肿瘤标志物Cyfra211在初治原发子宫颈鳞癌诊治中的意义

Clinical significance of tumor marker Cyfra211 in the diagnosis and treatment of primary squamous carcinoma of cervix

目的分析肿瘤标志物细胞角蛋白19片段抗原(Cyfra211)在初治原发宫颈鳞癌诊治中的临床意义。方法回顾性分析99例初治原发宫颈鳞癌住院患者(宫颈鳞癌组)的临床资料,年龄为(55±8)岁,采用电化学法检测治疗前后血清Cyfra211水平,并设立宫颈非鳞癌组(n=99)和正常对照组(n=100),采用电化学法检测血清Cyfra211水平。采用Mann-Whitney U检验分析各组Cyfra211水平的差异;通过ROC曲线分析血清Cyfra211诊断宫颈鳞癌的效能;通过Spearman相关性分析,分析治疗前后Cyfra211与宫颈鳞癌FIGO分期、宫颈鳞癌细胞分化程度及宫颈鳞癌3年随访结果相关性。结果宫颈鳞癌组Cyfra211水平显著高于宫颈非鳞癌组和正常对照组,差异有统计学意义(Mann-Whitney U值分别为1 810.00和752.50,P均<0.05);当Cyfra211值为4.04 ng/m L时有较理想的灵敏度和特异度,分别为80.80%和78.40%。治疗前患者Cyfra211水平高低与宫颈鳞癌患者FIGO分期和细胞分化程度成等级正相关关系(相关系数R分别为0.248和0.287,均P<0.05);而治疗前后Cyfra211变化率仅与细胞分化程度成等级正相关关系(相关系数R为0.237,P<0.05);不论是治疗前后Cyfra211水平还是治疗前后Cyfra211变化率与宫颈鳞癌患者3年随访结果均未发现有相关关系(相关系数R分别为0.110、0.027和0.125,P均>0.05)。结论血清Cyfra211水平可作为宫颈鳞癌鉴别诊断的标准;治疗前Cyfra211水平与宫颈鳞癌患者FIGO分期和细胞分化程度存在等级正相关关系,治疗前后Cyfra211变化率与癌细胞分化程度存在等级正相关关系。

Objective To investigate the clinical significance of tumor marker Cyfra211 in the diagnosis and treatment of primary squamous carcinoma of cervix(SCC）. Methods Clinical data of 99 cases of untreated primary SCC patients in the Department Gynecologic oncology of Henan Cancer Hospital from January 2014 to December 2016 were retrospectively reviewed,whose average age was 55 years with range from 25 to 76 years. Non-squamous carcinoma of cervix(non-SCC） control group and normal control group were set up. The levels of serum Cyfra211 before and after treatment were determined by electrochemical method. Mann-Whitney U test was used to analyze the difference of Cyfra211 levels among each group. The efficacy of serum Cyfra211 in diagnosis of SCC was analyzed by ROC curve. The correlations between Cyfra211 before and after treatment and FIGO staging,the degree of cell differentiation and 3 years of follow-up of SCC were analyzed by Spearman correlation analysis. Results The Cyfra211 level of ESCC group was significantly higher than those of non-SCC group and normal control group(Mann-Whitney U value： 1810. 00 and 752. 50,P〈 0. 05）. When the Cyfra211 value was 4. 04 ng/ml,the sensitivity(80. 80%） and specificity(78. 40%） were ideal. The level of Cyfra211 before treatment was positively correlated with the stage of FIGO and the degree of cell differentiation in patients with SCC(R： 0. 248 and 0. 287,P 〈0. 05）. The rate of Cyfra211 change was only positively correlated with the degree of cell differentiation before and after treatment(R： 0. 237,P〈 0. 05）. The Cyfra211 levels before and after the treatment or the rate of Cyfra211 change had no correlation with SCC 3 years follow-up results(R： 0. 110,0. 027 and 0.125,P 〉0. 05）. Conclusion The serum Cyfra211 level can be used as a standard for differential diagnosis of SCC.There is a positive correlation between the level of Cyfra211 and the stage of FIGO and the degree of cell differentiation in patients with SCC before and after treatment,and the rate of Cyfra211 change has positive correlation with the degree of differentiation of cancer cells.