食管鳞癌手术前后血清肿瘤标记物水平变化的临床意义
发布时间：2018-03-06 15:24
本文选题：食管鳞癌 切入点：CYFRA21-1 出处：《青海大学》2017年硕士论文 论文类型：学位论文
【摘要】：目的:探讨食管鳞癌患者手术治疗前后血清CYFRA21-1、CA125、SCC-Ag水平变化的临床意义。方法:选取2014年12月-2016年10月共收集符合研究条件病例40例,所有患者均行标准的食管癌根治手术,并采集患者手术前1周和术后2周、术后1月晨起空腹静脉血5ml送核医学科,应用夹心式原理采用罗氏(Roche)Cobas8000全自动电化学发光免疫分析系统及罗氏相配套肿瘤标记物检测试剂盒进行检测。所有数据建立采用Excel软件,数据统计用SPSS17.0分析软件。用均数±标准差(?X±S)表示计量资料,采用重复测量方差分析方法对患者术前1周、术后2周及术后1月的肿瘤标记物浓度水平进行分析,不同分期肿瘤标记物浓度比较采用两独立样本t检验或t′检验,检验水准α=0.05。结果:1、食管鳞癌患者血清中CYFRA21-1、CA125、SCC-Ag浓度水平术后2周较术前1周明显下降,均有显著性差异(P0.05);术后1月较术前1周CYFRA21-1和CA125明显下降,有显著性差异(P0.05),而SCC-Ag无显著性差异(P㧐0.05);术后1月较术后2周CYFRA21-1和CA125明显下降,有显著性差异(P0.05),SCC-Ag无显著性差异(P㧐0.05)。2、肿瘤分期Ⅱ期与Ⅲa期比较,血清中CYFRA21-1在术前1周、术后2周及术后1月均有显著性差异(P0.05);血清中CA125与SCC-Ag在术前1周、术后2周及术后1月均无显著性差异(P0.05)。结论:1、血清中CYFRA21-1、CA125浓度水平与食管鳞癌患者病期呈正相关,CYFRA21-1血清水平与肿瘤分期呈正相关,CA125及SCC-Ag与肿瘤分期无关。血清CYFRA21-1与CA125水平术后明显持续降低,说明术中瘤体及淋巴结清扫较彻底,表示食管鳞癌根治手术治疗成功;反之则表示病灶残留等可能,需术后相应的放、化疗;血清水平下降后再次升高,则提示可能存在疾病复发等情况。所以动态检测CYFRA21-1及CA125的血清水平,能为食管鳞癌患者的病情判断、手术疗效的观察、预后判断及术后制定更合理的个体化治疗方案提供重要的临床依据。2、本实验中,SCC-Ag与食管鳞癌相关性较差,其临床意义有待于进一步大样本的研究。
[Abstract]:Objective: to investigate the clinical significance of serum CYFRA21-1C125 and SCC-Ag levels in patients with esophageal squamous cell carcinoma before and after surgical treatment. Methods: 40 patients with esophageal carcinoma were collected from December 2014 to October 2016. The patients were collected 1 week before operation and 2 weeks after operation, and 5 ml of fasting venous blood was sent to the Department of Nuclear Medicine on the morning of January. The sandwich principle was applied to the detection of Rochea Rochea Cobas8000 automatic electrochemiluminescence immunoassay system and Roche matching tumor marker detection kit. All the data were established by Excel software. SPSS17.0 software was used to analyze the data. X 卤S (X 卤S) was used to analyze the tumor marker concentration of the patients at 1 week before operation, 2 weeks after operation and January after operation by means of repeated measurement variance analysis. Two independent samples t test or t 'test were used to compare the tumor marker concentration in different stages. The test level was 0. 05. Results the serum level of CYFRA21-1 CA125 and SCC-Ag in esophageal squamous cell carcinoma patients decreased significantly 2 weeks after operation compared with 1 week before operation. There was significant difference in CYFRA21-1 and CA125 between January and one week after operation (P 0.05), but there was no significant difference in SCC-Ag (P > 0.05). On January, CYFRA21-1 and CA125 were significantly lower than those in 2 weeks after operation (P < 0.05). There was no significant difference in SCC-Ag between two weeks after operation (P > 0.05). Compared with stage 鈪，
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