食管癌新辅助放化疗患者血清肿瘤标记物水平动态变化及意义

摘要

目的：探讨血清肿瘤标记物水平动态变化判断食管癌新辅助放化疗患者疗效及预后的价值。方法对30例行新辅助放化疗食管癌切除术患者的血清细胞角化素蛋白片段19（ CYFRA21-1）、癌胚抗原（ CEA ）及糖链抗原19-9（CA19-9）水平行动态观察，分析其变化与临床疗效及预后的关系。结果治疗前CEA阳性者中位生存期明显短于CEA阴性者，P＜0．05；CA19-9阳性者中位生存期短于CA19-9阴性者（但因阳性例数过少，无法行统计学处理）；CYFRA21-1阳性与阴性者中位生存期无统计学差异。治疗过程中标志物呈下降趋势者中位生存期长于、有效率高于呈上升趋势者，P均＜0．05。结论对食管癌新辅助放化疗患者血清CYFRA21-1、CEA及CA19-9联合动态及变化趋势检测，可评价治疗效果及判断预后。%Objective To discuss the dynamic changes of serum CYFRA 21-1, carcinoembryonic antigen (CEA) and carbohydrate antigen ( CA) 19-9 levels before and after neoadjuvant chemoradiotherapy to evaluate its efficacy and prognosis in treatment of patients with esophageal carcinoma .Methods The dynamic changes in serum levels of cytokeratin 19 frag-ment(CYFRA21-1), CEA and CA19-9 were observed during treatment and after treatment in 30 cases of patients who re-ceived neoadjuvant chemoradiotherapy with esophageal cancer resection .The relationship between the changes and the clin-ical efficacy and prognosis was analyzed .Results The median survival time of CEA positive people was significantly shor-ter than that of negative ones before treatment (P<0.05).The median survival time of CA19-9 positive people was shorter than that of negative ones ( because the positive cases were few , it was unable to statistical processing ) , and the median survival period of CYFRA21-1 positive and negative patients was not statistically different .During treatment, their median survival of those patients whose markers decreased was longer , and the effective rate was better than the increasing ones . Conclusions The dynamic and combined detections of serum CYFRA 21-1, CEA and CA19-9 in patients treated by preop-erative neoadjuvant chemotherapy can effectively evaluate the therapeutic effect and prognosis .