SCC、CEA及CYFRA211三者联合检测对早期宫颈癌筛查的临床意义研究

Study on the Clinical Significance of Combined Detection of SCC,CEA and CYFRA211 For Cervical Cancer Screening

目的探讨血清鳞状细胞癌抗原(squamous cell carcinomaantigen,SCC)、癌胚抗原(carcinoembryonic antigen,CEA)及细胞角蛋白19片段(CYFRA211)三者联合检测,对早期宫颈癌筛查的临床意义.方法选取来本院进行宫颈癌筛查的高危人群108例患者,根据病理诊断结果分为宫颈癌组67例和宫颈良性疾病组41例;选取同一时期来体检的健康人82例作为对照组,经TCT检验为正常宫颈,均采集周围静脉血3~5 mL,采用化学发光法测定血清SCC、CYFRA211和CEA的含量.结果在血清SCC、CYFRA211及CEA含量上,宫颈癌组高于宫颈良性疾病组和对照组,宫颈良性疾病组高于对照组,差异有统计学意义(P<0.05).在血清SCC、CYFRA211及CEA含量上,低分化组高于中分化组和高分化组,中分化组高于高分化组,差异有统计学意义(P<0.05).在血清SCC、CYFRA211含量上,鳞癌组高于腺癌组和鳞腺癌组,在血清CEA含量上,腺癌组高于鳞癌组和鳞腺癌组,差异有统计学意义(P<0.05).腺癌组和鳞腺癌组之间血清SCC、CYFRA211含量比较差异无统计学意义,鳞癌组和鳞腺癌组之间血清CEA含量比较差异无统计学意义.采用三者联合检测为早期宫颈癌筛查标准时,敏感度、特异度、阳性预测值、阴性预测值均高于血清SCC、CEA及CYFRA211单项检测,差异有统计学意义(P<0.05).结论血清SCC、CEA及CYFRA211三者联合检测对早期宫颈癌筛查具有临床意义,有助于早期宫颈癌的分化程度及病理分型鉴别.

Objective To explore the clinical significance of combined detection of SCC,CEA and CYFRA211 for early cervical cancer screening.Methods 108 patients with high risk of cervical cancer screened in our hospital were divided into cervical cancer group(67 cases)and Cervix benign disease group(41 cases),and 82 healthy people who had physical examinationin our hospital at the same period were selected as the control group,and the normal cervix was tested by TCT test.3-5mL blood were collectedfrom all ofsubjects,and levels of squamous cell carcinomaantigen(SCC),cytokeratin 19 fragment(CYFRA211)and carcinoembryonic antigen(CEA)were measured by chemiluminescence.The serum SCC,CEA and CYFRA211 single item detection or joint detection of tumor markers to the cervix in the cervix was compared.Results Levels of serum SCC,CYFRA211 and CEA in the cervical cancer group were higher than those of the benign cervical disease group and the control group,and the cervical benign disease group were higher than the control group,the difference were statistically significant(P<0.05).The serum levels of SCC,CYFRA211 and CEA in the low differentiation group were higher than the middle differentiation group and the high differentiation group,and the middle differentiation group was higher than the high differentiation group,and the difference was statistically significant(P<0.05).Serum SCC and CYFRA211 levels in squamous carcinoma group were higher than adenocarcinoma group and squamous adenocarcinoma group,serum CEA level in adenocarcinoma group were higher than squamous carcinoma group and squamous adenocarcinoma group(P<0.05).There was no difference in serum SCC and CYFRA211 between adenocarcinoma group and squamous adenocarcinoma group.There was no difference in serum CEA between squamous carcinoma group and squamous adenocarcinoma group.The sensitivity,specificity,positive predictive value and negative predictive value were higher than those of single detection of serum SCC,CEA or CYFRA211,and the difference was statistically significant(P<0.05)when the three groups were combined to detect the cervical cancer screening standard.Conclusion The combined detection of serum SCC,CEA and CYFRA211 has clinical significance for early cervical cancer screening,and is helpful for differentiation of early cervical cancer and differential diagnosis of pathological types.