血清SCCA、CYFRA21-1、TPS在宫颈鳞癌的表达及对化疗疗效评价的意义

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。

Serum levels of SCCA,CYFRA21-1 and TPS in patients with squamous cell cervical cancer and yheir value for monitoring chemotherapy effect of treating squamous cell cervical cancer

Objective To study the expression levels of squamous cell carcinoma antigen（SCCA）,cytokeration 19 fragment 21-1（CYFRA21-1） and tissue polypeptide specific antigen（TPS） in squamous cell cervical cancer（SCC）,and analyze their clinical significance in monitoring chemotherapy effect.Methods The levels of serum SCCA,CYFRA21-1 and TPS were determined by ELISA in 31 SCC patients and 30 health women.The levels of serum SCCA,CYFRA21-1 and TPS are compared between pre-and post-chemotherapy in patients of SCC.Results ①The levels of serum SCCA,CYFRA21-1 and TPS in SCC were significantly higher than those of normal group（P0.01）.The specificities of SCCA,CYFRA21-1 and TPS in diagnosing SCC were all 100%.The sensitivities of SCCA,CYFRA21-1 and TPS were 70.00%,48.00% and 86.21%,respectively.The level of TPS was significantly higher than that of SCCA and CYFRA21-1（P0.05）.The sensitivities of SCCA plus TPS and three markers was 96.43% and 95.83%,respectively.②There was no difference of SCCA level at different clinical stages（P0.05）.SCCA level was significantly higher in moderate and high differential carcinoma than that in low differential cancer（P0.05）,but there was no statistical significance between moderate and high differential carcinoma,and lymph node metastasis.The levels of CYFRA21-1 and TPS at stage Ⅲ plus Ⅳ was significantly higher than that at stage ⅠplusⅡ（P0.05）,but there was no statistical significance among the different differentiated cancer.TPS level,but not the CYFRA21-1 level showed significant difference in lymph node metastasis（P0.05）.③At post-chemotherapy,the levels of SCCA and TPS were decreased significantly than those of pre-chemotherapy in the CR and PR（P0.05）,but CYFRA21-1 level did not show the same change.The levels of SCCA,CYFRA21-1 and TPS did not show significant differences between post-and pre-chemotherapy in the SD or PD.Conclusion The serum levels of SCCA,CYFRA21-1 and TPS show a clinical significance in SCC and can be used to chemotherapy efficiency in patients with SCC.