血清骨胶素、癌胚抗原、抗原199在食管癌中的表达特点及诊断价值

Expression characteristics and diagnostic value of serum collagen,carcinoembryonic antigen and antigen 199 in esophageal cancer

目的探讨血清骨胶素(CYFRA 21-1)、癌胚抗原(CEA)、抗原199(CA199)在食管癌患者中的表达及意义。方法选取经手术后病理学证实的食管癌患者90例(食管癌组)、健康体检者90例(对照组),检测2组血清CYFRA 21-1、CEA、CA 199水平,将食管癌患者根据TNM分期、分化程度、是否发生淋巴结转移进行亚组分析,并计算诊断价值。结果食管癌组患者的血清CYFRA 21-1、CEA、CA 199水平显著高于对照组(P<0.05);TNM分期Ⅲ期+Ⅳ期、低分化、发生淋巴结转移的食管癌患者的血清CYFRA 21-1、CEA、CA 199水平均显著高于TNM分期Ⅰ期+Ⅱ期、分化程度高+中、未发生淋巴结转移的食管癌患者(P<0.05);血清CYFRA 21-1、CEA、CA 199联合检测诊断食管癌的灵敏度为80.00%,特异度为94.44%,漏诊率为20.00%,误诊率为5.56%。结论 CYFRA 21-1、CEA、CA 199在食管癌患者血清中显著升高,三者联合应用对于食管癌的鉴别诊断具有重要价值。

Objective To investigate the changes and clinical significance of CYFRA 21-1,CEA and CA199 in patients with esophageal cancer.Methods patients with esophageal cancer（esophageal cancer group） and 90 healthy subjects（control group） were enrolled in this study.Serum levels of CYFRA 21-1,CEA,and CA 199 were measured in two groups.Patients with esophageal cancer were subdivided according to TNM stage,differentiation,and lymph node metastasis condition,and the diagnostic value was calculated.Results The serum levels of CYFRA 21-1,CEA and CA 199 in patients with esophageal cancer were significantly higher than that in the control group（P 0.05）.The levels of above indicators in esophageal cancer patients with poorly differentiation,lymphatic metastasis in Ⅲ and Ⅳstages were significantly higher than those in Ⅰ,Ⅱ phase of TNM staging,high and mild differentiation,and without lymph node metastasis（P 0.05）.The sensitivity and specificity,missed diagnosis rate,misdiagnosis rate of combined detection of CYFRA 21-1,CEA,CA 199 levels for esophageal cancer were 80.00%,94.44%,20.00%,5.56%,respectively.Conclusion The levels of CYFRA 21-1,CEA,CA 199 in patients with esophageal cancer serum are significantly increased,and the combination detection of above three indicators has significant diagnosis value.