头颈鳞状细胞癌患者血清Cyfra21-1检测的临床意义

Clinical significance of Cyfra21-1 in patients with squamous cell carcinoma of the head and neck

目的探讨血清Cyfra21-1在头颈鳞状细胞癌(head and neck squamous cell carcinoma,HNSCC)中的临床意义。方法采用双抗体夹心ELISA法对随机选取的60例HNSCC患者,40例甲状腺良性肿瘤患者,20名健康对照组进行血清Cyfra21-1检测。应用SPSS 11.5统计软件包进行统计分析。结果 HNSCC组术前、术后7 d,甲状腺良性肿瘤组术前、术后7 d和健康对照组血清Cyfra21-1浓度分别为(6.49±2.90)、(3.39±1.45)、(2.01±0.83)、(1.98±0.85)和(1.90±0.69)ng/ml。HNSCC组术前血清Cyfra21-1浓度明显高于甲状腺良性肿瘤组(t=4.69,P<0.01)和健康对照组(t=5.74,P<0.01),统计学均具有显著性差异。甲状腺良性肿瘤组与健康对照组之间血清Cyfra21-1浓度差异无统计学意义(t=1.21,P>0.05)。HNSCC组术后7 d血清Cyfra21-1浓度比术前明显降低,统计学有显著性差异(t=3.57,P<0.01);而甲状腺良性肿瘤组术前和术后7 d血清Cyfra21-1浓度无显著性差异(t=1.92,P>0.05)。HNSCC组术前血清Cyfra21-1浓度与肿瘤T分级(t=2.35,P<0.05)和淋巴结有无转移(t=3.16,P<0.01)均有显著性统计学差异,而与性别(t=1.81,P>0.05)和年龄(t=1.32,P>0.05)均无统计学差异。4例术后放疗后复发患者的血清Cyfra21-1浓度较术后7 d明显升高。取甲状腺良性肿瘤组95%CI上限值3.69 ng/ml为界,>3.69 ng/ml判定HNSCC的阳性诊断为标准,血清Cyfra21-1诊断HNSCC患者敏感性为80.0%,特异度为91.7%。结论血清Cyfra21-1对HNSCC的诊断、疗效评价、监测肿瘤复发和预后有一定的临床应用价值。

OBJECTIVE To evaluate the clinical significance of Cyfra 21-1 in patients with head and neck squamous cell carcinoma（HNSCC）.METHODS Before and after treatment,the serum concentration of Cyfra 21-1 was measured by ELISA assay in 60 patients with HNSCC,40 patients with benign tumors of the thyroid.Also 20 healthy adults were included in this reseach as controls.Statistical analysis was performed using SPSS11.5 statistical package.RESULTSSerum levels of Cyfra21-1 were（6.49±2.90）ng/ml in preoperative patients with HNSCC,（3.39±1.45）ng/ml in postoperative patients with HNSCC,（2.01±0.83）ng/ml in preoperative patients with benign tumors of the thyroid,（1.98±0.85）ng/ml in postoperative patients with benign tumors of the thyroid and（1.90±0.69）ng/ml in control group,respectively.Serum levels of Cyfra21-1 in preoperative patients with HNSCC were significantly higher than those of benign tumors of the thyroid（t=4.69,P0.01）and healthy controls（t=5.74,P0.01）.There was no significant difference in the concentration of serum Cyfra21-1 between the patients with benign tumors of the thyroid and the healthy controls（t=1.21,P0.05）.After operation,levels of Cyfra21-1 in HNSCC decreased significantly（t=3.57,P0.01）,but it didn＇t displayed significant difference in benign tumors of the thyroid（t=1.92,P0.05）.The serum concentrations of Cyfra 21-1 in preoperative patients with HNSCC were statistically correlated with the T-stage of the disease（t=2.35,P0.05）and nodal status（t=3.16,P0.01）,but not related to the patient age（t=1.81,P0.05）or gender（t=1.32,P0.05）.In 4 patients with local tumor recurrence during follow-up,serum Cyfra21-1 levels showed a significant increase compared with the levels after surgery.At the cutoff value of 3.69 ng/ml,the diagnostic sensitivity and specificity of Cyfra 21-1 for HNSCC were 80.0% and 91.7%,respectively.CONCLUSION CYFRA 21-1 can be used as an useful tumor marker of HNSCC in diagnosis,evaluation of therapeutic effect,monitoring of tumor recurrence and the prognosis.