血清 TAM 和 Cyfra21-1检测在食管癌诊断和化疗疗效判定中的价值

Value of Detecting Serum TAM and Cyfra21-1 Levels in the Diagnosis and Chemotherapeutic Efficacy of Esophageal Cancer

目的：探讨血清肿瘤相关物质（tumor associated material，TAM）和角化素蛋白片段19（Cyfra21-1）检测在食管癌诊断和化疗疗效判定中的价值。方法选取2012年9月～2013年9月92例初诊食管癌和术后复发食管癌病人为研究对象，以同时期健康体检者为对照组，分别测定其血清 TAM 和 Cyfra21-1水平，计算检测指标的灵敏度和特异度。另外，收集2012年9月～2014年4月化疗前血清 TAM 和 Cyfra21-1均升高食管癌患者60例，化疗2周期后再次检测 TAM 和Cyfra21-1水平，以有效患者指标下降，进展患者指标上升计算判定符合率。结果92例初诊和术后复发食管癌患者，血清 TAM 升高66例，Cyfra21-1升高47例，灵敏度分别为71.7％和51.1％（χ2＝8.279，P ＝0.004）。对照组50例，TAM 阴性47例，Cyfra21-1阴性46例，TAM 特异度为94.0％，Cyfra21-1特异度为92.0％，差异无统计学意义（χ2＝0.154，P ＝0.695）。接受化疗患者，有效25例，进展11例，TAM 符合率为77.8％，Cyfra21-1符合率为75.0％，差异无统计学意义（χ2＝0.077，P ＝0.781）。结论TAM 和 Cyfra21-1为食管癌诊断和判定疗效的有用指标，并且 TAM 优于 Cyfra21-1。

Objective To evaluate the levels of serum TAM and Cyfra21-1 in diagnosis and chemotherapeutic efficacy assess-ment of patients with esophageal cancer.Methods The serum TAM and Cyfra21-1 levels were measured in 92 patients with initially diagnosed esophageal cancer or postoperative recurrence of esophageal cancer from September 2012 to September 2013 and 50 cases of healthy people in the same periods as control.The sensitivity and specificity of TAM and Cyfra21-1 were analyzed.Moreover,60 patients with high TAM and Cyfra21-1 levels before chemotherapy from September 2012 to A-pril 2014 were detected TAM and Cyfra21-1 levels after two cycles of chemotherapy.Relation between changes of TAM or Cyfra21-1 and chemotherapeutic efficacy were investigated.Results The diagnostic sensitivity of TAM for esophageal canc-er was 71.7%,which was higher than that of Cyfra21-1 （51.1%,P = 0.004）.The diagnostic specificity of TAM and Cy-fra21-1 for esophageal cancer was 94.0% and 92.0% respectively.There were no significantly different between TAM and Cyfra21-1 （P =0.695）.Of patients undergoing chemotherapy,the overall response was 25 cases,progress was 11 cases. There was no statistically significant difference in the coincidence rate of TAM and Cyfra21-1 （77.8% vs 75.0%,P =0.781）.Conclusion Detection of serum TAM and CYFRA21-1 was valuable in the diagnosis and assessment of the thera-peutic efficacy of chemotherapy in patients with esophageal carcinoma.TAM was better than Cyfra21-1 in the diagnosis of e-sophageal carcinoma.