摘要
目的:探讨血清鳞状细胞癌抗原(SCCA)、细胞角蛋白片段19抗原21-1(CYFRA21-1)水平与食管鳞状细胞癌(ESCC)患者同步放化疗近期疗效的关系。方法:ESCC患者120例,均行同步放化疗治疗并观察近期疗效,且治疗前行血清SCCA、CYFRA21-1水平的检测;采用受试者工作特征曲线(ROC)确定SCCA、CYFRA21-1的截断值,应用Logistic回归分析探究治疗前血清SCCA、CYFRA21-1与放化疗疗效的关系。结果:120例患者,完全缓解(CR)33例(27.50%),部分缓解(PR)47例(39.17%),稳定(SD)33例(27.50%),进展(PD)7例(5.83%)。缓解组80例(66.67%),未缓解组40例(33.33%)。缓解组放化疗前血清SCCA、CYFRA21-1水平均高于未缓解组(P<0.05)。ROC曲线分析显示,放化疗前血清SCCA、CYFRA21-1预测同步放化疗疗效的曲线下面积(AUC)分别为0.747、0.746,截断值分别为5.43 ng/mL、3.59 ng/mL。单因素分析显示,ESCC患者同步放化疗近期疗效与年龄、性别、肿瘤位置、临床分期、肿瘤直径和有无淋巴结转移均无相关性(P>0.05);与放化疗前血清SCCA、CYFRA21-1水平具有相关性(P<0.05),SCCA高表达(>5.43 ng/mL)放化疗缓解率低于低表达(≤5.43 ng/mL)(54.84%vs.76.67%,P<0.05),CYFRA21-1高表达组(>3.59 ng/mL)放化疗缓解率低于低表达组(≤3.59 ng/mL)(57.35%vs.78.85%,P<0.05)。Logistic回归分析显示,SCCA高表达、CYFRA21-1高表达是ESCC患者同步放化疗疗效的独立危险因素(P<0.05)。结论:治疗前血清SCCA、CYFRA21-1水平对可预测ESCC患者同步放化疗近期疗效,高SCCA、CYFRA21-1水平提示疗效较差。
Objective:To investigate the relationship between serum squamous cell carcinoma antigen(SCCA),cytokeratin fragment 19 antigen 21-1(CYFRA21-1)levels and short-term efficacy of concurrent chemoradiotherapy in patients with esophageal squamous cell carcinoma(ESCC).Methods:120 patients with ESCC underwent concurrent chemoradiotherapy and the short-term efficacy was observed.Serum SCCA and CYFRA21-1 levels were detected before treatment.The cut-off values of SCCA and CYFRA21-1 were determined by receiver operating characteristic curve(ROC).Logistic regression analysis was used to explore the relationship between serum SCCA and CYFRA21-1 before treatment and the efficacy of chemoradiotherapy.Results:Among 120 patients,complete remission(CR)was 33 cases(27.50%),partial remission(PR)was 47 cases(39.17%),stable(SD)was 33 cases(27.50%),and progressive(PD)was 7 cases(5.83%).There were 80 cases(66.67%)in the remission group and 40 cases(33.33%)in the non-relieving group.Serum SCCA and CYFRA21-1 levels in remission group were significantly higher than those in non-remission group before treatment(P<0.05).ROC curve analysis showed that the area under the curve of serum SCCA and CYFRA21-1 in predicting the efficacy of concurrent chemoradiotherapy was 0.747 and 0.746,respectively,and the cut-off values were 5.43 ng/ml and 3.59 ng/ml,respectively.Univariate analysis showed that the short-term efficacy of concurrent chemoradiotherapy in ESCC patients was not correlated with age,gender,tumor location,clinical stage,tumor diameter and lymph node metastasis(P>0.05).There was a correlation between serum SCCA and CYFRA21-1 levels before radiotherapy and chemotherapy(P<0.05).The remission rate of chemoradiotherapy with high SCCA expression(>5.43 ng/ml)was 54.84%,which was significantly lower than that of 76.67%with low SCCA expression(≤5.43 ng/ml).The remission rate of radiotherapy and chemotherapy with high CYFRA21-1 expression(>3.59 ng/ml)was 57.35%,which was significantly lower than that of 78.85%in the low CYFRA21-1 expression(≤3.59 ng/ml)group,and the differences were statistically significant(P<0.05).Logistic regression analysis showed that high expression of SCCA and CYFRA21-1 were independent risk factors for the efficacy of concurrent chemoradiotherapy in ESCC patients(P<0.05).Conclusion:Serum SCCA and CYFRA21-1 levels before treatment have predictive value for the short-term efficacy of concurrent chemoradiotherapy in patients with ESCC.High SCCA and CYFRA21-1 levels may indicate poor efficacy.
作者
丁柏英
曾淑超
郭英杰
张景旭
张凤志
DING Bai-ying;ZENG Shu-chao;GUO Ying-jie;ZHANG Jing-xu;ZHANG Feng-zhi(Department of Radiotherapy,the Third Hospital of Chengde,Chengde Hospital of Traditional Chinese Medicine,Chengde 067000,Hebei,China;Department of Oncology,Chengde Hospital of Traditional Chinese Medicine,Chengde 067000,Hebei,China)
出处
《川北医学院学报》
CAS
2022年第5期606-609,共4页
Journal of North Sichuan Medical College
基金
河北省承德市科技支撑计划项目(201701A006)。
关键词
食管鳞状细胞癌
鳞状细胞癌抗原
细胞角蛋白片段19抗原21-1
同步放化疗
近期疗效
Esophageal squamous cell carcinoma
Squamous cell carcinoma antigen
Cell keratin fragment 19 antigen 21-1
Concurrent chemoradiotherapy
Recent efficacy
