宫颈癌患者手术前后血清TK1检测的临床意义

The Clinical Significance of Serum Thymidine Kinase 1 in Patients with Cervical Cancer Pre-and Post-operation

[目的]探讨血清胸苷激酶1(thymidine kinase 1,TK1)在宫颈癌筛查、诊断及治疗中的作用。[方法]采用免疫印迹增强化学发光法检测125例宫颈癌患者手术前后血清TK1、鳞状细胞癌相关抗原(squamous cell carcinoma-related antigen,SCC-Ag)、肿瘤抗原125(cancer anti-gen 125,CA125)浓度,并对TK1与SCC-Ag、CA125作为宫颈癌诊断指标的相关参数进行评估。[结果]TK1浓度与细胞分化程度、FIGO分期明显相关,均有统计学意义(P<0.05)。与正常对照组比较,宫颈癌组术前TK1浓度增高约4.8倍,SCC-Ag增高约4.2倍,CA125浓度增高约2.1倍,均有显著性差异(P<0.05)。手术切除肿瘤后,TK1浓度与术前比较明显降低(P<0.05)。血清TK1浓度的假阳性率低于CA125,特异性、阳性预测值均高于CA125,但无统计学意义(P>0.05)。SCC-Ag的假阳性率、假阴性率低于TK1,敏感性、特异性、阳性预测值和阴性预测值均高于TK1,而有统计学意义的是假阴性率和敏感性(P<0.05)。在125例宫颈癌中,SCC-Ag诊断为假阴性的24例病例中14例为TK1阳性。[结论]TK1是一种高效灵敏的肿瘤标志物,与SCC-Ag、CA125等指标联合检测有望成为宫颈癌筛查的有效指标,在宫颈癌诊断及病情监测等方面发挥重要作用。

[Purpose] To investigate the role of serum thymidine kinase 1（TK1） in screening,diagnosis and treatment for cervical cancer.[Methods] The serum TKl,squamous cell carcinoma-related antigen（SCC-Ag） and cancer antigen 125（CA125） in 135 cases with cervical cancer were detected by enhanced chemiluminescence assay（ECLA） pre-and post-operation.The serum TK1,SCC-Ag and CA125 were evaluated as markers of cervical cancer diagnosis.[Results] The expression of TK1 was significantly correlated to cell differentiation and FIGO staging（P0.05）.The preoperative levels of TK1,SCC-Ag and CA125 in patients with cervical cancer were 4.8 times,4.2 times and 2.1 times to the control group,respectively（P0.05）.TK1 level post-operation decreased significantly compared to pre-operation（P0.05）.The false positive rate of TK1 was lower than that of CA125,but the specificity and positive predictive value of serum TK1 were higher than those of CA125,with no statistical significance（P0.05）.The false positive rate,false negative rate of serum SCC-Ag were lower than those of TK1,but the sensitivity,specificity,positive predictive value and negative predictive value were higher than those of TK1,of which the false positive rate and sensitivity had statistical significance（P0.05）.Among 125 cervical cancer patients,there were 24 negative results for SCC-Ag,but in which 14 were positive for TK1.[Conclusion] TK1 is a highly efficient and sensitive tumor marker.It plays an important role not only in screening,but also in diagnosis and monitoring for cervical cancer when combined with SCC-Ag and CA125.