Hao Junfei, Liu Wei, Zhao Chunyan, Xia Taiyu
Department of Medical Equipment, Dazu District People's Hospital, Chongqing, China.
Department of Oncology, Dazu District People's Hospital, Chongqing, China.
Transl Cancer Res. 2021 Dec;10(12):5383-5389. doi: 10.21037/tcr-21-2522.
To analyze the clinical value of multi-slice spiral computed tomography (MSCT) combined with carbohydrate antigen 19-9 (CA19-9), B-cell leukemia/lymphoma-2 protein (Bcl-2), and cytokeratin 19 fragment antigen 21-1 (CYFRA21-1) detection in the diagnosis of thoracic esophageal cancer.
The clinical data of 74 patients with thoracic esophageal cancer admitted to the Dazu District People's Hospital in Chonqing, China, from December 2019 to December 2020 were collected (esophageal cancer group), and their computed tomography (CT) signs were analyzed. Another 55 healthy people who underwent physical examination during the same period in the hospital were selected for the healthy group. The serum levels of CA19-9, Bcl-2, and CYFRA21-1 in the different populations were compared, using the receiver operating characteristic (ROC) curve to analyze the value of MSCT combined with CA19-9, Bcl-2, and CYFRA21-1 detection in the diagnosis of thoracic esophageal cancer.
The serum levels of CA19-9, Bcl-2, and CYFRA21-1 in patients of the esophageal cancer group were significantly higher than those in the healthy group (P<0.05). The serum levels of CA19-9, Bcl-2, and CYFRA21-1 in patients with poorly differentiated, stage III-IV carcinoma and lymph node metastasis were significantly higher than in those patients with moderately well-differentiated, stage I-II carcinoma and no lymph node metastasis (P<0.05). The CT scans of patients in the esophageal cancer group showed esophageal walls with irregular, needle-shaped, circular, or localized eccentric thickening and narrowed lumens, which were dilated above the cancerous lesions. Some tumors compressed adjacent organs to deform and shift the organs, resulting in the disappearance of surrounding fat layers. Enhanced scans showed mild or moderate enhancement, with large-diameter lesions unable to enhance central, low-density, necrotic areas. The ROC curve showed that the area under the curve (AUC) and the sensitivity and specificity of MSCT combined with CA19-9, Bcl-2, and CYFRA21-1 detection were all higher than for esophageal lesions detected by individual indicators.
CA19-9, Bcl-2, and CYFRA21-1, which are abnormally expressed in patients with esophageal cancer, may be related to the occurrence and development of esophageal cancer. MSCT combined with CA19-9, Bcl-2, and CYFRA21-1 detection appears to enhance the diagnosis of esophageal cancer.
分析多层螺旋计算机断层扫描（MSCT）联合糖类抗原19-9（CA19-9）、B细胞淋巴瘤/白血病-2蛋白（Bcl-2）及细胞角蛋白19片段抗原21-1（CYFRA21-1）检测在胸段食管癌诊断中的临床价值。
收集2019年12月至2020年12月在中国重庆大足区人民医院收治的74例胸段食管癌患者的临床资料（食管癌组），分析其计算机断层扫描（CT）征象。另选取同期在该院进行体检的55例健康人作为健康组。比较不同人群血清CA19-9、Bcl-2及CYFRA21-1水平，采用受试者工作特征（ROC）曲线分析MSCT联合CA19-9、Bcl-2及CYFRA21-1检测在胸段食管癌诊断中的价值。
食管癌组患者血清CA19-9、Bcl-2及CYFRA21-1水平显著高于健康组（P<0.05）。低分化、Ⅲ-Ⅳ期癌及有淋巴结转移患者血清CA19-9、Bcl-2及CYFRA21-1水平显著高于中高分化、Ⅰ-Ⅱ期癌且无淋巴结转移患者（P<0.05）。食管癌组患者CT扫描显示食管壁呈不规则、针状、圆形或局限性偏心增厚，管腔狭窄，癌灶上方食管扩张。部分肿瘤压迫相邻器官使其变形移位，导致周围脂肪层消失。增强扫描显示轻度或中度强化，直径较大的病灶中央低密度坏死区无强化。ROC曲线显示，MSCT联合CA19-9、Bcl-2及CYFRA21-1检测的曲线下面积（AUC）、敏感度及特异度均高于单项指标检测食管病变。
食管癌患者中异常表达的CA19-9、Bcl-2及CYFRA21-1可能与食管癌的发生发展有关。MSCT联合CA19-9、Bcl-2及CYFRA21-1检测似可提高食管癌的诊断水平。
