肿瘤异常蛋白和癌胚抗原在恶性肿瘤患者中的表达及其与化疗疗效的相关性

Study on the expression of TAP and CEA in patients with malignant tumor and their correlation with the efficacy of chemotherapy

目的探讨肿瘤异常蛋白(TAP)、癌胚抗原(CEA)在恶性肿瘤患者中的表达及其与化疗疗效的相关性,以分析其对患者化疗疗效的指导意义。方法回顾性选取2014年6月至2016年6月河北省沧州市中心医院收治的恶性肿瘤患者100例作为恶性组,同期选取良性肿瘤患者100例作为良性组,同期选取100例健康人员作为对照组,所有研究对象均取手指末梢血测定TAP、CEA水平,恶性组在化疗治疗后再行TAP、CEA检测。比较三组TAP、CEA水平,比较恶性组化疗前后TAP、CEA水平。结果恶性组、良性组、对照组TAP和CEA水平分别为(175.36±20.34)μm^2、(85.64±11.24)μm^2、(80.42±10.24)μm^2和(37.45±4.55)ng/ml、(3.45±0.56)ng/ml、(1.26±0.34)ng/ml,TAP和CEA阳性率分别90.00%、15.00%、8.00%和94.00%、10.00%、0.00%,三组比较差异具有统计学意义(P<0.001)。化疗后,恶性组完全缓解(CR)20例(20.00%)、部分缓解(PR)66例(66.00%)、稳定(SD)10例(10.00%)、进展(PD)4例(4.00%);在TAP、CEA水平方面,CR和PR患者化疗后[(134.25±15.36)μm^2、(10.34±2.42)ng/ml和(150.21±18.77)μm^2、(16.75±3.02)ng/ml]较化疗前[(172.36±26.34)μm^2、(38.21±7.82)ng/ml和(177.52±28.42)μm^2、(39.12±7.92)ng/ml]显著下降,下降值分别为(38.45±4.74)μm^2、(28.12±3.66)ng/ml和(27.01±4.03)μm^2、(23.14±3.24)ng/ml(P<0.001),PD患者化疗后[(214.36±30.45)μm^2、(45.64±8.12)ng/ml]较化疗前[(168.75±26.94)μm^2、(36.75±7.88)ng/ml]明显上升,上升值为(46.75±5.89)μm^2、(9.78±1.89)ng/ml(P<0.001),SD患者化疗后[(166.37±24.57)μm^2、(35.26±7.34)ng/ml]较化疗前[(170.24±26.75)μm^2、(37.04±7.73)ng/ml]下降,下降值为(4.06±0.57)μm^2、(2.04±0.35)ng/ml,但差异均无统计学意义(P>0.05)。结论 TAP、CEA在恶性肿瘤患者中水平升高,可作为筛查恶性肿瘤及评估其化疗疗效和预后的重要指标。

Objective To explore the expression of tumor abnormal protein(TAP)and carcino-embryonic antigen(CEA)in patients with malignant tumor and their correlation with the efficacy of chemotherapy.Methods One hundred patients with malignant tumor were retrospective selected as malignant group during June 2014 to June 2017 in Cangzhou Central Hospital of Hebei province,100 patients with benign tumor were selected as benign group,at the same period 100 healthy persons were selected as control group,the blood levels of TAP and CEA were detected by taking peripheral blood in all subjects,and the blood levels of TAP and CEA were detected again after chemotherapy in malignant group.The blood levels of TAP and CEA were compared between these three groups,the blood levels of TAP and CEA were compared before and after chemotherapy in malignant group.Results The blood levels of TAP and CEA in malignant group,benign group and control group were(175.36±20.34)μm 2,(85.64±11.24)μm 2,(80.42±10.24)μm 2 and(37.45±4.55)ng/ml,(3.45±0.56)ng/ml,(1.26±0.34)ng/ml,and positive rates of TAP and CEA were 90.00%,15.00%,8.00%and 94.00%,10.00%,0.00%,respectively,and the difference was statistically significant in these three groups(P<0.001).After chemotherapy,patients in the malignant group were completely relieved(CR)in 20 cases(20.00%),partial relief(PR)in 66 cases(66.00%),stable disease(SD)in 10 cases(10.00%),and progressive disease(PD)in 4 cases(4.00%).In the blood levels of TAP and CEA,and levels of CR and PR in patients after chemotherapy[(134.25±15.36)μm 2,(10.34±2.42)ng/ml and(150.21±18.77)μm 2,(16.75±3.02)ng/mll]were significantly decreased than those before treatment[(172.36±26.34)μm 2,(38.21±7.82)ng/ml and(177.52±28.42)μm 2,(39.12±7.92)ng/ml],the decline figures were(38.45±4.74)μm 2,(28.12±3.66)ng/ml and(27.01±4.03)μm 2,(23.14±3.24)ng/ml,respectively,(P<0.001),PD patients after chemotherapy[(214.36±30.45)μm 2,(45.64±8.12)ng/ml respectively]were significantly increased than those before treatment[(168.75±26.94)μm 2、(36.75±7.88)ng/ml],the increased figures were(46.75±5.89)μm 2,(9.78±1.89)ng/ml respectively(P<0.001),those in SD patients after chemotherapy,[(166.37±24.57)μm 2,(35.26±7.34)ng/ml]were dropped than them before treatment[(170.24±26.75)μm 2,(37.04±7.73)ng/ml],and the decline value was(4.06±0.57)μm 2,(2.04±0.35)ng/ml respectively,but the comparison in difference was all not statistically significacet(P>0.05).Conclusion Blood levels of TAP and CEA are elevated in patients with malignant tumor,they can be used as important indicators for screening malignant tumor and evaluation of its efficacy and prognosis.