国际肿瘤学杂志

国际肿瘤学杂志 ›› 2018, Vol. 45 ›› Issue (10): 604-609.doi: 10.3760/cma.j.issn.1673-422X.2018.10.006

• 论著 • 上一篇    下一篇

SCCAg、TAP、CEA对宫颈癌新辅助化疗疗效的评估价值

汪萍萍,冯六连   

  1. 435000 鄂东医疗集团黄石市中心医院（湖北理工学院附属医院）妇科
  • 收稿日期:2018-04-20 出版日期:2018-10-08 发布日期:2018-12-21
  • 通讯作者: 冯六连 E-mail:995491185@qq.com

Values of SCCAg, TAP and CEA in evaluating the efficacy of neoadjuvant chemotherapy for cervical cancer

Wang Pingping, Feng Liulian   

  1. Department of Gynaecology, Huangshi Central Hospital of Edong Healthcare Group (Affiliated Hospital of Hubei Polytechnic University), Huangshi 435000, China
  • Received:2018-04-20 Online:2018-10-08 Published:2018-12-21
  • Contact: Feng Liulian E-mail:995491185@qq.com

PDF

674

摘要： 目的 探讨鳞状细胞癌抗原（SCCAg）、肿瘤异常蛋白（TAP）、癌胚抗原（CEA）对宫颈癌新辅助化疗疗效的评估价值。方法 选取2015年9月至2017年9月本院新辅助化疗治疗的宫颈癌患者100例，同期选取健康人员100例作为对照组，检测所有人员血清SCCAg、TAP、CEA水平，分析SCCAg、TAP、CEA水平与化疗疗效的关系。采用受试者工作特征（ROC）曲线分析不同指标评估宫颈癌新辅助化疗疗效的效能。结果 宫颈癌患者SCCAg［（4.95±0.65）μg/L∶（0.22±0.04）μg/L］、TAP［（175.21±25.42）μm2∶（75.45±9.98）μm2］、CEA［（35.65±4.23）ng/ml∶（1.26±0.34）ng/ml］水平明显高于对照组，差异有统计学意义（t=75.382，P<0.001；t=62.215，P<0.001；t=55.452，P<0.001）。100例宫颈癌患者化疗3个月后，完全缓解（CR）6例（6.00%）、部分缓解（PR）50例（50.00%）、病情稳定（SD）26例（26.00%）、疾病进展（PD）18例（18.00%）。在SCCAg、TAP、CEA水平方面，CR患者［（2.12±0.32）μg/L∶（4.90±0.52）μg/L、（133.12±14.22）μm2∶（175.12±24.32）μm2、（10.34±2.42）ng/ml∶（38.21±7.82）ng/ml］和PR患者化疗后较化疗前［（3.22±0.47）μg/L∶（4.94±0.53）μg/L、（145.22±17.77）μm2∶（179.52±25.53）μm2、（16.75±3.02）ng/ml∶（39.12±7.92）ng/ml］显著降低，差异有统计学意义（t=11.153，P<0.001；t=3.562，P=0.004；t=8.340，P<0.001；t=17.169，P<0.001；t=7.797，P<0.001；t=18.662，P<0.001）；PD患者化疗后较化疗前［（7.21±0.84）μg/L∶（5.06±0.57）μg/L、（213.21±29.64）μm2∶（171.56±26.87）μm2、（46.64±5.12）ng/ml∶（35.75±7.88）ng/ml］均明显上升，差异有统计学意义（t=8.986，P<0.001；t=4.417，P<0.001；t=4.917，P<0.001）；SD患者化疗前后比较［（5.03±0.57）μg/L∶（4.97±0.55）μg/L、（175.51±23.37）μm2∶（176.27±26.55）μm2、（35.26±7.34）ng/ml∶（37.04±7.73）ng/ml］，差异无统计学意义（t=0.386，P=0.701；t=0.110，P=0.913；t=0.851，P=0.399）。ROC曲线分析结果显示，SCCAg评估宫颈癌新辅助化疗疗效的敏感性、特异性、准确率分别为85.71%、81.82%、84.00%，TAP分别为82.14%、77.27%、80.00%，CEA分别为78.57%、77.27%、78.00%，三者联合时分别为96.43%、95.45%、96.00%，三者联合检测时敏感性、特异性、准确率明显高于三者单独检测，差异有统计学意义（χ2=14.434，P<0.001；χ2=15.421，P<0.001；χ2=21.741，P<0.001）。结论 宫颈癌患者新辅助化疗后血清SCCAg、TAP、CEA水平降低，检测其水平变化可作为评估其化疗疗效的重要指标，且三者联合检测时具有更佳的评估效能，值得临床作进一步推广。

关键词: 宫颈肿瘤, 癌胚抗原, 化学疗法, 辅助, 鳞状细胞癌抗原, 肿瘤异常蛋白

Abstract: Objective To investigate the values of squamous cell carcinoma antigen (SCCAg), tumor abnormal protein (TAP), carcinoembryonic antigen (CEA) in evaluating the efficacy of neoadjuvant chemotherapy for cervical cancer. MethodsA total of 100 patients with cervical cancer treated by neoadjuvant chemotherapy were selected from September 2015 to September 2017 in our hospital, and 100 healthy persons were selected as the control group at the same time. The serum levels of SCCAg, TAP and CEA were detected and the relationships between the levels of SCCAg, TAP, CEA and the efficacy of neoadjuvant chemotherapy were analyzed. ResultsThe serum levels of SCCAg ［(4.95±0.65) μg/L vs. (0.22±0.04) μg/L］, TAP ［(175.21±25.42) μm2 vs. (75.45±9.98) μm2］, CEA ［(35.65±4.23) ng/ml vs. (1.26±0.34 )ng/ml］ in patients with cervical cancer were significantly higher than those of control group, and the differences were statistically significant (t=75.382, P<0.001; t=62.215, P<0.001; t=55.452, P<0.001). Three months after neoadjuvant chemotherapy for 100 cervical cancer patients, complete remission (CR) was achieved in 6 cases (6.00%), partial remission (PR) in 50 cases (50.00%), stable disease (SD) in 26 cases (26.00%), and progression disease (PD) in 18 cases (18.00%). The SCCAg, TAP and CEA levels of patients with CR ［(2.12±0.32) μg/L vs. (4.90±0.52) μg/L, (133.12±14.22) μm2 vs. (175.12±24.32) μm2, (10.34±2.42) ng/ml vs. (38.21±7.82) ng/ml］ and PR after chemotherapy were significantly lower than those before chemotherapy ［(3.22±0.47) μg/L vs. (4.94±0.53) μg/L, (145.22±17.77) μm2 vs. (179.52±25.53) μm2, (16.75±3.02) ng/ml vs. (39.12±7.92) ng/ml］, and the differences were statistically significant (t=11.153, P<0.001; t=3.562, P=0.004; t=8.340, P<0.001; t=17.169, P<0.001; t=7.797, P<0.001; t=18.662, P<0.001). The above indicators of patients with PD after chemotherapy were significantly higher than those before chemotherapy ［(7.21±0.84) μg/L vs. (5.06±0.57) μg/L, (213.21±29.64) μm2 vs. (171.56±26.87) μm2, (46.64±5.12) ng/ml vs. (35.75±7.88) ng/ml］, and the differences were statistically significant (t=8.986, P<0.001; t=4.417, P<0.001; t=4.917, P<0.001). The differences of the above indicators before and after chemotherapy in patients with SD were not statistically significant ［(5.03±0.57) μg/L vs. (4.97±0.55) μg/L; (175.51±23.37) μm2 vs. (176.27±26.55) μm2; (35.26±7.34) ng/ml vs. (37.04±7.73) ng/ml; t=0.386, P=0.701; t=0.110, P=0.913; t=0.851, P=0.399］. The results of receiver operating characteristic (ROC) curve analysis showed that the sensitivity, specificity and accuracy of SCCAg in evaluating the neoadjuvant chemotherapy for cervical cancer were 85.71%, 81.82%, 84.00%, those of TAP were 82.14%, 77.27%, 80.00%, those of CEA were 78.57%, 77.27%, 78.00%, and those of the combined detection were 96.43%, 95.45%, 96.00%. The sensitivity, specificity and accuracy of the combined detection were significantly higher than those of the three alone, and the differences were statistically significant (χ2=14.434, P<0.001, χ2=15.421, P<0.001, χ2=21.741, P<0.001). ConclusionThe serum levels of SCCAg, TAP and CEA in patients with cervical cancer are decreased after neoadjuvant chemotherapy. Their level changes can be used as important indicators to evaluate the efficacy of chemotherapy, and the combination of the three has better evaluation efficiency, which is worth for further clinical promotion.

Key words: Uterine cervical neoplasms, Carcinoembryonic antigen, Chemotherapy, adjuvant, Squamous cell carcinoma antigen, Tumor abnormal protein