CEA、CA125、CA19-9对食管癌诊断的临床意义
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摘要
目的探讨CEA、CA125、CA19-9对食管癌(EC)诊断的临床意义。方法 72例EC患者作为EC组,体检健康人群72例作为对照组。比较两组受试者血清CEA、CA125、CA19-9含量及阳性率,记录CEA、CA125、CA19-9联合诊断价值。结果 EC组的血清CEA、CA125、CA19-9水平均显著高于对照组(P <0. 05)。EC组的CEA、CA125、CA19-9阳性率分别为34. 7%、62. 5%、38. 9%,均显著高于对照组的4. 2%、5. 6%、6. 9%(P <0. 05)。CEA、CA125、CA19-9联合检测对EC的诊断敏感性为86. 3%,特异性为85. 7%,准确性为89. 1%。随访结果显示,EC组72例患者中死亡12例,死亡率为16. 7%,多因素Cox比例风险模型结果分析显示,CEA、CA125、CA19-9均是影响EC患者预后的主要独立危险因素(P <0. 05)。结论 CEA、CA125、CA19-9在EC患者中呈现高表达状况,联合检测对于EC的诊断效果好,可有效预测患者的预后死亡情况,有很好的检测价值。
Objective To investigate the clinical significance of CEA,CA125 and CA19-9 in the diagnosis of esophageal carcinoma( EC). Methods 72 cases of EC patients were selected as the EC group,72 healthy people were selected as the control group. Serum CEA,CA125 and CA19-9 levels and positive rates between two groups were compared. The combined diagnostic value of CEA,CA125 and CA19-9 was recorded. Results The serum levels of CEA,CA125 and CA19-9 in EC group were significantly higher than those in control group,compared the difference were statistically significant( P < 0. 05). The positive rates of CEA,CA125 and CA19-9 in the EC group were 34. 7%,62. 5% and 38. 9%,respectively,while those in the control group were4. 2%,5. 6% and 6. 9%,which the observation group were significantly higher in the observation group than in the control group( P < 0. 05). The sensitivity of joint detection of CEA,CA125 and CA19-9 for EC were 86. 3%,85. 7% and 89. 1% respectively.All patients were followed up to date,there were 12 patients were died with a mortality rate of 16. 7%. The analysis of multiple factor Cox proportional risk models showed that CEA,CA125 and CA19-9 were the main independent risk factors affecting the prognosis of EC patients( P < 0. 05). Conclusion The expression of CEA,CA125 and CA19-9 in the patients with EC were high,and the joint detection of EC is good for the diagnosis of EC,and they can predict the mortality of the patients effectively,and have good detection values.
Objective To investigate the clinical significance of CEA,CA125 and CA19-9 in the diagnosis of esophageal carcinoma( EC). Methods 72 cases of EC patients were selected as the EC group,72 healthy people were selected as the control group. Serum CEA,CA125 and CA19-9 levels and positive rates between two groups were compared. The combined diagnostic value of CEA,CA125 and CA19-9 was recorded. Results The serum levels of CEA,CA125 and CA19-9 in EC group were significantly higher than those in control group,compared the difference were statistically significant( P < 0. 05). The positive rates of CEA,CA125 and CA19-9 in the EC group were 34. 7%,62. 5% and 38. 9%,respectively,while those in the control group were4. 2%,5. 6% and 6. 9%,which the observation group were significantly higher in the observation group than in the control group( P < 0. 05). The sensitivity of joint detection of CEA,CA125 and CA19-9 for EC were 86. 3%,85. 7% and 89. 1% respectively.All patients were followed up to date,there were 12 patients were died with a mortality rate of 16. 7%. The analysis of multiple factor Cox proportional risk models showed that CEA,CA125 and CA19-9 were the main independent risk factors affecting the prognosis of EC patients( P < 0. 05). Conclusion The expression of CEA,CA125 and CA19-9 in the patients with EC were high,and the joint detection of EC is good for the diagnosis of EC,and they can predict the mortality of the patients effectively,and have good detection values.
引文
[1]Fernandes E,Peixoto A,Neves M,et al.Humoral response against sialyl-Le(a)glycosylated protein species in esophageal cancer:Insights for immunoproteomic studies[J].Electrophoresis,2015,36(23):2902-2907.
[2]Nozaki Y,Nishida T,Hori Y,et al.Chemoradiotherapy is effective for primaryesophageal adenosquamous cell carcinoma but ineffective for the metastaticadenocarcinoma component[J].Nihon Shokakibyo Gakkai Zasshi,2015,112(2):278-286.
[3]朱娜,彭建美,袁军.CEA、AFP、CA-199和CA72-4联合检测在食管癌诊断中的价值[J].陕西医学杂志,2018,47(1):120-122.
[4]许畅,李文晶,丁磊.Claudin-7在肿瘤干细胞中的研究进展[J].医学综述,2017,23(17):3373-3377.
[5]Yanoma T,Fukuchi M,Sakurai S,et al.Granular cell tumor of the esophagus with elevated preoperative serum carbohydrate antigen 19-9:a case report[J].Int Surg,2015,100(2):365-369.
[6]Jing JX,Wang Y,Xu XQ,et al.Tumor markers for diagnosis,monitoring of recurrence and prognosis in patients with upper gastrointestinal tract cancer[J].Asian Pac J Cancer Prev,2014,15(23):10267-10272.
[7]梁敏,付茂勇,王烈,等.全腔镜食管癌根治术联合TP化疗方案对食管癌患者血清肿瘤相关因子及survivin蛋白表达的[J].中国医药导报,2017,14(23):75-79.
[8]Acharya A,Markar SR,Matar M,et al.Use of tumor markers in gastrointestinal cancers:surgeon perceptions and costbenefit trade-off analysis[J].Ann Surg Oncol,2017,24(5):1165-1173.
[9]Luo T,Chen W,Wang L,et al.CA125 is a potential biomarker to predict surgically incurable gastric and cardia cancer:A retrospective study[J].Medicine(Baltimore),2016,95(51):e5297.
[10]Zhao H,Chen W,Wu J,et al.Clinical significance of preoperative serum tumor markers in esophageal squamous cell carcinoma[J].J Cancer Res Ther,2014,10(Suppl):C179-C185.
[11]宁超,马遇庆,杜靖.Rock2和Wnt11在食管癌细胞系中的表达及意义[J].医学研究生学报,2017,30(1):10-13.
[12]Nakamura T,Ide H,Eguchi R,Hayashi K,et al.CYFRA21-1 as a tumor marker for squamous cell carcinoma of the esophagus[J].Dis Esophagus,2017,11(1):35-39.
[13]Acharya A,Markar SR,Matar M,et al.Use of tumor markers in gastrointestinal cancers:surgeon perceptions and costbenefit trade-off analysis[J].Ann Surg Oncol,2017,24(5):1165-1173.
[14]祝铖,李莲.食管癌外周血循环肿瘤细胞检测的临床价值[J].中国癌症防治杂志,2017,9(3):233-235.
[15]Zhang H,Li H,Ma Q,et al.Predicting malignant transformation of esophageal squamous cell lesions by combined biomarkers in an endoscopic screening program[J].World JGastroenterol,2016,22(39):8770-8778.
[16]Zhang F,Chen Z,Wang P,et al.Combination of platelet count and mean platelet volume(COP-MPV)predicts postoperative prognosis in both resectable early and advanced stage esophageal squamous cell cancer patients[J].Tumour Biol,2016,37(7):9323-9331.
[17]赵安,郭利伟,陈爱萍,等.肿瘤外泌体:诊断与治疗[J].中国肿瘤,2017,26(3):190-195.
[18]Ma Z,Wu X,Xu B,et al.Development of a novel biomarker model for predicting preoperative lymph node metastatic extent in esophageal squamous cell carcinoma[J].Oncotarget,2017,8(62):105790-105799.
[19]Koshikawa N,Minegishi T,Kiyokawa H,et al.Specific detection of soluble Eph A2 fragments in blood as a new biomarker for pancreatic cancer[J].Cell Death Dis,2017,8(10):e3134.
[20]张冬云,李夏,库建伟,等.CD56 Cg A Syn在92例原发食管小细胞癌中的表达及临床意义和预后分析[J].中国肿瘤临床,2017,44(5):204-209.
[21]Tokunaga R,Imamura Y,Nakamura K,et al.Carbohydrate antigen 19-9 is a useful prognostic marker in esophagogastric junction adenocarcinoma[J].Cancer Med,2015,4(11):1659-1666.
[22]Shida A,Futawatari N,Fukuyama T,et al.Frequent high expression of kita-kyushu lung cancer antigen-1(KK-LC-1)in gastric cancer[J].Anticancer Res,2015,35(6):3575-3579.
[23]孙雅文,王家林.食管癌诊断中代谢组学应用进展[J].中华肿瘤防治杂志,2017,24(14):1021-1024.
[24]Bagaria B,Sood S,Sharma R,et al.Comparative study of CEA and CA19-9 in esophageal,gastric and colon cancers individually and in combination(ROC curve analysis)[J].Cancer Biol Med,2013,10(3):148-157.
[2]Nozaki Y,Nishida T,Hori Y,et al.Chemoradiotherapy is effective for primaryesophageal adenosquamous cell carcinoma but ineffective for the metastaticadenocarcinoma component[J].Nihon Shokakibyo Gakkai Zasshi,2015,112(2):278-286.
[3]朱娜,彭建美,袁军.CEA、AFP、CA-199和CA72-4联合检测在食管癌诊断中的价值[J].陕西医学杂志,2018,47(1):120-122.
[4]许畅,李文晶,丁磊.Claudin-7在肿瘤干细胞中的研究进展[J].医学综述,2017,23(17):3373-3377.
[5]Yanoma T,Fukuchi M,Sakurai S,et al.Granular cell tumor of the esophagus with elevated preoperative serum carbohydrate antigen 19-9:a case report[J].Int Surg,2015,100(2):365-369.
[6]Jing JX,Wang Y,Xu XQ,et al.Tumor markers for diagnosis,monitoring of recurrence and prognosis in patients with upper gastrointestinal tract cancer[J].Asian Pac J Cancer Prev,2014,15(23):10267-10272.
[7]梁敏,付茂勇,王烈,等.全腔镜食管癌根治术联合TP化疗方案对食管癌患者血清肿瘤相关因子及survivin蛋白表达的[J].中国医药导报,2017,14(23):75-79.
[8]Acharya A,Markar SR,Matar M,et al.Use of tumor markers in gastrointestinal cancers:surgeon perceptions and costbenefit trade-off analysis[J].Ann Surg Oncol,2017,24(5):1165-1173.
[9]Luo T,Chen W,Wang L,et al.CA125 is a potential biomarker to predict surgically incurable gastric and cardia cancer:A retrospective study[J].Medicine(Baltimore),2016,95(51):e5297.
[10]Zhao H,Chen W,Wu J,et al.Clinical significance of preoperative serum tumor markers in esophageal squamous cell carcinoma[J].J Cancer Res Ther,2014,10(Suppl):C179-C185.
[11]宁超,马遇庆,杜靖.Rock2和Wnt11在食管癌细胞系中的表达及意义[J].医学研究生学报,2017,30(1):10-13.
[12]Nakamura T,Ide H,Eguchi R,Hayashi K,et al.CYFRA21-1 as a tumor marker for squamous cell carcinoma of the esophagus[J].Dis Esophagus,2017,11(1):35-39.
[13]Acharya A,Markar SR,Matar M,et al.Use of tumor markers in gastrointestinal cancers:surgeon perceptions and costbenefit trade-off analysis[J].Ann Surg Oncol,2017,24(5):1165-1173.
[14]祝铖,李莲.食管癌外周血循环肿瘤细胞检测的临床价值[J].中国癌症防治杂志,2017,9(3):233-235.
[15]Zhang H,Li H,Ma Q,et al.Predicting malignant transformation of esophageal squamous cell lesions by combined biomarkers in an endoscopic screening program[J].World JGastroenterol,2016,22(39):8770-8778.
[16]Zhang F,Chen Z,Wang P,et al.Combination of platelet count and mean platelet volume(COP-MPV)predicts postoperative prognosis in both resectable early and advanced stage esophageal squamous cell cancer patients[J].Tumour Biol,2016,37(7):9323-9331.
[17]赵安,郭利伟,陈爱萍,等.肿瘤外泌体:诊断与治疗[J].中国肿瘤,2017,26(3):190-195.
[18]Ma Z,Wu X,Xu B,et al.Development of a novel biomarker model for predicting preoperative lymph node metastatic extent in esophageal squamous cell carcinoma[J].Oncotarget,2017,8(62):105790-105799.
[19]Koshikawa N,Minegishi T,Kiyokawa H,et al.Specific detection of soluble Eph A2 fragments in blood as a new biomarker for pancreatic cancer[J].Cell Death Dis,2017,8(10):e3134.
[20]张冬云,李夏,库建伟,等.CD56 Cg A Syn在92例原发食管小细胞癌中的表达及临床意义和预后分析[J].中国肿瘤临床,2017,44(5):204-209.
[21]Tokunaga R,Imamura Y,Nakamura K,et al.Carbohydrate antigen 19-9 is a useful prognostic marker in esophagogastric junction adenocarcinoma[J].Cancer Med,2015,4(11):1659-1666.
[22]Shida A,Futawatari N,Fukuyama T,et al.Frequent high expression of kita-kyushu lung cancer antigen-1(KK-LC-1)in gastric cancer[J].Anticancer Res,2015,35(6):3575-3579.
[23]孙雅文,王家林.食管癌诊断中代谢组学应用进展[J].中华肿瘤防治杂志,2017,24(14):1021-1024.
[24]Bagaria B,Sood S,Sharma R,et al.Comparative study of CEA and CA19-9 in esophageal,gastric and colon cancers individually and in combination(ROC curve analysis)[J].Cancer Biol Med,2013,10(3):148-157.