血清细胞角蛋白19片段检测对食管癌的临床意义

目的 探讨血清细胞角蛋白19片段（CYFRA21－1）增高在食管癌患者中的临床意义。方法 应用ELISA技术,检测了84例确诊为食管癌患者的术前及术后10d的血清中CYFRA21－1水平,并对患者3年生存情况进行了随访,用SAS6．21软件进行统计学分析。结果（1）在阈值定为3．3ng/ml时,食管癌阳性率为72．6（61／84）。（2）Ⅲ期或高分化食管癌患者血清CYFRA21－1水平在手术前后差异有显著意义（P＜0．05）。（3）根治手术时,手术前后血清CYFRA21－1水平差异有显著意义,但在姑息手术时,CYFRA21－1水平变化差异无显著意义。（4）用Logistic程序分析影响患者3年生存情况的因素。除分期（P＜0．05）,手术根治与否（P＜0．05）外,手术前后CYFRA21－1的血清水平变化幅度也与患者预后关系密切（P＜0．05）。结论 CYFRA21－1在食管癌的诊断、预后预测中具有应用价值。

Clinical significance of the novel tumor marker CYFRA21-1 in patients with esophageal cancer

OBJECTIVE: To study the clinical significance of the novel tumor marker--CYFRA21-1 in patients with esophageal cancer. METHODS: The CYFRA21-1 level in serum of 84 patients with a definite diagnosis of esophageal cancer was examined 10 days before and after operation by ELISA. A 3 years' follow-up was conducted to the survival of patients. RESULTS: (1) The CYFRA21-1 level was > 3.3 ng/ml in 72.6% of the patients (61/84). (2) The serum CYFRA21-1 level decreased significantly after operation in patients at stage III or with high differentiation (P < 0.05). (3) The difference between pre- and post-operative serum CYFRA21-1 levels was statistically significant in patients who had undegone radical operation, and was not in patients who had undergone palliative operation. (4) In addition to stage (P < 0.05) and type of operation (P < 0.05), the difference of CYFRA21-1 level before and after operationwas closely related to the prognosis (P < 0.05). CONCLUSION: CYFRA21-1 is a useful marker in diagnosis and prediction of prognosis of esophageal cancer.