血清Cyfra21-1诊断卵巢恶性肿瘤的研究

Value of Serum Cyfra21-1 Assay on the Diagnosis of Ovarian Cancer

目的 :研究细胞角蛋白片段抗原 2 1- 1(Cyfra2 1 1)对卵巢恶性肿瘤诊断及疗效判断的临床意义。方法 :应用免疫放射分析法 (IRMA)测定 10 2例卵巢肿瘤患者及 2 0例正常妇女血清中Cyfra2 1 1和CA12 5的水平 ,并对 12例Cyfra2 1 1阳性的恶性组患者于术后 1周开始 ,每月 1次 ,进行 4个月血清水平的动态观察。结果 :Cyfra2 1 1诊断卵巢恶性肿瘤的敏感性、特异性、准确性分别为 80 0 %、10 0 0 %、89 0 % ,CA12 5分别为 85 0 %、6 2 .0 %、76 .0 % ,Cyfra2 1 1诊断的特异性和准确性明显高于CA12 5(P <0 .0 1,P <0 .0 5 )。上皮性癌和转移性腺癌患者血清Cyfra2 1 1含量显著高于其他组织类型 (P <0 .0 5 ) ,分化程度不同的肿瘤血清Cyfra2 1 1水平差异有非常显著性 (P <0 .0 1) ,血清Cyfra2 1 1值与临床分期显著相关 (P <0 .0 0 1)。Cyfra2 1 1浓度在术后 1周明显下降 ,术后 1个月内恢复至正常范围。下降不明显或下降后再升高者 ,提示病情进展或复发。结论 :血清Cyfra2 1 1测定对卵巢恶性肿瘤患者的早期诊断、病情监测和疗效评估有重要的临床应用价值。

Objective:To evaluate the clinical relevance of serum cytokeratin 19 fragment (Cyfra21-1) as a diagnostic and monitoring marker in ovarian cancer.Methods:Serum levels of Cyfra21-1 and CA 125 were detected in 102 patients with ovarian neoplasm and 20 healthy women by immunoradiometric assay.One week after operation,12 cases with positively preoperative Cyfra21-1 assay were followed-up and monitored monthly until four month.Results:The sensitivity,specificity,and accuracy of Cyfra21-1 and CA 125 as a diagnostic marker were 80.0%,100%,89.0% and 85.0%,62.0%,76.0%,respectively.Cyfra21-1 showed significantly higher specificity and accuracy than those of CA 125 ( P <0.01).Compared with other histological types,serum levels of Cyfra21-1 were significantly elevated in patients with epithelial cancer or metastastic adenocarcinoma( P <0.05).Cyfra21-1 assay were significantly associated with clinical stages( P <0.001) and pathological grades( P <0.01).After operation,Cyfra21-1 concentrations. After operation,Cyfra21-1 concentrations dropped obviously in one week and declined to normal range within a one month,whereas steadily high levels or re-elevated Cyfra21-1 levels predicted disease advanced or relapse.Conclusions:The measurement of Cyfra21-1 has important clinical relevance in the early diagnosis,monitoring disease status and assessing treatment in ovarian cancer.