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目的检测血清鳞状细胞癌抗原(SCCA)、细胞角蛋白19片段抗原21-1(CYFRA21-1)、组织多肽特异性抗原(TPS)在宫颈鳞癌的表达,分析其在化疗疗效评价中的意义。方法宫颈鳞癌患者31例,健康对照组30例,采用酶联免疫吸附法(ELISA)检测血清SCCA、CYFRA21-1、TPS水平,并比较3项指标在两组人员中的差异及在宫颈癌患者组中化疗前后的变化。结果①宫颈癌组血清SCCA、CYFRA21-1、TPS水平明显高于健康对照组(P<0.01)。宫颈鳞癌患者中,血清SCCA、CYFRA21-1、TPS诊断敏感性分别为70.00%、48.00%、86.21%,特异性均为100%。TPS诊断敏感性明显高于SCCA、CYFRA21-1(P<0.05)。SCCA和TPS联合及三者联合诊断敏感性提高,分别为96.43%、95.83%。②SCCA在不同临床分期表达差异均无统计学意义(P>0.05),在中或高分化组表达明显高于低分化组(P<0.05),与有无淋巴结转移无关(P>0.05)。CYFRA21-1、TPS在Ⅲ+Ⅳ期表达明显高于Ⅰ+Ⅱ期(P<0.05),与肿瘤分化程度无关(P>0.05)。对有无淋巴结转移,CYFRA21-1的表达差异无统计学意义(P>0.05),而TPS表达差异有统计学意义(P<0.05)。③化疗有效(CR+PR)的患者中,化疗后血清SCCA、TPS较化疗前明显下降(P<0.05),CYFRA21-1化疗后下降,但差异无统计学意义(P>0.05)。化疗后病情稳定(SD)或进展(PD)的患者中,化疗前后血清SCCA、CYFRA21-1、TPS水平均无明显差异(P>0.05)。结论 SCCA、CYFRA21-1、TPS检测对宫颈鳞癌的诊断具有一定意义,SCCA、TPS水平变化在化疗疗效评估方面具有一定指导作用。
Objective To detect the expression of serum squamous cell carcinoma antigen (SCCA), cytokeratin 19 fragment antigen 21-1 (CYFRA21-1) and tissue polypeptide specific antigen (TPS) in cervical squamous cell carcinoma significance. Methods Thirty-one patients with cervical squamous cell carcinoma and 30 healthy controls were enrolled in this study. Serum levels of SCCA, CYFRA21-1 and TPS were measured by enzyme-linked immunosorbent assay (ELISA). The differences of the three indexes between the two groups were compared. Changes in patient group before and after chemotherapy. Results ① The levels of SCCA, CYFRA21-1 and TPS in cervical cancer group were significantly higher than those in healthy control group (P <0.01). In cervical squamous cell carcinoma, the diagnostic sensitivity of serum SCCA, CYFRA21-1 and TPS were 70.00%, 48.00% and 86.21% respectively, and the specificity was 100%. The diagnostic sensitivity of TPS was significantly higher than that of SCCA and CYFRA21-1 (P <0.05). SCCA and TPS combination and the combination of the three diagnostic sensitivity increased, respectively, 96.43%, 95.83%. There was no significant difference in the expression of SCC between different clinical stages (P> 0.05). The expression of SCC in moderate or high differentiated group was significantly higher than that in poorly differentiated group (P <0.05), but not with or without lymph node metastasis (P> 0.05). The expression of CYFRA21-1 and TPS in stage Ⅲ + Ⅳ was significantly higher than that in stage Ⅰ + Ⅱ (P <0.05), but not with the degree of tumor differentiation (P> 0.05). There was no significant difference in the expression of CYFRA21-1 between lymph node metastasis and non-lymph node metastasis (P> 0.05), but the difference of TPS expression was statistically significant (P <0.05). ③ In patients with chemotherapy-induced (CR + PR), the serum levels of SCCA and TPS were significantly decreased (P <0.05) before chemotherapy and decreased after chemotherapy with CYFRA21-1, but the difference was not statistically significant (P> 0.05). There were no significant differences in serum SCCA, CYFRA21-1 and TPS levels between patients with stable disease (SD) and progression (PD) after chemotherapy (P> 0.05). Conclusion The detection of SCCA, CYFRA21-1 and TPS is of certain significance for the diagnosis of cervical squamous cell carcinoma. The changes of SCCA and TPS levels may play a guiding role in evaluating the curative effect of chemotherapy.