摘要
[目的]探讨血清鳞状细胞癌肿瘤相关抗原(SCCAg)、细胞角蛋白19片段抗原21-1(CYFRA21-1)、癌胚抗原(CEA)对判断中晚期宫颈鳞癌同步放化疗疗效及在复发宫颈癌诊断、治疗和预后评估中的作用。[方法]随机选取468例接受同步放化疗的中晚期宫颈鳞癌患者(KPS≥70分),检测患者同步放化疗前后血清中SCCAg、CYFRA21-1、CEA的水平变化。比较复发转移者与未复发转移者,以及复发转移者治疗前后血清中SCCAg、CYFRA21-1、CEA的变化情况。[结果]SCCAg、CYFRA21-1、CEA联合检测较单项检测诊断中晚期宫颈癌的灵敏度明显提高(P<0.05),灵敏度随临床分期的进展而升高,差异有统计学意义(P<0.05);放化疗后,患者血清中SCCAg、CYFRA21-1、CEA水平均明显下降,其差异有显著统计学意义(P<0.001)。复发及转移患者较无瘤生存患者血清中SCCAg、CYFRA21-1、CEA的水平明显升高,差异有统计学意义(P<0.001);复发患者治疗后完全缓解(CR)及部分缓解(PR)者血清中SCCAg、CYFRA21-1、CEA较治疗前明显降低,差异有统计学意义(P<0.05),稳定(SD)及病情进展(PD)患者,治疗前后比较差异无统计学意义(P>0.05)。[结论]SCCAg、CYFRA21-1和CEA联合检测对中晚期宫颈癌及复发宫颈癌的诊断、疗效评价、预后预测及病情监测有一定的临床价值。
[Purpose] To investigate the clinical value of SCCAg,CYFRA21-1 and CEA on the diagnosis and monitoring prognosis for advanced squamous cell cervical cancer after concurrent chemoradiotherapy. [Methods] Four hundreds and sixty-eight patients with advanced cervical squamous cell carcinoma were enrolled （KPS ≥70）.All patients underwent serum SCCAg, CYFRA21-1 and CEA detection before treatment and after treatment. The sensitivity of SCCAg, CYFRA21-1 and CEA as diagnostic indexes were analyzed. [Results] The sensitivity of com- bined detection of SCCAg,CYFRA21-1 and CEA was significantly higher than that of single marker in advanced cervical squamous cell cancer （P〈0.05）.The sensitivity of SCCAg, CYFRA21-1 and CEA in patients with stage Ⅲ or Ⅳ were significantly higher than that in pa- tients with stage Ⅱ b（P〈0.05）. The serum levels of SCCAg,CYFRA21-1 and CEA significantly decreased after chemoradiotherapy （P〈0.001）. The serum levels of SCCAg,CYFRA21-1 and CEA were significantly higher in recurrent or/and metastatic patients than those in disease-free patients （P〈0.001）,but significantly decreased in patients with complete remission （CR） and partial remission（PR） after chemoradiotherapy（P〈0.05）. [Conclusions] The combined detection of SCCAg,CYFRA21-1 and CEA is helpful for the diagnosis and monitoring prognosis in ad- vanced squarnous cell cervical cancer and recurrence cervical cancer.
出处
《肿瘤学杂志》
CAS
2013年第8期595-599,共5页
Journal of Chinese Oncology
