SiewertⅡ型食管胃交界腺癌患者手术前后血清CYFRA21-1、CA125及SCC水平变化及其临床意义

The changes and clinical significance of serum levels of CYFRA21-1,CA125 and SCC in patients with Siewert Ⅱ type of esophagogastric junction adenocarcinoma before and after operation

目的探讨SiewertⅡ型食管胃交界腺癌患者手术前后血清肿瘤相关抗原细胞角蛋白19片段抗原21-1(CYFRA21-1)、糖类癌抗原125(CA125)及鳞状细胞癌相关抗原(SCC)水平变化及其临床意义。方法我院收治的96例SiewertⅡ型食管胃交界腺癌患者(病例组),均接受手术治疗;同期30例健康体检者(对照组)。检测两组血清CYFRA21-1、CA125及SCC水平。结果病例组术前血清CYFRA21-1、CA125及SCC水平均高于对照组(P<0. 05)。病例组术后2周、术后1月及6月血清CYFRA21-1、CA125及SCC水平均下降(P<0. 05)。不同分期患者术前、术后2周、术后1月及3月血清CYFRA21-1水平比较,差异有统计学意义(P<0. 05),血清CA125、SCC水平比较差异无统计学意义(P>0. 05)。病例组术后6月内复发21例(21. 88%),复发与未复发患者术前、术后2周血清CYFRA21-1、CA125及SCC水平比较差异无统计学意义(P>0. 05),复发患者术后1、6月血清CYFRA21-1、CA125及SCC水平高于未复发患者(P<0. 05)。结论 SiewertⅡ型食管胃交界腺癌患者血清CYFRA21-1、CA125及SCC水平明显升高,术前、术后动态检测有助于判断病情、手术效果及术后复发等。

Objective To investigate the changes and clinical significance of serum levels of cytokeratin 19-fragment antigen21-1(CYFRA21-1),carbohydrate antigen 125(CA125) and squamous cell carcinoma-related antigen(SCC) before and after operation in patients with Siewert Ⅱ type of esophagogastric junction adenocarcinoma. Methods Ninety-six patients with Siewert Ⅱ type of adenocarcinoma of esophagogastric junction were selected as case group and the patients all underwent surgery. At the same time,30 healthy volunteers enrolled in the hospital for physical examination were selected as control group.Blood samples were collected to detect serum levels of CYFRA21-1,CA125 and SCC.Results Compared with the control group,the serum levels of CYFRA21-1,CA125 and SCC were significantly higher in the case group before operation(P < 0. 05). The serum levels of CYFRA21-1,CA125 and SCC were successively decreased obviously after 2 weeks,1 month and 6 months of operation in the case group(P<0. 05).There were significant differences in serum CYFRA21-1 level before and after 2 weeks,1 month and 3 months of operation in patients with different stages(P<0. 05),but there was no significant difference in serum levels of CA125 and SCC(P> 0. 05).In the case group,there were 21 cases(21. 88%) with recurrence within 6 months after operation,and there was no statistically significant difference in serum levels of CYFRA21-1,CA125 and SCC before and after 2 weeks of operation between patients with and without recurrence(P>0. 05).However,the serum levels of CYFRA21-1,CA125 and SCC in the recurrent patients were significantly higher than those in the non-recurrent patients after 1 month and 6 months of operation(P< 0. 05). Conclusion The levels of serum CYFRA21-1,CA125 and SCC in the patients with Siewert Ⅱ type of esophagogastric junction adenocarcinoma are significantly increased.The dynamic test before and after operation is helpful to judge the disease condition,the operative effect and the postoperative recurrence.