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目的探讨细胞角蛋白18(cytokeratin 18,CK18)在胃癌化疗疗效评价中的临床意义。方法胃癌患者96例,根据化疗后是否出现转移分为转移组13例与未转移组83例,检测2组化疗前、后血清癌胚抗原(carcinoembryonic antigen,CEA)、糖链抗原(carbohydrate antigen,CA)19-9、CA72-4和CK18水平,比较2组肿瘤标志物水平,分析CK18疗效评价与客观疗效评价的一致性。结果未转移组化疗后CEA、CA72-4和CK18水平及阳性率均较化疗前明显降低(P<0.05);转移组化疗前、后CEA、CA19-9、CA72-4与CK18水平及阳性率比较差异均无统计学意义(P>0.05);化疗前、后2组CEA、CA19-9和CK18水平比较差异均有统计学意义(P<0.05);CK18高于参考值的35例患者CK18疗效评价与客观疗效评价符合率为71.43%,有较高一致性(Kappa=0.559)。结论化疗前、后血清CK18水平可作为胃癌化疗疗效的辅助评价指标。
Objective To investigate the clinical significance of cytokeratin 18 (CK18) in evaluating the curative effect of gastric cancer chemotherapy. Methods 96 cases of gastric cancer patients were divided into metastasis group (n = 13) and metastasis group (n = 83) according to the metastasis after chemotherapy. The levels of carcinoembryonic antigen (CEA), carbohydrate antigen CA) 19-9, CA72-4 and CK18 levels were compared between the two groups of tumor markers to analyze the efficacy of CK18 evaluation and objective evaluation of the consistency. Results The levels and positive rates of CEA, CA72-4 and CK18 in the non-metastatic group were significantly lower than those before chemotherapy (P <0.05). The levels of CEA, CA19-9, CA72-4 and CK18 in the metastatic group were significantly higher than those before chemotherapy (P> 0.05). The levels of CEA, CA19-9 and CK18 in two groups before and after chemotherapy were significantly different (P <0.05). CK18 in CK18 higher than the reference value The coincidence rate of curative effect evaluation and objective curative effect evaluation was 71.43%, with a high consistency (Kappa = 0.559). Conclusions Serum CK18 level before and after chemotherapy can be used as an adjunct evaluation indicator of gastric cancer chemotherapy.