国际肿瘤学杂志 ›› 2018, Vol. 45 ›› Issue (11): 675-680.doi: 10.3760/cma.j.issn.1673-422X.2018.11.008

• 论著 • 上一篇    下一篇

血清MG7-Ag、CA125在晚期宫颈癌患者化疗前后的水平变化及其与疗效的关系

罗南友   

  1. 642150 四川省隆昌市人民医院检验科
  • 出版日期:2018-11-08 发布日期:2018-12-21
  • 通讯作者: 罗南友,Email: luonanyoulny@126.com E-mail: luonanyoulny@126.com

Changes of serum MG7-Ag and CA125 levels before and after chemotherapy in patients with advanced cervical cancer and their relationships with the curative effect

Luo Nanyou   

  1. Department of Clinical Laboratory, Longchang Municipal People′s Hospital of Sichuan Province, Longchang 642150, China
  • Online:2018-11-08 Published:2018-12-21
  • Contact: Luo Nanyou, Email: luonanyoulny@126.com E-mail: luonanyoulny@126.com

摘要: 目的 探讨血清胃癌相关抗原MG7(MG7-Ag)、糖类抗原125(CA125)在晚期宫颈癌患者化疗前后的水平变化及其与疗效的关系。方法 选取2014年6月至2017年6月本院经紫杉醇联合顺铂治疗的晚期宫颈癌患者150例,同期选取健康人员150例,检测所有人员血清MG7-Ag、CA125水平,分析健康人员与晚期宫颈癌患者MG7-Ag、CA125水平的差异以及晚期宫颈癌患者化疗前后MG7-Ag、CA125水平变化及其与化疗疗效的关系。结果 晚期宫颈癌患者血清MG7-Ag、CA125水平明显高于健康人员[(15.36±2.23)U/ml∶(2.42±0.31)U/ml,(275.42±30.52)U/ml∶(11.89±1.77)U/ml],差异均有统计学意义(t=26.215,P<0.001;t=82.243,P<0.001)。150例晚期宫颈癌患者化疗后,完全缓解(CR)5例(3.33%),部分缓解(PR)58例(38.67%),病情稳定(SD)60例(40.00%),疾病进展(PD)27例(18.00%)。在MG7-Ag、CA125水平方面,CR和PR患者化疗后较化疗前显著下降[(7.12±1.22)U/ml∶(15.12±3.32)U/ml, (180.34±22.42)U/ml∶(274.21±30.82)U/ml, (9.22±1.77)U/ml∶(15.52±3.53)U/ml, (206.75±23.02)U/ml∶(276.12±30.92)U/ml],差异有统计学意义(t=5.057,P=0.001;t=12.150,P<0.001; t=5.507,P<0.001;t=13.705,P<0.001),PD患者化疗后较化疗前均明显上升[(24.21±3.64)U/ml∶(15.56±3.87)U/ml, (376.64±45.12)U/ml∶(280.75±31.88)U/ml],差异有统计学意义(t=8.460,P<0.001;t=9.019,P<0.001),SD患者化疗后较化疗前上升[(16.01±2.37)U/ml∶(15.67±3.55)U/ml,(285.26±37.34)U/ml∶(277.04±31.73)U/ml],但差异无统计学意义(t=0.617,P=0.538;t=1.299,P=0.196)。受试者工作特征(ROC)曲线分析结果显示,在评估晚期宫颈癌化疗有效性的敏感性、特异性、准确性方面,MG7-Ag下降百分比以>25%为临界值时分别为82.54%、82.76%、82.67%,CA125下降百分比以>18%为临界值时分别为85.71%、86.21%、86.00%,二者联合时分别为96.83%、97.70%、97.33%,二者联合时敏感性、特异性、准确性明显高于二者单独时,差异有统计学意义(χ2=6.948,P=0.008;χ2=11.018,P=0.001;χ2=17.926,P<0.001;χ2=4.881,P=0.027;χ2=7.768,P=0.005;χ2=12.611,P<0.001)。结论 晚期宫颈癌患者血清MG7-Ag、CA125水平高于健康人员,且CR和PR患者化疗后水平均有所下降,其水平变化可作为评估其化疗疗效的重要指标,二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, 药物疗法, 治疗结果, CA-125抗原, 胃癌相关抗原MG7

Abstract: Objective To discuss the changes of serum gastric cancer associated antigen MG7 (MG7-Ag), carbohydrate antigen 125 (CA125) levels before and after chemotherapy in patients with advanced cervical cancer and their relationships with the curative effect. Methods A total of 150 advanced cervical cancer patients with paclitaxel combined with cisplatin treatment were selected from June 2014 to June 2017 in our hospital, and 150 cases of healthy persons were selected at the same time. The serum MG7-Ag and CA125 levels of all persons were detected. The differences of MG7-Ag and CA125 levels between healthy persons and advanced cervical cancer patients were analyzed. And the changes of MG7-Ag, CA125 levels before and after chemotherapy and the relationships between the MG7-Ag, CA125 levels and the curative effect of chemotherapy were analyzed. Results The serum MG7-Ag and CA125 levels in the patients with advanced cervical cancer were significantly higher than those in the healthy persons [(15.36±2.23) U/ml vs. (2.42±0.31) U/ml, (275.42±30.52) U/ml vs. (11.89±1.77) U/ml], and the differences were statistically significant (t=26.215, P<0.001; t=82.243, P<0.001). After chemotherapy for 150 patients with advanced cervical cancer, the complete remission (CR) was 5 cases (3.33%), the partial remission (PR) was 58 cases (38.67%), the stable disease (SD) was 60 cases (40.00%), and the progression disease (PD) was 27 cases (18.00%). The MG7-Ag and CA125 levels after chemotherapy in the patients with CR and PR were decreased significantly than those before chemotherapy [(7.12±1.22) U/ml vs. (15.12±3.32) U/ml, (180.34±22.42) U/ml vs. (274.21±30.82) U/ml, (9.22±1.77) U/ml vs. (15.52±3.53) U/ml, (206.75±23.02) U/ml vs. (276.12±30.92) U/ml], and the differences were statistically significant (t=5.057, P=0.001; t=12.150, P<0.001, t=5.507, P<0.001; t=13.705, P<0.001). The MG7-Ag and CA125 levels after chemotherapy in the patients with PD were increased significantly than those before chemotherapy [(24.21±3.64) U/ml vs. (15.56±3.87) U/ml, (376.64±45.12) U/ml vs. (280.75±31.88) U/ml], and the differences were statistically significant (t=8.460, P<0.001; t=9.019, P<0.001). The MG7-Ag, CA125 levels after chemotherapy in the patients with SD were increased than those before chemotherapy [(16.01±2.37) U/ml vs. (15.67±3.55) U/ml, (285.26±37.34) U/ml vs. (277.04±31.73) U/ml], but the differences were not statistically significant (t=0.617, P=0.538; t=1.299, P=0.196). The results of receiver operating characteristic (ROC) curve analysis showed that, in the aspect of sensitivity, specificity and accuracy of chemotherapy effect evaluation for cervical cancer, MG7-Ag decline percentage with >25% as the critical value were 82.54%, 82.76%, 82.67%, CA125 decline percentage with >18% as the critical value were 85.71%, 86.21%, 86.00%, and the combination of the two were 96.83%, 97.70%, 97.33%. The combination of the two were significantly higher than that of the two alone, and the differences were statistically signi-ficant (χ2=6.948, P=0.008; χ2=11.018, P=0.001; χ2=17.926, P<0.001; χ2=4.881, P=0.027; χ2=7.768, P=0.005; χ2=12.611, P<0.001). Conclusion The serum MG7-Ag and CA125 levels in patients with advanced cervical cancer are higher than those in healthy persons. The MG7-Ag and CA125 levels of patients with CR and PR are decreased after chemotherapy, and their changes of serum levels can be used as the important indexes for evaluating the efficacy of chemotherapy. The combined detection of them has the better evaluation efficiency, and it is worth for further clinical promotion.

Key words: Uterine cervical neoplasms, Drug therapy, Treatment outcome, CA-125 antigen, Gastric cancer associated antigen MG7