CYFRA21-1在局部晚期鼻咽癌治疗前后检测的意义

Significance of Detecting Serum CYFRA21-1 in the Nasopharyngeal Carcinoma Before and After Chemotherapy

目的探讨局部晚期鼻咽癌患者治疗前后细胞角蛋白19片段水平变化的临床意义。方法经病理证实的局部晚期鼻咽癌患者43例,测定治疗前细胞角蛋白19片段水平与临床特征的关系,并对细胞角蛋白19片段化放疗前后的水平进行配对比较。结果 43例患者的治疗前细胞角蛋白19片段水平为3.72 ng/m L,阳性率为58.1%,与N分期有相关性,与年龄、性别、T分期、总分期、既往吸烟史无关。20例患者于诱导化疗两周期后进行了复查,诱导化疗前细胞角蛋白19片段水平为3.98 ng/m L,阳性率为60.0%;诱导化疗两周期后复查细胞角蛋白19片段水平为3.74 ng/m L,阳性率为55.0%,诱导化疗前后比较,P>0.05,无显著性差异。另有20例患者于诱导化疗两周期后根治性放疗结束时进行了复查,化放疗前细胞角蛋白19片段为3.97 ng/m L,阳性率为60%,诱导化疗加根治性放疗结束时复查为2.20 ng/m L,阳性率为15%,治疗前后比较,P<0.05),有显著性差异。结论细胞角蛋白19片段水平诱导化疗前后无明显变化,化放疗后显著降低,治疗前细胞角蛋白19片段水平的高低可能与N分期有关,但其影响因素尚有待进一步研究。

Objective To study clinical significance the patients with locally advanced nasopharyngeal carcinoma cy- tokeratin 19 fragment level changes before and after the treatment. Methods A retrospective analysis of 43 cases con- firmed by pathology in patients with locally advanced nasopharyngeal carcinoma, and explore the treatment of cytokeratin 19 fragment level before the relationship with the clinical features, and cytokeratin 19 fragment level paired comparison be- fore and after the radiotherapy. Results 43 patients of cytokeratin 19 fragment level before treatment was 3.72 ng/mL, positive rate is 58.1%, has correlation with N stage, with age, sex, T stage, total installment, history of smoking. In 20 pa- tients induced after 2 cycles of chemotherapy has carried on the review, induction chemotherapy before cytokeratin 19 frag- ment level of 3.98 ng/mL, the positive rate is 60.0%; induction chemotherapy after two periodic review cytokeratin 19 frag- ment level of 3.74 ng/mL, positive rate was 55.0%, there was no statistically significant difference （P〉0.05）. Another 20 pa- tients at the end of induction chemotherapy ＋ 2 cycle radical radiotherapy has carried on the review, prior to the radiothera- py cytokeratin 19 fragment was 3.97 ng/mL, positive rate was 60%, the induction chemotherapy plus radical radiation at the end of the review was 2.20 ng/mL, the positive rate was 15%, the difference was statistically significant （P〈 0.05）. Con- clusion cytokeratin 19 fragment level no obvious change before and after in duction chemotherapy,the radiotherapy significantly reduced after treatment before the level of cytokeratin 19 fragment may be associated with N staging, but its influence remains to be further studied.