肿瘤标志物检测评价胃肠腺癌术后患者化疗疗效

目的探讨血清角蛋白19(cytokeratin 19,CK19)、癌胚抗原(carcinoembryonic angigen,CEA)和糖链抗原(carbohydrate antigen,CA)19-9检测对胃肠腺癌复发和疗效评估的临床价值。方法 50例胃肠腺癌术后患者,根据有无复发转移分为转移组和非转移组,采用化学发光免疫分析法动态监测2组化疗前、化疗第1周期后、化疗第2周期前CK19水平,并检测化疗前和足疗程化疗后血清CEA及CA19-9水平。结果化疗前转移组CEA,CA19-9及CK19水平均明显高于非转移组(P<0.05);化疗前转移组CEA,CA19-9,CK19及3种肿瘤标志物联合检测的阳性率分别为37.50%,75.00%,75.00%,100.00%;非转移组分别为3.85%,30.77%,15.38%,42.31%,差异均有统计学意义(P<0.05);转移组与未转移组CK19中位数与总体中位数的总体偏离度(66.01%,33.3%)均明显大于CEA(61.62%,9.21%)和CA19-9(59.92%,28.40%),差异有统计学意义(P<0.05);化疗前CEA或CA19-9高于正常,经足疗程化疗后降至正常范围的肿瘤患者,与首次化疗初期动态监测CK19变化的符合率为66.7%。结论 CK19与CEA和CA19-9联合检测对胃肠腺癌术后化疗患者的预后评价有较高准确性;CK19对胃肠腺癌术后复发预测评价优于CEA和CA19-9;CK19的变化与肿瘤化疗疗效明显相关。

Tumor marker detection in estimation of chemotherapy effect on gastrointestinal adenocarcinoma after operation

Objective To evaluate the value of serum cytokeratin 19(CK19),carcinoembryonic antigen(CEA) and carbohydrate antigen 19-9(CA19-9) detection to estimation of gastrointestinal adenocarcinoma relapse and therapeutic effect.Methods Fifty postoperative patients with gastrointestinal adenocarcinoma were divided into metastasis group and non-metastasis group.The serum CK19 of the patients in two groups was detected before chemotherapy,first cycle after chemotherapy,and second cycle after chemotherapy.The serum CEA and CA19-9 levels were detected with chemiluminescence method before chemotherapy and after chemotherapy.Results The levels of CEA,CA19-9 and CK19 in metastasis group were significantly higher than those in non-metastasis group before chemotherapy(P<0.05).The positive rates of CEA,CA19-9,CK19 and combined detection of the three markers were 37.50%,75.00%,75.00% and 100.00% in metastasis group,and 3.85%,30.77%,15.38% and 42.31% in non-metastasis group before chemotherapy,which showed significant differences between two groups(P<0.05).The deviation ratio to median value of CK19 in metastasis group and non-metastasis group(66.01%,33.3%) was significantly higher than that of CEA(61.62%,9.21%) and CA19-9(59.92%,28.40%)(P<0.05).After operation 66.7% patients with high CEA or CA199 before chemotherapy and normal CEA or CA19-9 after chemotherapy,were consistent to the change of CK19 in the first chemotherapy cycle.Conclusion The combination of CK19,CEA and CA19-9 detection is more coincident in estimation the prognosis of postoperative patients with gastrointestinal adenocarcinoma.CK19 is superior to CEA or CA19-9 in estimation the relapse of postoperative patients.The change of CK19 is closely correlated with effect of chemotherapy.