人血清半胱氨酸蛋白酶抑制剂S及肿瘤标志物在口腔颌面部恶性肿瘤中的诊断价值

Diagnostic values of human serum cysteine protease inhibitor S and tumor markers in oral and maxillofacial malignancies

目的:探讨人血清半胱氨酸蛋白酶抑制剂S(CST4)、鳞状上皮细胞癌抗原(SCC)、糖类抗原19-9(CA19-9)、可溶性细胞角蛋白组分(CYFRA21-1)在口腔颌面部恶性肿瘤中的诊断价值。方法:选取2022年1—11月于河北医科大学第四医院治疗的232例口腔颌面部恶性肿瘤患者、49例口腔颌面部良性肿瘤患者以及同时期的40例健康体检者为研究对象,分析上述3组人群血清CST4、SCC、CA19-9和CYFRA21-1表达水平,制作ROC曲线评价不同指标对口腔颌面部恶性肿瘤的诊断效能。结果:口腔颌面部恶性肿瘤组的血清CST4、SCC、CYFRA21-1中位数水平明显高于良性肿瘤组和健康对照组,差异均具有统计学意义(P<0.05)。不同部位及不同病理类型口腔颌面部恶性肿瘤患者血清CST4的表达水平无明显差异(P>0.05)。ROC曲线显示血清CST4检测对口腔颌面部恶性肿瘤的诊断价值较高(AUC=0.954,敏感度为97.5%,特异度为78.45%,截断值为74.68 ng/mL),且CST4、SCC和CYFRA21-1三者联合检测对口腔颌面部恶性肿瘤的临床诊断效能更高。结论:血清CST4、SCC和CYFRA21-1在口腔颌面部恶性肿瘤中均高表达,与单独检测血清肿瘤标志物相比,三者联合检测对口腔颌面部恶性肿瘤的诊断具有较高的参考价值,可推荐作为口腔颌面部恶性肿瘤辅助诊断的肿瘤标志物。

OBJECTIVE:To investigate diagnostic values of human serum cysteine protease inhibitor S(CST4),squamous cell carcinoma antigen(SCC),carbohydrate antigen 199(CA19-9)and soluble cytokeratin component(CYFRA21-1)in oral and maxillofacial malignant tumors.METHODS:A total of 232 patients with oral and maxillofacial malignancies tumors who were admitted to our hospital from January 2022 to November 2022,and 40 healthy physical examination subjects were selected during the same period as the research objects.Serum levels of CST4,SCC,CA19-9 and CYFRA21-1 from them were analyzed.ROC curve was developed to evaluate diagnostic efficacy of the different indexes.RESULTS:The serum median levels of CST4,SCC and CYFRA21-1 in the malignant tumor group were significantly higher than those in the benign tumor group and the healthy control group(P<0.05).There was no difference in expression levels of CST4 in patients with malignant tumors at different sites and pathological types(P>0.05).ROC curve showed that serum CST4 detection had a high diagnostic value for the tumors(AUC=0.954,sensitivity 97.5%,specificity 78.45%,cut off value 74.68 ng/mL).However,the combined detections of CST4,SCC and CYFRA21-1 were more effective and specific in the clinical diagnosis of the malignant tumors.CONCLUSION:Serum CST4,SCC and CYFRA21-1 were highly expressed in oral and maxillofacial malignant tumors.Compared with the single detection of serum tumor markers,the combined detection of the three had higher reference value in the diagnosis of malignant tumors,and can be recommended as useful tumor markers.