早期食管癌患者外周血DKK-1、CEA、CYFRA21-1和NSE的检测及临床意义

摘要

目的:探讨血清分泌型蛋白Dikkopf1(DKK-1)、癌胚抗原(carcino-embryonic antigen,CEA)、细胞角蛋白19片段(cytokeratin 19 fragment antigen 21-1,CYFRA21-1)和神经元特异性烯醇化酶(neuron-specific enolization enzyme,NSE)在早期食管癌诊断中的应用价值.方法:食管癌 (Ⅰ-Ⅱ期)患者41例及同期健康体检者32例,采用电化学发光免疫分析仪检测血清CEA、CYFRA21-1和NSE的含量,改良双抗体夹心酶联免疫吸附法检测DKK-1含量.结果:食管癌患者血清DKK-1、CEA、CYFRA21-1和NSE含量均明显高于对照组的健康体检者(均P<0.05);食管癌患者外周血DKK-1、CEA、CYFRA21-1和NSE含量均随肿瘤分期升高而升高,呈正相关;四项指标联合检测可使食管癌的诊断敏感性与特异性分别达到90.2%和95.1%.结论:外周血DKK-1、CEA、CYFRA21-1和NSE联合检测能明显提高食管癌的诊断敏感性与特异性,利于Ⅰ-Ⅱ期食管癌的诊断与治疗.%Objective:To investigate the clinical values of secreted protein Dikkopf1(DKK-1),carcino-embryonic antigen(CEA),cytokeratin 19 fragment antigen 21-1(CYFRA21-1) and neuron-specific enolization enzyme(NSE) for diagnosis in early stage of esophageal cancer.Methods:Totally 41 patients with stage Ⅰ-Ⅱ esophageal cancer and 32 healthy volunteers were selected.CYFRA21-1,NSE and CEA were detected by electrochemical luminescence immunity analyzer and DKK-1 was detected by improved double antibody sandwich enzyme-linked immunosorbent method.Results:The contents of serum DKK-1,CYFRA21-1,NSE and CEA in the early esophageal cancer patients were significantly higher than that of the control group(P<0.05).Also contents of the factors were positively correlated with tumor stage.Combined the results of four indicators can make diagnostic sensitivity in 90.2% and specificity in 95.1% for esophageal cancer.Conclusion:Joint detection of serum DKK 1,NSE,CEA and CYFRA21-1 can improve the diagnostic sensitivity and specificity for patients with esophageal cancer,particularly benefit to those with stage Ⅰ-Ⅱ.