive results with ProGRP, and this marker is useful in the histological differential diagnosis of lung cancer.     

VEGF, TNF-alpha and 8-isoprostane levels in exhaled breath condensate and serum of patients with lung cancer

The aim of the present study was to evaluate the levels of VEGF, 8-isoprostane and TNF-alpha in EBC and serum of patients with primary lung cancer prior to the initiation of any treatment, in order to evaluate their possible diagnostic role. Furthermore, associations between VEGF, 8-isoprostane and TNF-alpha levels in EBC and serum with clinicopathologic factors were investigated. We enrolled 30 patients with lung cancer (mean age 65.2+/-10.5 years) and 15 age and gender-matched healthy smokers as controls. Serum and EBC were collected before any treatment. TNF-alpha, VEGF and 8-isoprostane levels in EBC and serum were analyzed by an immunoenzymatic method (ELISA). A statistically significant difference was observed between lung cancer patients and the control group regarding the values of TNF-alpha, both in EBC (52.9+/-5.0 pg/ml vs. 19.4+/-3.9 pg/ml, p<0.0001) and serum (44.5+/-6.3 pg/ml vs. 22.2+/-4.3 pg/ml, p=0.035). Moreover, EBC VEGF levels were higher in patients with T3-T4 tumor stage compared to T1-T2 (9.3+/-2.8 pg/ml vs. 2.3+/-0.7pg/ml, p=0.047). A statistically significant correlation was also observed between serum and EBC values of VEGF (r=0.52, p=0.019). In addition, serum levels of VEGF were higher in lung cancer patients than in controls (369.3+/-55.1 pg/ml vs. 180.5+/-14.7 pg/ml, p=0.046). VEGF serum levels were also found higher in patients with advanced stage of disease (IIIB-IV) and distant nodal metastasis (N2-N3). No differences were observed in 8-isoprostane in EBC between lung cancer patients and controls. In contrast, serum 8-isoprostane levels were higher in lung cancer patients compared to controls (24.9+/-3.6 pg/ml vs. 12.9+/-1.6 pg/ml, p=0.027) and were higher in patients with advanced disease. All three biomarkers presented acceptable reproducibility in the EBC on two consecutive days. In conclusion, we have shown that TNF-alpha, VEGF and 8-isoprostane are elevated in the serum of lung cancer patients and increased serum VEGF and 8-isoprostane levels are related to advanced disease. In EBC, increased TNF-alpha levels were observed in lung cancer patients, whereas increased VEGF levels were observed in advanced T-stage. Further longitudinal studies are warranted for the evaluation of the prognostic role of these biomarkers in lung cancer.     

Squamous cell carcinoma antigen in the diagnosis and treatment follow-up of oral and facial squamous cell carcinoma

The squamous cell carcinoma (SCC) antigen was determined by radioimmunoassay in the serum of 40 untreated patients with SCC of the oromaxillofacial region. The mean (+/- SEM) serum concentration for these patients (3.8 +/- 0.8 ng/ml) was significantly higher than that of 52 disease-free patients coming to routine postoperative care (1.2 +/- 0.1 ng/ml) and of 74 healthy controls (1.1 +/- 0.07 ng/ml). Using a arbitrary limit of 2.2 ng/ml, pathologic serum levels of SCC were observed in 15 (38%) of 40 untreated patients, whereas only four (7.7%) of 52 tumor-free patients revealed an elevated serum SCC. Serial measurements of SCC were pretherapeutically available in 28 patients as well as during individual therapy and further follow-up. All but one of these patients had a normal serum SCC postoperatively. The authors' results demonstrate that the clinical value of SCC lies mainly in monitoring the course of the disease. Careful follow-up studies should be undertaken to determine whether serial determination of SCC is promising in early prediction of tumor reoccurrence.     

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。     

锰超氧化物歧化酶基因的多态性与食管癌发生和发展的关系

目的 探讨锰超氧化物歧化酶(MnSOD)基因单核苷酸多态性与食管癌的发生及病变进展的关系.方法 采用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)方法,分析103例食管癌患者(食管癌组)和195例正常对照人群(对照组)的MnSOD基因启动子区上游第9位点单核苷酸多态性,比较不同基因型与食管癌发病风险以及病变部位、病变长度、最大直径和临床分期之间的关系.结果 在食管癌组中,MnSOD基因启动子区上游第9位点变异基因型(TC+CC)分布的频率为28.2%,明显高于对照组(17.4%;X~2=4.645,P＜0.05);与携带TT基因型者相比,携带C等位基因(TC+CC)的个体患食管癌的风险增加了1.889倍(95%CI为1.052～3.391).食管癌组中,病变长度≤5 cm者,变异基因型分布的频率为16.3%;病变长度＞5 cm者,变异基因型分布的频率为36.7%,差异有统计学意义(X~2=5.147,P＜0.05).MnSOD 9 T→C变异与食管癌的病变长度呈正相关,但与食管癌的病变部位、最大直径以及临床分期之间无明显的相关性.结论 MnSOD 9 T→C变异增加了食管癌的发病风险,其可以作为食管癌遗传易感性的标志物,用于易感个体的预警,并且该基因的多态性可能与食管癌病变的纵向进展相关.