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重庆医科大学附属第一医院口腔颌面外科
纸质出版日期:2017,
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袁川淑, 杨凯, 唐洪, 等. 血清肿瘤标志物Cyfra 21-1、SCCAg、Ferritin、CEA、CA19-9和AFP对口腔/口咽鳞癌的诊断价值[J]. 重庆医科大学学报, 2017,42(9):1066-1071.
Yuan Chuanshu, Yang Kai, Tang Hong, et al. Diagnostic values of serum tumor markers Cyfra 21-1,SCCAg,Ferritin,CEA,CA19-9 and AFP for oral/oropharyngeal squamous cell carcinomas[J]. Journal of Chongqing Medical University, 2017,42(9):1066-1071.
袁川淑, 杨凯, 唐洪, 等. 血清肿瘤标志物Cyfra 21-1、SCCAg、Ferritin、CEA、CA19-9和AFP对口腔/口咽鳞癌的诊断价值[J]. 重庆医科大学学报, 2017,42(9):1066-1071. DOI: 10.13406/j.cnki.cyxb.001129.
Yuan Chuanshu, Yang Kai, Tang Hong, et al. Diagnostic values of serum tumor markers Cyfra 21-1,SCCAg,Ferritin,CEA,CA19-9 and AFP for oral/oropharyngeal squamous cell carcinomas[J]. Journal of Chongqing Medical University, 2017,42(9):1066-1071. DOI: 10.13406/j.cnki.cyxb.001129.
目的:探讨血清肿瘤标志物细胞角蛋白19片段(cytokeratin 19 fragment
Cyfra 21-1)、鳞状细胞癌抗原(squamous cell carcinoma antigen
SCCAg)、铁蛋白(Ferritin)、癌胚抗原(carcino-embryonic antigen
CEA)、糖类抗原19-9(Carbohydrate antigen
CA19-9)和甲胎蛋白(α-fetoprotein
AFP)对口腔/口咽鳞癌的诊断价值。方法:169例口腔/口咽鳞癌患者为实验组
86例口腔良性肿瘤患者为良性肿瘤对照组
30例健康人为健康人对照组
用电化学发光免疫测定法(electro chemiluminescence immunoassay
ECLIA)检测各组血清Cyfra 21-1、SCCAg、Ferritin、CEA、CA19-9、AFP的水平
数据经SPSS 21.0统计软件处理
并行ROC(receiver operator characteristic)曲线分析。结果:实验组血清Cyfra 21-1、SCCAg、Ferritin和CEA水平分别明显高于良性肿瘤对照组和健康人对照组(均P
<
0.05)
CA19-9和AFP水平在实验组、良性肿瘤对照组和健康人对照组之间无统计学差异(均P
>
0.05);早期(Ⅰ期+Ⅱ期)口腔/口咽鳞癌患者血清Cyfra 21-1水平明显高于良性肿瘤对照组和健康人对照组(均P
<
0.05)
但血清SCCAg、Ferritin、CEA、CA19-9、AFP水平分别与良性肿瘤对照组和健康人对照组无统计学差异(均P
>
0.05);中晚期(Ⅲ期+Ⅳ期)口腔/口咽鳞癌患者血清Cyfra 21-1、SCCAg、Ferritin和CEA水平分别明显高于早期口腔/口咽鳞癌患者、良性肿瘤对照组和健康人对照组(均P
<
0.05);Cyfra 21-1的ROC曲线下面积最大(AUC=0.748
95%CI=0.692
0
.805)
SCCAg、CEA和Ferritin的ROC曲线下面积依次减小(AUC分别为0.708
0.669
0.627
95%CI分别为0.647
0
.768
0.605
0
.733
0.561
0
.692);Cyfra 21-1的诊断临界点为2.17 ng/m L
敏感性为60.36%
特异性为81.03%;口腔/口咽鳞癌的分化程度越高
Cyfra 21-1的血清水平越低(rs=-0.223
P=0.004)。结论:在Cyfra 21-1、SCCAg、Ferritin、CEA、CA19-9和AFP 6种血清肿瘤标志物中
Cyfra 21-1和SCCAg对口腔/口咽鳞癌的诊断优于其他标志物
同时Cyfra 21-1对口腔/口咽鳞癌具有较好的早期诊断价值
而CA19-9和AFP对口腔/口咽鳞癌没有诊断价值。
Objective:To investigate the diagnosis value of serum tumor markers cytokeratin 19 fragment(Cyfra 21-1)
squamous cell carcinoma antigen(SCCAg)
Ferritin
carcino-embryonic antigen(CEA)
carbohydrate antigen(CA19-9)and α-fetoprotein(AFP)for patients with oral/oropharyngeal squamous cell carcinomas(OSCC/OPSCC). Methods:This study had involved in 169 patients with OSCC/OPSCC as experimental group
86 patients with oral benign tumor as control group
and 30 healthy people as normal control group. The pre-treatment serum levels of Cyfra 21-1
SCCAg
Ferritin
CEA
CA19-9
and AFP were detected by electro chemiluminescence immunoassay(ECLIA)
and then calculated with a receiver operating characteristic(ROC) curve. Results:The serum Cyfra21-1
SCCAg
Ferritin and CEA levels of OSCC/OPSCC group were significantly higher than those of control group and healthy group(all P<0.05)
while there was no significant difference in serum CA19-9 and AFP levels among the three groups(all P>0.05). The serum Cyfra 21-1 level of patients with early stage OSCC/OPSCC(Ⅰ+Ⅱphase)was significantly higher than that of control group and healthy group(all P<0.05)
but there was no significant difference in serum SCCAg
Ferritin
CEA
CA19-9 and AFP levels among the three groups(all P >0.05). Serum Cyfra21-1
SCCAg
Ferritin and CEA levels of patients with middle-late OSCC/OPSCC(Ⅲ+Ⅳphase)were significantly higher than that of early OSCC/OPSCC
control group and healthy group(all P<0.05). The area under the ROC curve of Cyfra 21-1 was the largest
while areas under the ROC curve of SCCAg
CEA and Ferritin decreased in turn(the AUC were 0.748
0.708
0.669
0.627 respectively
and the 95% CI were 0.692 to 0.805
0.647 to 0.768
0.605 to 0.733
0.561 to 0.692 respectively);the diagnostic cut-off level of Cyfra 21-1 was 2.17 ng/m L
and the sensitivity and specificity was 60.36% and 81.03% . The higher the differentiation degree of oral/oropharyngeal squamous cell carcinomas
the lower the serum level of Cyfra 21-1(rs=-0.223
P=0.004). Conclusion:In the six kinds of serum tumor markers above
serum Cyfra 21-1 and SCCAg are superior to other markers in diagnosing OSCC/OPSCC. At the same time Cyfra 21-1 had better diagnosis value for OSCC/OPSCC at early stage
whlie CA19-9 and AFP don’t.
口腔口咽鳞状细胞癌肿瘤标志物诊断
oral cavityoropharynxsquamous cell carcinomatumor markerdiagnosis
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