Uenishi T, Kubo S, Hirohashi K, Tanaka H, Shuto T, Yamamoto T, Nishiguchi S
Department of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka 545-8585, Japan.
Br J Cancer. 2003 Jun 16;88(12):1894-9. doi: 10.1038/sj.bjc.6601026.
Using an electrochemiluminescence immunoassay, CYFRA 21-1 concentrations were measured in sera from 187 patients with primary liver cancer (164 with hepatocellular carcinoma (HCC) and 23 with intrahepatic cholangiocarcinoma (ICC)) and 87 patients with benign liver diseases. Concentrations of CYFRA 21-1 were significantly higher in patients with ICC (5.0; interquartile range 3.1-10.7 ng ml(-1)) than in those with benign liver disease (1.4; 1.0-1.9; Mann-Whitney U-test, P<0.0001) or HCC (1.7; 1.1-2.7; Mann-Whitney U-test, P<0.0001). Using cutoff values selected for 95% specificity in the benign group (3.0 ng ml(-1)), CYFRA 21-1 showed higher sensitivity for ICC (87.0%) than three commonly used markers including alpha-fetoprotein (17.4%), carcinoembryonic antigen (34.8%), and carbohydrate antigen 19-9 (60.9%). Serum CYFRA 21-1 increased in ICC from stages I/II to IV (Kruskal-Wallis test, P=0.0102). CYFRA 21-1 concentration increased with extent of local invasion, but not nodal status. Serum CYFRA 21-1 represents a useful diagnostic test for ICC that offers high sensitivity. CYFRA 21-1 reflected differences in tumour burden, suggesting applicability to staging and follow-up.
采用电化学发光免疫分析法，检测了187例原发性肝癌患者（164例肝细胞癌（HCC）和23例肝内胆管癌（ICC））以及87例良性肝病患者血清中的细胞角蛋白19片段（CYFRA 21-1）浓度。ICC患者的CYFRA 21-1浓度（5.0；四分位间距3.1-10.7 ng/ml）显著高于良性肝病患者（1.4；1.0-1.9；Mann-Whitney U检验，P<0.0001）或HCC患者（1.7；1.1-2.7；Mann-Whitney U检验，P<0.0001）。以良性组95%特异性对应的临界值（3.0 ng/ml）为标准，CYFRA 21-1对ICC的敏感性（87.0%）高于三种常用标志物，包括甲胎蛋白（17.4%）、癌胚抗原（34.8%）和糖类抗原19-9（60.9%）。ICC患者血清CYFRA 21-1从I/II期到IV期升高（Kruskal-Wallis检验，P=0.0102）。CYFRA 21-1浓度随局部侵犯程度增加而升高，但与淋巴结状态无关。血清CYFRA 21-1是一种对ICC有用的诊断检测方法，具有高敏感性。CYFRA 21-1反映了肿瘤负荷的差异，提示其适用于分期和随访。
