CA724、CA242及AFP在肝癌TACE治疗前后的表达变化及临床意义

Analysis of the dynamic changes and clinic significance of serum CA724, CA242 and AFP levels before and after TACE treatment of primary hepatic carcinoma

目的观察血清CA724、CA242及甲胎蛋白(AFP)在原发性肝癌患者肝动脉化疗栓塞术(TACE)治疗前后的变化及临床意义。方法选取原发性肝癌患者(原发性肝癌组)45例及健康对照者(健康对照组)40例,应用电化学发光免疫分析法检测健康对照组及肝癌患者在TACE术前2 d、术后1周和1个月时血清CA724、CA242及AFP,分析3个指标的相关性及与临床资料间的关系,观察肝癌患者AFP<400μg/L与AFP≥400μg/L组中血清CA724、CA242在手术前后的变化。结果原发性肝癌组术前血清CA724、CA242及AFP含量均高于健康对照组(P<0.05),血清CA724、AFP阳性率高于健康对照组(P<0.01)。原发性肝癌组AFP在TACE治疗后1周及1个月均较治疗前2 d降低(P<0.01),CA724在治疗后1个月低于治疗前(P<0.05),而CA242差异无统计学意义(P>0.05)。原发性肝癌患者血清CA724及AFP的表达与肿瘤大小有关(P<0.05)。术后1个月,AFP<400μg/L与AFP≥400μg/L组CA724均较术前下降(P<0.05)。CA724与AFP的表达呈正相关(r=0.754,P<0.05)。结论血清CA724可作为协助评价肝癌TACE术后疗效的肿瘤标志物之一。

Objective To investigate the change of serum CA724, CA242 and AFP levels before and after transcatheter artery chemoembolization （TACE） treatment of primary hepatic carcinoma（PHC）patients as well as its clinic significance. Methods Patients of PHC （n=45） and healthy adults （n=40） were enrolled. Serum samples were collected from each healthy people and PHC patients 2 days before TACE,l week and 1 month after TACE. Electrochemiluminescence Immunoassay （ECLI） was used to determine serum CA724, CA242 and AFP levels, and correlations among three indexes as well as their relationships with clinical data were also analysed., Change of serum CA724 and CA242 levels before and after TACE were compared in AFP〈400μg/L group and AFP≥400μg/L group. Results Serum levels of CA724, CA242 and AFP in PHC group were significantly higher than that in healthy control groups before TACE therapy（P〈0.05）. Positive rates of serum CA724 and AFP were higher in PHC group（P〈0.01）than that in healthy control group. AFP decreased significantly at both 1 week and 1 month upon TACE treatment compared with that at before teratment（P〈0.01）. CA724 was significantly lower at one month after treatment than that at before treatment（P〈0.05）. But there was no significant difference in CA242 before and after treatment（P＆gt;0.05）. CA724 and AFP expressions are associated with tumor size（P〈0.05）. After one month of therapy, serum CA724 level was obviously decreased in both AFP〈400μg/L and AFP≥400μg/L groups. Before and after TACE therapy, there was a positive correlation between the expression of AFP and CA724（r=0.754,P〈0.05）. Conclusion Serum CA724 can be used as one of the tumor markers to assist the evaluation of curative effect of TACE on PHC.