鼻咽癌患者血清细胞角蛋白19片段检测的临床价值

Clinical values of serum cytokeratin-19 fragment in nasopharyngeal carcinoma

目的探讨血清细胞角蛋白19片段(CYFRA21-1)作为鼻咽癌(NPC)诊断及治疗预后标志物的临床价值。方法收集2013年7月~2016年7月在本院就诊的NPC患者336例,收集年龄、性别匹配的健康体检人群208例作为健康对照组。同时在纳入的NPC患者中随机随访100例,于治疗前及治疗后3个月各收集外周血1次,其中10例分别在放疗前及放疗5、10、15、20、25、30次时收集外周血。采用电化学发光法检测血清中的CYFRA21-1。结果 NPC患者血清CYFRA21-1水平为(4.12±3.23)ng/m L,显著高于健康对照组的(2.15±0.94)ng/m L(t=10.507,P<0.001)。CYFRA21-1的受试者工作特征曲线(ROC曲线)诊断NPC的曲线下面积为0.765(最佳临界值为2.61,灵敏度为63.10%,特异度为79.33%,P<0.001)。NPC患者治疗后血清CYFRA21-1水平为(2.93±3.61)ng/m L,明显低于治疗前的(4.10±3.83)ng/m L(P=0.020 3),并随放疗次数的增加而呈下降趋势。结论血清CYFRA21-1可作为NPC诊断和疗效监测的有效参考指标。

Objective To evaluate the clinical values of serum cytokeratin-19 fragment （CYFRA21-1） for the diagnosis and prognosis of nasopharyng-eal carcinoma（NPC）.Methods Electrochemiluminescence immunoassay was used to measure the serum CYFRA21-1 in untreated patients with NPC（n =336） and in the age and sex-matched healthy control group（n=208）.One hundred NPC patients were randomly chosen and followed up, whose blood was collected before and 3 months after the treatment.Among them,the blood of 10 cases were collected before the treatment and after the 5th,10th,15th, 20th,25th and 30th radiotherapy.Results Compared with the healthy controls （2.15±0.94 ng/mL）,the level of serum CYFRA21-1 in the patients with NPC （4.12±3.23 ng/rnL）was ignificantly elevated （t=10.507,P〈0.001）.The area of receiver operating characteristic curve（ROC curve） was 0.765（best cut-off value was 2.61,sensitivity was 63.10%,specitivity was 79.33%,P〈0.001）.The level of serum CYFRA21-1 after the treatment（2.93±3.61ng/mL） was significantly lower than that before treatment （4.10±3.83 ng/mL,P=0.020 3）.And the level of serum CYFRA21-1 was in a downtrend with the increasing numbers of radiotherapies.Conclusions The level of serum CYFRA21-1 is an effective reference for the diagnosis and treatment of NPC.