Kawaguchi H, Ohno S, Miyazaki M, Hashimoto K, Egashira A, Saeki H, Watanabe M, Sugimachi K
Department of Surgery II, Faculty of Medicine, Kyushu University, Fukuoka 812-8582, Japan.
Cancer. 2000 Oct 1;89(7):1413-7. doi: 10.1002/1097-0142(20001001)89:7<1413::aid-cncr1>3.0.co;2-i.
While there are reports that CYFRA 21-1 is a useful tumor marker, to our knowledge the clinical utility of this marker to detect recurrences for squamous cell carcinoma of the esophagus has not been addressed.
By immunoradiometric assay, human serum levels of CYFRA 21-1, SCC antigen and CEA were measured in esophageal squamous cell carcinoma patients prior to their initial treatment. Monthly follow-ups of these tumor markers was done after surgery.
The diagnostic sensitivity of CYFRA 21-1 was 43.9% (18 of 41), a value superior to that for SCC antigen (26.8%) and CEA (17.0%) (P < 0.05). The positive rates of CYFRA 21-1 increased with progression of the disease, 22.2% of pTNM Stage 0-IIA and 77.8% of pTNM Stage IIB/III (P = 0.013), whereas SCC antigen and CEA rates were not related to pTNM stage. Among 13 patients with clinical evidence of a recurrence, 76.9% (10 of 13) exhibited an increase in CYFRA 21-1, and this increase was evident before clinical detection of the recurrence in 9 of these 13 patients (69.2%). Consequently, postoperative elevations of serum CYFRA 21-1 levels were indicative of a tumor recurrence 1-13 months before acquisition of clinical and radiological data.
The assay of CYFRA 21-1 is useful not only for diagnosis but also for close monitoring of patients with esophageal squamous cell carcinoma.
虽然有报道称细胞角蛋白19片段（CYFRA 21-1）是一种有用的肿瘤标志物，但据我们所知，该标志物在检测食管鳞状细胞癌复发方面的临床应用尚未得到探讨。
采用免疫放射分析方法，对食管鳞状细胞癌患者初始治疗前的血清CYFRA 21-1、鳞状细胞癌抗原（SCC抗原）和癌胚抗原（CEA）水平进行检测。术后对这些肿瘤标志物进行每月一次的随访。
CYFRA 21-1的诊断敏感性为43.9%（41例中的18例），该值高于SCC抗原（26.8%）和CEA（17.0%）（P<0.05）。CYFRA 21-1的阳性率随疾病进展而升高，pTNM 0-IIA期为22.2%，pTNM IIB/III期为77.8%（P = 0.013），而SCC抗原和CEA的阳性率与pTNM分期无关。在13例有临床复发证据的患者中，76.9%（13例中的10例）的CYFRA 21-1升高，其中9例（69.2%）在临床检测到复发之前CYFRA 21-1就已明显升高。因此，术后血清CYFRA 21-1水平升高表明在获得临床和影像学数据前1-13个月肿瘤复发。
CYFRA 21-1检测不仅有助于食管鳞状细胞癌的诊断，还可用于对患者进行密切监测。
