SCC-Ag、CA19-9、VEGF在晚期食管鳞癌化疗疗效判断中的价值

doi:10.3969/j.issn.1673-8640.2021.01.004

摘要/Abstract

摘要：

目的探讨鳞状细胞癌抗原（SCC-Ag）、糖类抗原19-9（CA19-9）、血管内皮生长因子（VEGF）在晚期食管鳞癌患者化疗疗效判断中的价值。方法选取晚期食管鳞癌患者112例,所有患者均给予多西他赛+奈达铂化疗,采用酶联免疫吸附试验检测所有患者化疗前及化疗3个疗程后的血清SCC-Ag、CA19-9、VEGF水平,采用受试者工作特征（ROC）曲线评价SCC-Ag、CA19-9、VEGF判断化疗有效的效能。结果 112例食管鳞癌患者化疗有效率为53.57%（60/112）。化疗有效组与化疗无效组化疗前血清SCC-Ag、CA19-9、VEGF水平差异均无统计学意义（P>0.05）。化疗有效组化疗后血清SCC-Ag、CA19-9、VEGF水平明显低于化疗前（P<0.01）。化疗无效组化疗后血清SCC-Ag、CA19-9、VEGF水平高于化疗前（P<0.001）。化疗有效组SCC-Ag、CA19-9、VEGF水平的下降比明显高于化疗无效组（P<0.001）。ROC曲线分析结果显示,SCC-Ag下降比、CA19-9下降比、VEGF下降比判断食管鳞癌化疗疗效的曲线下面积（AUC）分别为0.741、0.712、0.783,最佳临界值分别为20%、26%、27%,敏感性分别为76.67%、80.00%、83.33%,特异性分别为76.92%、73.08%、80.77%;三者联合检测（三者任意一项高于最佳临界值）判断食管鳞癌化疗有效的AUC为0.926,敏感性为96.67%,特异性为96.15%。结论 SCC-Ag、CA19-9、VEGF可用于晚期食管鳞癌化疗疗效的判断。

关键词: 鳞状上皮细胞癌抗原, 糖类抗原19-9, 血管内皮生长因子, 食管鳞癌, 化疗, 疗效判断

Abstract:

Objective To investigate the roles of squamous cell carcinoma antigen（SCC-Ag）,carbohydrate antigen 19-9（CA19-9） and vascular endothelial growth factor（VEGF） for chemotherapy efficacy in advanced esophageal squamous cell carcinoma. Methods Totally,112 patients with advanced esophageal squamous cell carcinoma were enrolled. All the patients were treated with docetaxel + nedaplatin. Serum levels of SCC-Ag,CA19-9 and VEGF before and after chemotherapy were determined by enzyme-linked immunosorbent assay,and the chemotherapy efficacy of SCC-Ag,CA19-9 and VEGF was evaluated by receiver operating characteristic（ROC） curve. Results The effective rate of chemotherapy in 112 patients with esophageal squamous cell carcinoma was 53.57%（60/112）. There was no statistical significance in serum levels of SCC-Ag,CA19-9 and VEGF between effective chemotherapy group and ineffective chemotherapy group（P>0.05）. Serum levels of SCC-Ag,CA19-9 and VEGF in effective chemotherapy group after chemotherapy were lower than those before chemotherapy（P<0.001）,and serum levels of SCC-Ag,CA19-9 and VEGF in ineffective chemotherapy group after chemotherapy were higher than those before chemotherapy（P<0.001）. The suppression ratios of SCC-Ag,CA19-9 and VEGF in effective chemotherapy group were higher than those in ineffective chemotherapy group（P<0.001）. ROC curve analysis results showed that the area under curve（AUC） of the suppression ratios of SCC-Ag,CA19-9 and VEGF in evaluating the chemotherapy efficacy of esophageal squamous cell carcinoma were 0.741,0.712 and 0.783,the optimal cut-off values were 20%,26% and 27%,the sensitivities were 76.67%,80.00% and 83.33%,the specificities were 76.92%,73.08% and 80.77%,respectively. The AUC of the combination of the 3 factors（SCC-Ag suppression ratio >20%,CA19-9 suppression ratio >26%,VEGF suppression ratio >27%） in evaluating the chemotherapy efficacy of esophageal squamous cell carcinoma was 0.926,the sensitivity was 96.67%,and the specificity was 96.15%. Conclusions SCC-Ag,CA19-9 and VEGF can be used to evaluate the chemotherapy efficacy of advanced esophageal squamous cell carcinoma.

Key words: Squamous cell carcinoma antigen, Carbohydrate antigen 19-9, Vascular endothelial growth factor, Esophageal squamous cell carcinoma, Chemotherapy, Efficacy evaluation

中图分类号:

R446.1

杨勇. SCC-Ag、CA19-9、VEGF在晚期食管鳞癌化疗疗效判断中的价值[J]. 检验医学, 2021, 36(1): 20-24.

YANG Yong. Roles of SCC-Ag,CA19-9 and VEGF for chemotherapy efficacy in advanced esophageal squamous cell carcinoma[J]. Laboratory Medicine, 2021, 36(1): 20-24.

图/表 3

参考文献 12

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组别	例数	SCC-Ag
组别	例数	化疗前/（µg/L）	化疗后/（µg/L）	t值	P值	下降比/%
化疗无效组	52	5.06±0.57	6.21±0.84	8.775	<0.001	-24.55±3.04
化疗有效组	60	4.94±0.53	3.22±0.47	17.509	<0.001	34.34±4.91
t值		1.148	22.757			77.381
P值		0.254	<0.001			<0.001
组别		CA19-9
组别		化疗前/（U/mL）	化疗后/（U/mL）	t值	P值	下降比/%
化疗无效组		85.75±9.88	101.64±12.12	7.871	<0.001	-19.05±2.86
化疗有效组		84.21±9.82	54.75±7.02	17.599	<0.001	35.43±4.05
t值		0.825	24.548			83.035
P值		0.411	<0.001			<0.001
组别		VEGF
组别		化疗前/（ng/L）	化疗后/（ng/L）	t值	P值	下降比/%
化疗无效组		270.52±30.82	331.29±35.61	9.995	<0.001	-22.59±3.08
化疗有效组		268.23±30.13	163.52±24.06	19.583	<0.001	39.25±5.19
t值		0.396	28.751			77.852
P值		0.693	<0.001			<0.001

组别	例数	SCC-Ag
组别	例数	化疗前/（µg/L）	化疗后/（µg/L）	t值	P值	下降比/%
化疗无效组	52	5.06±0.57	6.21±0.84	8.775	<0.001	-24.55±3.04
化疗有效组	60	4.94±0.53	3.22±0.47	17.509	<0.001	34.34±4.91
t值		1.148	22.757			77.381
P值		0.254	<0.001			<0.001
组别		CA19-9
组别		化疗前/（U/mL）	化疗后/（U/mL）	t值	P值	下降比/%
化疗无效组		85.75±9.88	101.64±12.12	7.871	<0.001	-19.05±2.86
化疗有效组		84.21±9.82	54.75±7.02	17.599	<0.001	35.43±4.05
t值		0.825	24.548			83.035
P值		0.411	<0.001			<0.001
组别		VEGF
组别		化疗前/（ng/L）	化疗后/（ng/L）	t值	P值	下降比/%
化疗无效组		270.52±30.82	331.29±35.61	9.995	<0.001	-22.59±3.08
化疗有效组		268.23±30.13	163.52±24.06	19.583	<0.001	39.25±5.19
t值		0.396	28.751			77.852
P值		0.693	<0.001			<0.001

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