Ki-67与Cyfra21-1联合检测在鼻咽癌不良预后评估中的作用

发布时间：2018-12-17 20:19

【摘要】：目的探讨检测鼻咽癌组织Ki-67的表达水平及治疗后血清细胞角蛋白19片段21-1(Cyfra21-1)、鳞状细胞癌抗原(SCCA)、乳酸脱氢酶(LDH)、碱性磷酸酶(ALP)的含量在鼻咽癌不良预后评估中的作用及临床意义。方法回顾性分析2008年6-12月经病理确诊并接受根治性同步放化疗治疗的鼻咽鳞癌患者89例。免疫组化法检测患者鼻咽癌组织Ki-67表达情况,化学发光法检测治疗后血清Cyfra21-1、SCCA含量,连续监测法检测患者治疗后血清中的LDH、ALP含量。结果至2013年12月随访日结束,36例患者入组复发组,34例患者入组远处转移组,19例患者入组临床缓解组。临床缓解组患者鼻咽癌组织中的Ki-67表达水平低于远处转移组(P0.05),且血清Cyfra21-1表达水平低于复发组及远处转移组(P0.05)。同时,复发组患者的血清LDH表达水平低于远处转移组(P0.05);血清ALP与SCCA在各组间未见明显差异(P0.05)。Cox回归分析结果显示,组织Ki-67高表达(P0.01,HR=1.973)与血清Cyfra21-1高表达(P0.01,HR=1.537)均为无进展生存期的不良预后因素,血清Cyfra21-1高表达(P0.01,HR=1.492)为总生存期的不良预后因素。通过建立预后指数方程发现,高危组与低危组患者的无进展生存期和总生存期差异有统计学意义(P0.01)。结论联合检测患者鼻咽癌组织中Ki-67的表达水平与血清Cyfra21-1的含量可用于评估鼻咽癌患者的不良预后情况。
[Abstract]:Objective to investigate the expression of Ki-67 and serum cytokeratin 19 21-1 (Cyfra21-1), squamous cell carcinoma antigen (SCCA), lactate dehydrogenase (LDH), in nasopharyngeal carcinoma (NPC) after treatment. The role and clinical significance of alkaline phosphatase (ALP) in the evaluation of adverse prognosis of nasopharyngeal carcinoma. Methods 89 patients with nasopharyngeal squamous cell carcinoma diagnosed pathologically from June to December 2008 and treated with radical concurrent radiotherapy and chemotherapy were retrospectively analyzed. Immunohistochemical method was used to detect the expression of Ki-67 in nasopharyngeal carcinoma, chemiluminescence method was used to detect the content of serum Cyfra21-1,SCCA after treatment, and continuous monitoring method was used to detect the content of LDH,ALP in serum of patients with nasopharyngeal carcinoma after treatment. Results at the end of the follow-up day in December 2013, 36 patients were enrolled in the relapse group, 34 patients in the distant metastasis group and 19 patients in the clinical remission group. The expression of Ki-67 in nasopharyngeal carcinoma in clinical remission group was lower than that in distant metastasis group (P0.05), and the level of serum Cyfra21-1 expression was lower than that in recurrence group and distant metastasis group (P0.05). At the same time, the expression of serum LDH in recurrent group was lower than that in distant metastasis group (P0.05). There was no significant difference in serum ALP and SCCA between the groups (P0.05). Cox regression analysis showed that the high expression of Ki-67 (P0.01) and the high expression of Cyfra21-1 (P0.01) were found in the tissues. The high expression of serum Cyfra21-1 (P0.01? HR1. 492) was the negative prognostic factor of the overall survival period. By establishing the prognostic index equation, it was found that there were significant differences in progression free survival and total survival between high risk group and low risk group (P0.01). Conclusion the expression of Ki-67 and the content of serum Cyfra21-1 in nasopharyngeal carcinoma can be used to evaluate the poor prognosis of nasopharyngeal carcinoma.
【作者单位】：第三军医大学大坪医院野战外科研究所肿瘤中心;
【分类号】：R739.63

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