宫颈癌患者CEA和SCC-Ag血清水平联合检测的临床应用价值

Clinical characteristic of CEA and SCC-Ag in patients with cervical cancer

目的:探讨癌胚抗原(CEA)和鳞状细胞癌抗原(SCC-Ag)血清水平联合检测对宫颈癌患者的临床诊断、分期、分型,病理类型和疗效观察的价值。方法:采用酶联免疫吸附法(ELISA)以100名健康人做对照,检测217例宫颈癌患者,其中手术或放射治疗后119例CEA与SCC-Ag血清水平。结果:宫颈癌患者CEA与SCC-Ag血清水平明显高于健康人,P<0.01;SCC-Ag检测宫颈癌的敏感度、准确度和阴性预测值明显高于CEA,均P<0.01;宫颈癌分期(0期-Ⅲ期)CEA和SCC-Ag血清水平组间比较,均P<0.01;宫颈癌分型(糜烂型、外生型、内生型和溃疡型)CEA和SCC-Ag血清水平组间比较,均P<0.01;治疗后缓解(CR+PR)的患者CEA和SCC-Ag血清水平明显下降,P<0.01,未缓解(MR+PD)的患者明显升高,P<0.05。另外,在检测的5例宫颈腺癌患者中有4例CEA血清水平高于界值,2例SCC-Ag高于界值。结论:宫颈癌患者CEA和SCC-Ag血清水平均明显升高,SCC-Ag对宫颈癌的诊断要优于CEA,而CEA对宫颈腺癌的诊断可能是一个良好的指标。两项检测对宫颈癌的分期,分型均有临床指导意义,特别是对宫颈癌的疗效观察作用明显,有重要的参考价值。

Objective：To study the clinical characteristics of CEA and SCC -Ag in patients with cervical cancer. Methods：Serum level of CEA and SCC -Ag was measured by ELISA in 217 patients with cervical cancer, and 100 healthy subjects, 119 patients with cervical cancer before and after treatment were also measured. Results：The serum level of CEA and SCC - Ag significantly increased in patients with cervical cancer as compared to that of the healthy subjects（ P 〈 0.01 ）. The sensitivity, accuracy and NPV of diagnosis with SCC -Ag in cervical cancer patients was significantly higher than that with CEA（ P 〈0. Ol ）. Among the four stages（O - Ⅲ ） ,the serum levels of CEA and SCC - Ag were significantly different（ P 〈 0.01 ）, among the four morphologys （ erosive, Exogenous, Endogenous and ulcerative types）, the serum levels of CEA and SCC - Ag in erosive cervical cancer was significantly lower than that in the other three groups（ P 〈0.01 ）. In 88 patients with belief after treatment the levels of CEA and SCC - Ag was sig- nificantly lower than that before treatment, but in the 31 patients without belief the levels were significantly higher than that before treatment. In addition, in 5 patients with cervical adenomatous carcinoma, there was 4 patients that the CEA was higher than the cut - off value,and only 2 patients that the SCC - Ag was higher than the cut - off value. Conclusion： The serum levels of CEA and SCC - Ag in patients with cervical cancer were both increased. SCC - Ag is a more sensitive marker than CEA for the diagnosis of cervical cancer. CEA maybe a good marker for cervical adenom- atous carcinoma. Both of the two markers is useful for cervical carcinoma staging and typing, especially for treatment assessment.