非小细胞肺癌患者血清CYFRA21-1、VEGF及CEA的表达及与临床病理特征的相关性研究

目的:研究非小细胞肺癌(NSCLC)患者血清细胞角蛋白19片段(CYFRA21-1)、血管内皮生长因子(VEGF)、癌胚抗原(CEA)的表达及与临床病理特征的相关性。方法:选取2015年12月至2016年4月在我院接受治疗的NSCLC患者120例作为观察组,另选取同期在我院接受治疗的肺部良性病变患者50例作为良性对照组,比较两组患者血清中CYFRA21-1、VEGF及CEA的表达,分析观察组患者血清中CYFRA21-1、VEGF及CEA的表达与临床病理特征之间的关系,采用Pearson相关系数分析观察组患者血清中CYFRA21-1、VEGF、CEA的相关性。结果:观察组患者血清中的CYFRA21-1、VEGF及CEA水平均高于良性对照组(P0.05)。鳞状细胞癌患者血清中CYFRA21-1水平高于腺癌患者,CEA水平低于腺癌患者(P0.05),鳞状细胞癌患者和腺癌患者血清中VEGF水平比较无统计学差异(P0.05)。TNM分期为III-IV期的观察组患者血清中CYFRA21-1、VEGF及CEA水平均明显高于I-II期患者,有统计学差异(P0.05)。经Pearson相关系数分析显示,观察组患者血清中CYFRA21-1与VEGF、CEA呈正相关(r=0.512,0.423,P=0.000,0.000),VEGF与CEA呈正相关(r=0.452,P=0.000)。结论:NSCLC患者血清中CYFRA21-1、VEGF及CEA呈高表达,且CYFRA21-1、CEA与病理类型和TNM分期有关,VEGF与TNM分期有关,且三种指标存在一定的相关性。     

血清及胸腔积液中CA19-9、SCC-Ag及CYFRA21-1对肺癌诊断意义的对比研究

目的:探讨肺癌患者血清及胸腔积液中的糖蛋白抗原19-9(CA19-9)、鳞状细胞癌抗原(SCC-Ag)和细胞角蛋白19片段(CYFRA21-1)对肺癌的诊断意义。方法:选取2016年1月到2017年6月在我院接受治疗的肺癌患者67例作为肺癌组,另选取我院同期收治的肺良性病变患者55例纳入良性病变组。采用电化学发光法检测并对比两组患者血清及胸腔积液中的CA19-9、SCC-Ag和CYFRA21-1水平,比较所有研究对象血清及胸腔积液中CA19-9、SCC-Ag和CYFRA21-1的阳性率并分析其诊断价值。结果:肺癌组患者血清及胸腔积液中的CA19-9、SCC-Ag和CYFRA21-1水平显著高于良性病变组,有统计学差异(P0.05)。CA19-9、SCC-Ag和CYFRA21-1在胸腔积液中的阳性率高于在血清中的阳性率,有统计学差异(P0.05)。胸腔积液中CA19-9、SCC-Ag和CYFRA21-1单项检测对肺癌的灵敏度显著高于血清检测,血清及胸腔积液中CA19-9、SCC-Ag和CYFRA21-1三项联合检测的灵敏度、特异性、阳性预测值均高于单项检测,差异均有统计学意义(P0.05)。结论:肺癌患者血清及胸腔积液中CA19-9、SCC-Ag和CYFRA21-1呈现高表达,三项指标联合检测可提高诊断肺癌的灵敏度、特异性和阳性预测值。     

CYFRA21-1 and CEA are useful markers for predicting the sensitivity to chemoradiotherapy of esophageal squamous cell carcinoma

Background: Chemoradiotherapy (CRT) is currently performed for patients with advanced esophageal carcinoma. Sensitivity of tumours to CRT differs from one case to another and may be influenced by the expression of biological molecules. The aim of this study was to identify biological markers which could predict sensitivities of esophageal squamous cell carcinoma (ESCC) to CRT.

Methods: A total of 84 patients with stage I–IV ESCC were evaluated. The cytokeratin 19 fragment antigen 21-1 (CYFRA21-1) and carcinoembryonic antigen (CEA) levels were measured before CRT by enzyme-linked immunosorbent assays in patients with primary ESCCs using 3.4?ng ml^?1 and 3.3?ng ml^?1, respectively, as cut-off values. The relationships between pretreatment expression of CYFRA 21-1 and CEA and the effectiveness of CRT were analysed.

Results: The complete response (CR) rates of the primary tumours estimated by computed tomography in patients with high levels of CYFRA21-1 and CEA were 10% (3/30) and 4.2% (1/24), while in cases with low CYFRA21-1 and CEA the CR rates were 50% (27/54) and 48.3% (29/60), respectively (p?=?0.002 and 0.003). The effective rates (CR+PR) in CYFRA21-1 high and low groups were 60% (18/30) and 96.3% (52/54), while in CEA high and low groups they were 58.3% (14/24) and 93.3% (56/60), respectively (p?=?0.013 and 0.013).

Conclusion: CYFRA21-1 and CEA may be helpful in predicting the responsiveness in ESCC of primary lesions to CRT, although the results should be confirmed in larger, more homogeneous studies.     

CYFRA21-1 can predict the sensitivity to chemoradiotherapy of non-small-cell lung carcinoma

Background: The increasing panel of systemic therapies enables the individual management of lung cancer patients, even in advanced stages. However, predictive tools indicating the efficacy of chemoradiotherapy (CRT) are badly needed.

Aims: To determine the tumour markers for predicting the therapeutic effect in non-small-cell lung carcinoma (NSCLC) patients treated with CRT.

Methods: The serum levels of cytokeratin 19 fragment antigen 21-1 (CYFRA21-1), neurone-specific enolase (NSE) and carcinoembryonic antigen (CEA) were measured before CRT by enzyme-linked immunosorbent assays, while the tumour responses were assessed according to the World Health Organization (WHO) response criteria. The relationships between pretreatment expression of CYFRA21-1, NSE, CEA and the effectiveness of CRT were analysed.

Results: The complete response (CR) rate of the primary tumours estimated by computed tomography in patients with high levels of CYFRA21-1 was 2.9% (2/68) while in cases with low CYFRA21-1 it was 20.3% (12/59) (p?=?0.005). The effective rates (CR+PR) in CYFRA21-1 high and low groups were 52.9% (36/68) and 72.9% (43/59), respectively (p?=?0.022).

Conclusions: CYFRA21-1 may be a reliable surrogate marker of CRT efficacy in patients with NSCLC.     

肺癌患者血清CEA、CYFRA21-1和NSE的检测及临床意义

目的探讨外周血癌胚抗原(CEA)、细胞角蛋白19片段(CYFRA21-1)和神经元特异性烯醇化酶(NSE)的检测对肺癌的诊断、病理分型和疗效判断的临床用价值。方法采用化学发光法检测了62例肺癌患者、54例良性肺部疾病患者、36例健康人、40例肺癌患者手术前后血清CEA、CYFRA21-1和NSE的水平。结果肺癌患者手术前血清CEA、CYFRA21-1和NSE的含量明显高于良性肺部疾病组及正常对照组(P0.01)。鳞癌组、腺癌组和小细胞癌组之间肿瘤标志物CEA、CYFRA21-1和NSE水平差异有统计学意义。CEA阳性率以腺癌组最高(84%),CYFRA21-1阳性率以鳞癌组最高(85.2%),NSE阳性率以小细胞癌组最高(80.0%)。手术治疗后未复发转移组CEA、CYFRA21-1和NSE水平低于术前,而复发转移组与术前比变化不显著(P0.05)。结论血清CEA、CYFRA21-1和NSE的检测对不同病理类型肺癌患者的诊断、病情检测及疗效判断有较好的临床参考价值。     

Serum CYFRA21-1 as a prognostic marker for patients with undifferentiated nasopharyngeal carcinoma

The purpose of this study was to evaluate the potential of serum CYFRA21-1 and carcinoembryonic antigen (CEA) as prognostic markers in patients with undifferentiated nasopharyngeal carcinoma. Sixty-one patients who received definitive radiotherapy/chemoradiotherapy were analysed retrospectively. We investigated the association of the follow-up results with pretreatment level, post-treatment level and change of serum CYFRA21-1 and CEA, respectively. Patients with low pretreatment CYFRA21-1 had a significantly better overall survival. There were no significant associations among the remaining serum markers, and the survival and recurrence rates on multivariate analysis. The present study shows that pretreatment CYFRA21-1 level is a potential factor for predicting long-term survival.     

血清CEA、CA19-9、CYFRA21-1与结直肠腺癌的相关性分析

目的:探究血清癌胚抗原(carcinoembryonic antigen,CEA)、糖类抗原19-9、细胞角蛋白19片段(cytokeratin19 fragements,CYFRA21-1)与结直肠腺癌的病理相关性。方法:选择于我院接受治疗的80例结直肠腺癌患者为病例组,选择同期于我院接受治疗的50例良性结直肠病变患者为良性对照组,选择我院体格检查的50例健康个体为对照组,分别采集三组个体的血样并进行CEA、CA19-9以及CYFRA21-1水平的检测,并比对三组个体上述因子阳性表达率、因子水平,同时分析三种因子同结直肠腺癌患者TNM分期相关性,最后探究三种因子对结直肠腺癌的诊断价值。结果:(1)以CEA≥2.805μg/L、CA19-9≥39 U/m L、CYFR21-1≥3.3 ng/mL为临界值,结果显示病例组CEA阳性率51.25%,CA19-9阳性率31.25%,CYFR21-1阳性率40.00%,明显高于良性组的10.00%、20.00%和10.00%,高于对照组的8.00%、12.00%和2.00%(P<0.05);(2)比较显示病例组患者的CEA、CA19-9以及CYFR21-1水平明显高于良性对照组以及对照组(P<0.05),良性对照组CEA、CA19-9以及CYFR21-1水平明显高于对照组(P<0.05);(3)比较显示IV期结直肠腺癌患者CEA、CA19-9以及CYFRA21-1水平明显高于III期以及I+II期(P<0.05),III期三种因子水平明显高于I+II期(P<0.05);(4)CEA对结直肠腺癌诊断一致性71.25%,灵敏度65.00%,特异度90.00%;CA19-9诊断一致性46.25%,灵敏度35.00%,特异度80.00%;CYFRA21-1诊断一致性55.00%,灵敏度46.67%,特异度80.00%;联合诊断一致性95.00%,灵敏度95.00%,特异度95.00%。结论:血清CEA、CA19-9以及CYFRA21-1对结直肠腺癌具有较明确的诊断价值,不同病理分期患者中表达差异明显,可以考虑将联合诊断作为结直肠腺癌鉴别方式之一,推广于临床中。     

Diagnostic value of plasma vascular endothelial growth factor as a tumor marker in patients with non-small cell lung cancer

We assessed the diagnostic value of circulating VEGF as a tumor marker in patients with lung cancer and compared its clinical utility with that of other markers such as carcinoembryonic antigen (CEA) and cytokeratin 19 (CYFRA). One hundred and sixty non-small cell lung cancer patients and 70 healthy volunteers were included in the study. Circulating VEGF was assessed by enzyme-linked immunosorbent assay (ELISA). The serum concentrations of both CEA and CYFRA were measured by means of immunoradiometric assays. The diagnostic value of plasma VEGF (VEGFp) was better than that of CYFRA and similar to that of CEA. When the diagnostic value of VEGFp and CEA for the diagnosis of adenocarcinoma was compared, the two markers proved to have nearly equal discriminatory power. In diagnosing squamous cell carcinoma, VEGFp showed less discrimination than CYFRA. When the diagnostic value of VEGFp was analyzed for stage I adenocarcinoma patients, VEGFp was slightly more discriminatory than CEA. The combination assay of VEGFp and CEA had a sensitivity of 75% and a specificity of 60% at a cutoff of 104.4 pg/mL for VEGFp and 5.2 ng/mL for CEA. The combination of VEGF and CEA was superior to CEA alone in the early diagnosis of adenocarcinoma of the lung.     

血清CEA、NSE、CYFRA21-1 联合支气管活检在周围型肺癌诊断鉴别中的应用

目的:探讨血清肿瘤标志物癌胚抗原(CEA)、神经元特异性烯醇化酶(NSE)、细胞角蛋白19片段(CYFRA21-1)联合经纤维支气管镜肺活检(TBLB)在周围型肺癌诊断鉴别中的应用价值。方法:选择2012年9月到2014年9月在我院临床确诊的402例周围型肺癌患者。检测所有患者的血清CEA、NSE和CYFRA21-1的浓度及分析TBLB检测结果,分析不同病理类型和不同病灶直径大小时各项检测指标及联合检测的阳性检出率。结果:所有肺癌患者中,血清CEA、NSE、CYFRA21-1和TBLB的阳性检出率分别为51.74%,35.07%,41.79%和60.70%。四项指标联合检测的阳性检出率为89.05%,明显分别高于四项指标的阳性检出率(均P0.05)。腺癌、鳞癌、小细胞肺癌及其他类型肺癌组四项联合检测的阳性检出率明显高于四项单独检测(均P0.05)。病灶直径为2 cm、2-6 cm和6 cm时,四项联合检测的阳性检出率明显高于四项单独检测(均P0.05)。结论:血清CEA、NSE、CYFRA21-1联合TBLB检测周围型肺癌较单项检测,阳性检出率高,值得在临床上推广应用。     

肺癌肿瘤标志物的临床意义及研究进展

肺癌血清肿瘤标志物在肺癌的早期筛查、诊断、疗效评价、复发及预后预测等方面有重要的指导意义。本研究对目前临床常用的癌胚抗原（CEA）、神经元特异性烯醇化酶（NSE）、细胞角蛋白19片段抗原（CYFRA21—1）、鳞状细胞癌相关抗原（SCC—Ag）、乳酸脱氢酶（LDH）5种肺癌相关血清肿瘤标志物的临床意义及研究进展进行综述。     

血清肿瘤标志物检测对晚期非小细胞肺癌靶向治疗的预后分析

目的：探究检测血清肿瘤标志物对预测晚期非小细胞肺癌靶向治疗预后的影响。方法：选取2010年4月至2012年12我院收治的晚期非小细胞肺癌患者70例,均予以吉非替尼进行治疗,检测治疗前及治疗后2个月肿瘤标志物癌胚抗原CEA、角蛋白19的可溶性片段（CYFRA21—1）、癌抗原125（CA125）的表达水平,观察其表达水平与患者疗效之间的关系。结果：治疗后,患者完全缓解1例,部分缓解37例,疾病稳定19例,疾病进展13例,有效率为54．3％。治疗后,治疗有效的患者CEA、CA125明显比治疗前降低,结果具有统计学意义（P〈0．05）;而疾病稳定、疾病进展的患者治疗后CEA、CA125与治疗前比却无明显差异（P〉0．05）。治疗有效与疾病稳定的患者治疗后CYFRA21．1有明显降低,但与治疗前比却无明显差异（P〉0．05）;而疾病进展患者的CYFRA21—1却明显升高,与治疗前比有显著差异（P〈0．05）。而治疗前,治疗有效的患者血清中CEA、CA125比疾病稳定、疾病进展的患者明显较高,结果具有统计学意义（P〈0．05）;疾病稳定患者的CEA、CA125与疾病进展患者的相比,治疗有效的患者CYFRA21-1与疾病稳定、疾病进展的相比,结果均不具有统计学意义（P〉0．05）。结论：治疗前CEA、CA125浓度较高则治疗效果不错．治疗后效果较好则CEA、CA125浓度较低,效果不好则CYFRA21-1浓度较高。利用血清肿瘤标志物可显著反映肿瘤靶向药物治疗的预后情况,为临床判断其治疗效果提供依据。     

Ⅲ期非小细胞肺癌患者精确放疗前后血清CEA、SCC、NSE水平变化及与放疗疗效的关系研究

目的:研究Ⅲ期非小细胞肺癌(NSCLC)患者精确放疗前后血清癌胚抗原(CEA)、鳞状细胞癌相关抗原(SCC)、神经元特异性烯醇化酶(NSE)水平变化及与放疗疗效的关系。方法:选择2014年1月到2016年12月在亳州市人民医院肿瘤科就诊的60例Ⅲ期NSCLC患者纳入此次研究,其中鳞癌14例,腺癌26例,腺鳞癌20例。所有患者均实施4周的精确放疗,放疗后肿瘤标记物水平降低43例,升高17例。根据放疗疗效将患者分为有效组39例,无效组21例。对比不同病理类型的Ⅲ期NSCLC患者CEA、SCC、NSE水平,不同疗效组放疗前后CEA、SCC、NSE水平,并分析患者的肿瘤标记物水平变化与放疗疗效的关系。结果:腺癌Ⅲ期NSCLC患者的CEA、NSE水平高于鳞癌及腺鳞癌者,且腺鳞癌者又高于鳞癌者;SCC水平低于鳞癌及腺鳞癌者,且腺鳞癌者又低于鳞癌者(P0.05)。放疗后有效组CEA、SCC、NSE水平均低于放疗前和无效组,而无效组CEA、SCC、NSE水平高于放疗前(P0.05)。肿瘤标记物水平降低者的有效率高于升高者,差异有统计学意义(P0.05)。结论:在实施精确放疗后治疗有效的Ⅲ期NSCLC患者,其血清CEA、SCC、NSE水平均呈现出明显的下降趋势,且与病理类型密切相关,临床上可重点关注上述指标水平,有助于患者的诊疗过程。     

鼻咽癌患者血清中CYFRA21-1 和SCCAg水平检测的临床意义

目的:探讨血清中CYFRA21-1和SCCAg水平对鼻咽癌患者临床病理特征及恶性程度的评价作用。方法:选择2009年4月-2010年12月期间在我院确诊为鼻咽癌并接受放疗的55例患者作为研究的实验组,同期体检的60例健康志愿者作为研究的对照组,检测血清中CYFRA21-1和SCCAg水平以及肿瘤组织中Livin、CDK6、Caspase-3、Caspase-9的m RNA含量。结果:实验组患者血清中CYFRA21-1和SCCAg的水平显著高于对照组(P0.05);TNM分期越高、分化程度越低,血清中CYFRA21-1、SCCAg含量以及肿瘤组织中Livin、CDK6的m RNA含量越高,肿瘤组织中Caspase-3、Caspase-9的m RNA含量越低(P0.05);CYFRA21-1含量与肿瘤组织中Livin、CDK6的m RNA含量呈正相关,与Caspase-3、Caspase-9的m RNA含量呈负相关,相关系数r分别为0.723、0.693、-0.714、-0.648;SCCAg含量与肿瘤组织中Livin、CDK6的m RNA含量呈正相关,与Caspase-3、Caspase-9的m RNA含量呈负相关,相关系数r分别为0.645、0.703、-0.751、-0.681。结论:血清中CYFRA21-1和SCCAg水平能够反应鼻咽癌患者的肿瘤分期、分化程度以及肿瘤组织中细胞的增殖活力,是用于评价鼻咽癌患者临床病理特征及恶性程度的理想指标。     

血清NSE、SCCA及CEA在肺癌早期诊断和预后预测中的应用价值研究

目的:研究血清神经元特异性烯醇化酶(NSE)、鳞状细胞癌抗原(SCCA)及癌胚抗原(CEA)在肺癌早期诊断和预后预测中的应用价值。方法:选择我院2013年1月~2017年1月收治的110例肺癌患者(肺癌组)及同期96例肺部良性疾病患者(肺良性病组)和85例门诊健康体检者(对照组)。比较各组血清NSE、SCCA及CEA水平,采用受试者工作特征(ROC)曲线分析以上指标对肺癌的诊断价值。结果:肺癌组血清NSE、SCCA、CEA水平高于肺良性病组及对照组,肺良性病组血清NSE、SCCA、CEA水平高于对照组(P<0.05)。肺癌Ⅲ+Ⅳ组血清NSE、SCCA及CEA水平高于Ⅰ+Ⅱ组(P<0.05)。小细胞肺癌组血清NSE水平高于鳞癌组、腺癌组,鳞癌组血清SCCA水平高于腺癌组及小细胞肺癌组,腺癌组血清CEA水平高于鳞癌组及小细胞肺癌组(P<0.05)。NSE<16.0μg/L者平均无疾病进展生存期(PFS)长于NSE≥16.0μg/L,SCCA<1.5μg/L者平均PFS长于SCCA≥1.5μg/L,CEA<5.0μg/L平均PFS长于CEA≥5.0μg/L(P<0.05)。NSE、SCCA和CEA及三者联合诊断肺癌的ROC曲线下面积分别为0.880、0.651、0.830及0.937,NSE+SCCA+CEA联合诊断的曲线下面积高于单个指标单独诊断(P<0.05)。结论:血清NSE、SCCA及CEA对肺癌的诊断有重要的参考价值,且有利于肺癌的分期、分型及预后评价。     

Increased CYFRA 21-1, CEA and NSE are Prognostic of Poor Outcome for Locally Advanced Squamous Cell Carcinoma in Lung: A Nomogram and Recursive Partitioning Risk Stratification Analysis

OBJECTIVES: This study aimed to: (1) assess the prognostic significance of serum tumor markers in locally advanced squamous cell carcinoma in lung (LA-SCCL); (2) generate a nomogram to predict the overall survival (OS) and (3) identify a prognostic stratification to assist the therapeutic decision-making. METHODS: LA-SCCL patients receiving definitive radiotherapy and baseline tumor marker measurement were eligible for this retrospective study. Cox proportional hazards regression was used to determine independent factors associated with various survival indexes and a nomogram was created to estimate the 5-year OS probability for individual patient. The identified prognostic factors were recruited into a recursive partitioning analysis (RPA) for OS to stratify patients with distinct outcome. RESULTS: A total of 224 patients were eligible for analysis. Increased cytokeratin-19 fragment (CYFRA 21-1) was independently associated with inferior OS, progression free survival (PFS) and a borderline decreased local-regional progression free survival (LRPFS). Elevated carcino-embryonic antigen (CEA) served as an unfavorable determinant for OS and increased neuron-specific enolase (NSE) was predictive of poor distant metastasis free survival (DMFS). A nomogram integrating KPS, TNM stage, CEA and CYFRA 21-1 was created, resulting in a c-index of 0.62. RPA identified 4 prognostic classifications, with median OS of 27.6, 19.9, 17.3 and 10.9?months for low, intermediate, high and very-high risk groups, respectively. CONCLUSIONS: Baseline tumor marker panel including CYFRA 21-1, CEA and NSE can be prognostic of outcome for LA-SCCL receiving definitive radiotherapy. The RPA identified four prognostic subgroups, which could assist personalized therapy and clinical trial design in LA-SCCL.     

槐耳颗粒联合GP方案治疗晚期非小细胞肺癌的疗效及对Th1/Th2免疫平衡和血清肿瘤标志物的影响

摘要 目的：观察晚期非小细胞肺癌（NSCLC）采用吉西他滨+顺铂（GP方案）联合槐耳颗粒治疗的疗效及对Th1/Th2免疫平衡和血清肿瘤标志物的影响。方法：选取2020年01月~2022年02月期间来成都市第六人民医院接受治疗的晚期NSCLC患者80例。采用双色球法将患者分为对照组（40例,GP方案治疗）和研究组（40例,槐耳颗粒联合GP方案治疗）。对比两组临床疗效、血清肿瘤标志物[糖类抗原125（CA125）、癌胚抗原（CEA）、细胞角蛋白19片段21-1（CYFRA21-1）]、Th1/Th2免疫平衡和不良反应。结果：研究组客观缓解率、疾病控制率高于对照组（P<0.05）。两组不良反应发生率组间对比无差异（P>0.05）。研究组治疗后卡式评分（KPS）、Th1、Th1/Th2高于对照组（P<0.05）,Th2低于对照组（P<0.05）。治疗后研究组血清CA125、CYFRA21-1、CEA水平较对照组低（P<0.05）。结论：槐耳颗粒联合GP方案治疗晚期NSCLC,可有效降低血清CA125、CEA、CYFRA21-1水平,改善Th1/Th2免疫平衡,安全可靠。     

Cytokeratins as serum markers in egyptian bladder cancer. A comparison of CYFRA 21-1, TPA and TPS

Cytokeratins (CKs) have been shown to be overexpressed in bladder cancer and to be valuable as tumor markers. The present study was designed to evaluate the single and combined use of three cytokeratin fragments, CYFRA 21-1, TPA, and TPS, in serum of Egyptian bladder cancer patients. The study subjects comprised 40 healthy controls, 30 patients with benign bladder diseases, and 60 patients with histologically confirmed primary bladder cancer. The cutoff was set at 95% specificity versus benign bladder diseases, resulting in cutoff values of 2.93 ng/mL for CYFRA 21-1, 158 U/L for TPA and 143.7 ng/mL for TPS. With 41% true positive results CYFRA 21-1 had a higher sensitivity than TPA (32%) and TPS (27%). Evaluation by histological findings revealed a highest sensitivity of CYFRA 21-1 (46%) in transitional cell carcinoma (TCC) followed by TPA (27%) and TPS (21%). Also in adenocarcinoma CYFRA 21-1 showed the highest sensitivity (38%) followed by TPA (32%) and TPS (28%). A high percentage (41.6%) of Egyptian bladder cancers is represented by squamous cell carcinoma (SCC). In this population TPS showed the highest sensitivity (69%), followed by CYFRA 21-1 (54%) and TPA (41 %). The sensitivity of each of the three markers increased with advancing tumor stage and increasing tumor grade. Combined use of two of the three markers did not raise the sensitivities obtained by single determination of CYFRA 21-1. The present study suggests that serum CYFRA 21-1 could be a marker of choice in bladder cancer.     

吉非替尼联合GP化疗方案治疗晚期非小细胞肺癌的效果及对血清CEA、SCC、NSE、CYFRA21-1水平的影响

目的:研究吉非替尼联合吉西他滨和顺铂(GP)化疗方案治疗晚期非小细胞肺癌的效果及对血清癌胚抗原(Carcinoembbryonic antigen,CEA)、鳞状细胞癌相关抗原(Squamous cell carcinoma,SCC)、神经元特异烯醇化酶(Neuron-specific enolase,NSE)、细胞角蛋白19片段(Cytokeratin-19-fragment,CYFRA21-1)水平的影响。方法:选取2016年6月～2018年6月我院收治的晚期非小细胞肺癌患者110例,采用随机数字表法将患者分为两组,每组55例。对照组患者给予GP化疗方案,观察组在对照组的基础上给予吉非替尼。比较两组患者的临床治疗效果,治疗前后血清肿瘤标志物水平和生活质量的变化以及不良反应发生情况。结果:治疗后,观察组疾病控制率为86.67%,对照组为74.55%,观察组显著高于对照组(P0.05);两组治疗后血清CEA、SCC、NSE和CYFRA21-1水平均较治疗前显著下降,且观察组以上指标均显著低于对照(P0.05);两组治疗后FACT-L各项评分包括躯体状况、社会家庭状况、情感状况、肺癌特异性模块和功能状况评分均较治疗前显著升高,且观察组以上指标均显著高于对照(P0.05)。治疗期间,观察组患者白细胞减少、血小板减少、肝肾功能异常的发生率显著低于对照组(P0.05),两组贫血、恶心呕吐的发生率比较无统计学差异(P0.05)。结论:与GP化疗方案相比,吉非替尼联合GP化疗方案可更显著提高晚期非小细胞肺癌患者的治疗效果,改善其生活质量,且安全性较高,可能与其降低血清CEA、SCC、NSE和CYFRA21-1水平有关。     

孤立性肺结节患者血清CEA、NSE、Cyfra21-1水平与结节直径的关系及联合高分辨率CT的诊断价值研究

摘要 目的：研究孤立性肺结节（SPN）患者血清癌胚抗原（CEA）、神经特异性烯醇化酶（NSE）、细胞角蛋白19片段（Cyfra21-1）水平与结节直径的关系及联合高分辨率CT的诊断价值。方法：将医院从2017年3月～2020年3月期间收治的SPN患者154例纳入研究。根据术后病理检查结果分为恶性结节组104例和良性结节组50例。对所有患者均进行高分辨率CT胸部增强扫描,并比较不同结节患者的CT影像征象表现。此外,检测并比较不同结节患者的血清CEA、NSE、Cyfra21-1水平,分析血清CEA、NSE、Cyfra21-1与结节直径的关系。通过受试者工作特征（ROC）曲线分析血清CEA、NSE、Cyfra21-1水平联合高分辨率CT诊断SPN良恶性的效能。结果：肺恶性结节患者胸部CT影像征象表现为毛刺征、深分叶征、胸膜凹陷征、血管集数征、棘突征人数占比均高于良性结节,而钙化征人数占比低于良性结节（均P＜0.05）。肺恶性结节患者的血清CEA、NSE、Cyfra21-1水平均明显高于良性结节患者（均P＜0.05）。结节最大直径＞2.0 cm的SPN患者血清CEA明显高于结节最大直径1.0～2.0 cm患者,而结节最大直径1.0～2.0 cm患者血清CEA明显高于结节最大直径＜1.0c m患者（均P＜0.05）;且经Spearman相关性分析显示,血清CEA水平与SPN患者结节直径呈正相关,而血清NSE、Cyfra21-1水平与SPN患者结节直径无相关性。经ROC曲线分析可得,血清CEA、NSE、Cyfra21-1联合高分辨率CT诊断SPN良恶性的曲线下面积、灵敏度、特异度均明显高于上述各项血清学指标和高分辨率CT单独诊断。结论：SPN患者血清CEA水平与结节直径呈正相关,而血清NSE、Cyfra21-1水平与结节直径无明显相关,血清CEA、NSE、Cyfra21-1联合高分辨率CT诊断SPN良恶性的价值较高。