摘要目的 通过检测食管癌放疗前后血清肿瘤标志物癌胚抗原(CEA)、鳞状上皮细胞癌相关抗原(SCC)和细胞角化素蛋白片段19(CYFRA21-1)水平的变化.探讨食管癌放疗前后多种生物标志物联合检测的临床意义.方法 收集初治食管癌患者226例,采用酶联免疫吸附法检测放疗前后食管癌患者血清CEA、SCC和cYFRA21-1水平,通过SPSS13.0软件进行统计学处理.结果 226例食管癌患者放疗前CEA、SCC和CYFRA21-1的阳性率分别为11.1%、16.8%、27.4%,联合检测阳性率39.8%.病变长度愈长,病期愈晚,肿瘤浸润愈深.CEA、SCC、CYFRA21-1血清总体平均水平愈高,早期患者水平较低.三者中CEA和CYFRA21-1的个体差异较大,CYFRA21-1与食管癌病理分期、放疗疗效相关性最好.90例阳性患者放疗后76.7%的患者标志物水平下降至正常值.结论 血清CEA、SCC、CYFRA21-1联合检测可用于食管癌的辅助诊断,对疗效和预后判断有较好的临床应用价值.

abstractsObjective To investigate the clinical significance of combined detection of serum CEA, SCC, CYFRA21-1 before and after radiotherapy in esophagus carcinoma. Methods 226 cases of esophagus carcinoma patient were collected from November, 2006 to December, 2008. ELISA was used to detect the serum CEA, SCC and CYFRA21-1 of patients with esophagus cancer before and after radiotherapy. SPSS13.0 was used for the statistical analysis. Results The positive rate of CEA, SCC and CYFRA21-1 was 11.1 %, 16.8%, 27.4 %, respectively and the combined positive rate was 39.8 % from 226 patient serums before radiotherapy. The longer the lesion length, the later the clinical stage,the deeper the tumor invasion, the higher the mean value of serum CEA, SCC, CYFRA21-1 was. The mean value was lower in the early stage. The mean value of CEA, SCC and CYFRA21-1 was found to be well correlated with tumor size, TNM stage and depth of tumor invasion. Among three tumor biomarkers, the individual difference of CEA and CYFRA21-1 was bigger and the pathological stage and prognosis correlation with CYFRA21-1 was the best. The biomarker value dropped to the level below the normal in 76.7% patient out of 90 cases after radiotherapy. Conclusion The combined detection of serum CEA, SCC, CYFRA21-1 may be used as adjuvant diagnosis for esophagus cancer and has better clinical value for prediction to treatment and prognosis.