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目的:探讨细胞角蛋白19片段(CYFRA21-1)在食管鳞状细胞癌诊断中的应用价值。方法:采用电化学发光法分别检测健康对照组(45例)和初次诊断食管鳞状细胞癌患者(90例)血清中CYFRA21-1和癌胚抗原(CEA)质量浓度,并对患者进行随访,出现淋巴结转移和(或)远处转移者再次检测血清中CYFRA21-1和CEA质量的浓度。结果:食管磷状细胞癌组CYFRA21-1和CEA质量浓度明显高于对照组[分别为(3.81±1.7)μg·L-1比(1.15±0.68)μg·L-1,(7.36±3.5)μg·L-1比(1.34±0.65)μg·L-1,均P<0.05]。食管磷状细胞癌组出现淋巴结转移和(或)远处转移者CYFRA21-1和CEA质量浓度高于初次诊断时[分别为(4.93±0.83)μg·L-1比(2.04±0.29)μg·L-1,(16±2.96)μg·L-1比(7.55±1.23)μg·L-1],差异具有统计学意义(均P<0.05)。初次诊断食管鳞癌患者CYFRA21-1阳性率(56.7%,51/90)高于CEA(20.0%,18/90),差异有统计学意义(χ2=25.59,P<0.01);出现淋巴结转移和远处转移的患者CYFRA21-1阳性率(71.1%,32/45)高于CEA(26.7%,12/45),差异有统计学意义(χ2=17.79,P<0.01)。结论:血清CYFRA21-1对食管鳞状细胞癌诊断和判断预后方面比CEA更优。
Objective: To investigate the value of cytokeratin 19 (CYFRA21-1) in the diagnosis of esophageal squamous cell carcinoma. Methods: The serum levels of CYFRA21-1 and CEA in healthy control group (45 cases) and primary esophageal squamous cell carcinoma patients (90 cases) were detected by electrochemiluminescence. The patients were followed up, Serum levels of CYFRA21-1 and CEA were again tested in patients with lymph node metastases and / or distant metastases. Results: The concentrations of CYFRA21-1 and CEA in esophageal squamous cell carcinoma were significantly higher than those in the control group [(3.81 ± 1.7) μg · L -1 (1.15 ± 0.68) μg · L -1, (7.36 ± 3.5) μg · L-1 ratio (1.34 ± 0.65) μg · L-1, all P <0.05]. The concentrations of CYFRA21-1 and CEA in patients with esophageal squamous cell carcinoma were higher than those at initial diagnosis [(4.93 ± 0.83) μg · L -1 (2.04 ± 0.29) μg · L-1, (16 ± 2.96) μg · L-1 (7.55 ± 1.23) μg · L-1, respectively), the difference was statistically significant (all P <0.05). The positive rate of CYFRA21-1 in the first diagnosis of esophageal squamous cell carcinoma (56.7%, 51/90) was significantly higher than that in CEA (20.0%, 18/90) (χ2 = 25.59, P <0.01) The positive rate of CYFRA21-1 (71.1%, 32/45) in distant metastasis patients was higher than that in CEA patients (26.7%, 12/45). The difference was statistically significant (χ2 = 17.79, P <0.01). Conclusion: Serum CYFRA21-1 is superior to CEA in the diagnosis and prognosis of esophageal squamous cell carcinoma.