血清肿瘤标志物联合检测在食管癌诊断中的临床意义

Clinical Significance of Combined Detection of Serum Tumor Markers in Diagnosis of Esophageal Cancer

目的研究肿瘤标志物癌胚抗原(CEA)、糖链抗原(CA199)、鳞状细胞相关抗原(SCC)、细胞角蛋白19片段相关抗原(CYFRA21-1)单项检测及联合检测对食管癌的诊断意义。方法选取2019年10月至2021年2月于河南科技大学第一附属医院确诊为食管癌的患者共75例,同期于我院体检的健康人群70例。采用电化学发光免疫分析法检测两组血清CEA、CA199、SCC、CYFRA21-1表达水平,食管癌组不同分期4种血清肿瘤标志物表达水平,食管癌组在不同分化程度中4种血清肿瘤标志物表达水平以及食管癌组4种血清肿瘤标志物单项检测与联合检测敏感度与特异度分析。采用SPSS 22.0软件进行统计学分析。结果食管癌组CEA、SCC、CYFRA21-1表达水平高于对照组,差异有统计学意义(P<0.05)。在食管癌组中,Ⅲ~Ⅳ期患者CEA、CYFRA21-1表达水平高于Ⅰ~Ⅱ期,差异有统计学意义(P<0.05)。食管癌组4项指标单项检测对食管癌的诊断均有较高的特异度,但敏感度和准确度不高,4项指标联合检测可显著提高其准确度,差异有统计学意义(P<0.05)。结论血清CEA、CA199、SCC、CYFRA21-1联合检测可明显提高食管癌诊断的准确度,具有一定临床应用价值。

Objective To study the significance of single and combined detection of tumor markers carcinoembryonic antigen(CEA),sugar chain antigen(CA199),squamous cell associated antigen(SCC)and cytokeratin 19 fragment associated antigen(CYFRA21-1)in the diagnosis of esophageal cancer.Methods 75 patients diagnosed with esophageal cancer in our hospital from October 2019 to February 2021 were selected as observation group,and 70 healthy people for health checkup were selected as control group.Electrochemical luminescence immunoassay was used to detect the expression levels of serum CEA,CA199,SCC,CYFRA21-1 of two groups;the expression levels of 4 serum tumor markers in different differentiation processes of esophageal cancer group,and the sensitivity and specificity of single and combined detection of 4 serum tumor markers in this group were analyzed.SPSS22.0 software was used for statistical analysis.Results The expression levels of CEA,SCC and CYFRA21-1 in esophageal cancer group were significantly higher than those in control group(P<0.05).In esophageal cancer group,the expression levels of CEA and CYFRA21-1 in patients with stageⅢ~Ⅳwere significantly higher than those in patients with stageⅠ~Ⅱ(P<0.05),and the single detection of4 indicators had high specificity for the diagnosis of esophageal cancer,but the sensitivity and accuracy were not high.The combined detection of four indicators could significantly improve its accuracy(P<0.05).Conclusion The combined detection of serum CEA,CA199,SCC and CYFRA21-1 can significantly improve the accuracy of diagnosis of esophageal cancer and has certain clinical application value.