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。

The Clinical Value of CYFRA21-1 Detection in Esophageal Squamous Cell Carcinoma

Objective To study the clinical value of CYFRA21 1 detection in patients with esophageal squamous cell carcinoma.Methods The serum levels of CYFRA21 1,SCC antigen and CEA were determined in 35 patients with esophageal squamous cell carcinoma by immunoradiometric assay,and the correlation between serum CYFRA21 1 levels and clinicopathologic factors was analyzed.In the mean time,the serum concentrations of CYFRA21 1 was compared between preoperation and postoperation in 27 patients.Results 20 of 35 patients had elevated CYFRA21 1 levels(>3.5 ng/ml).The specificity,sensitivity and accuracy of CYFRA21 1 in detecting esophageal squamous cell carcinoma was 100.0% ,57.1%,66.7%,respectively,and the sensitivity was increased to 77.1% when combining to SCC antigen assay.The CYFRA21 1 levels in postoperative patients was lower than in preoperative patients( P <0.01).Univariate analysis revealed that the CYFRA21 1 levels correlated to disease progression(including tumor size,tumor depth,lymph node metastases and resectability).Conclusion CYFRA21 1 appears to be a useful marker for human squamous cell carcinoma of the esophagus,it is more valuable for diagnosis to use a combination of CYFRA21 1 and SCC antigen assay.The serum level of CYFRA21 1 can be used to effectively monitor the course of disease and detect the relapse of esophageal SCC.The independent prognostic role of CYFRA21 1 level may be useful in stratifying populations with advanced esophageal SCC.