Obata K, Yutori H, Yoshida K, Sakamoto Y, Ono K, Ibaragi S
Department of Oral and Maxillofacial Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
Department of Oral and Maxillofacial Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
Int J Oral Maxillofac Surg. 2023 Apr;52(4):417-422. doi: 10.1016/j.ijom.2022.08.019. Epub 2022 Sep 9.
Squamous cell carcinoma antigen (SCC-Ag) and cytokeratin 19 fragment (CYFRA) are used to screen and monitor oral cancer patients. However, recent studies have reported that tumour markers become elevated as renal function decreases, regardless of tumour progression. A retrospective study was performed of 423 oral cancer patients who underwent blood testing for these tumour markers and other blood analytes during a 10-year period. The values of SCC-Ag and CYFRA increased significantly with decreasing renal function (P < 0.01), and the values were abnormal at a median 2.6 ng/ml for SCC-Ag and 4.7 ng/ml for CYFRA in the group with estimated glomerular filtration rate (eGFR) values of< 30 ml/min/1.73 m. The factors that were related to the variation in tumour markers were albumin and creatinine. The cut-off values of eGFR were 59.7 ml/min/1.73 m for SCC-Ag and 63.6 ml/min/1.73 m for CYFRA, and the cut-off age when the tumour markers might rise due to the effect of renal function were 72 years for SCC-Ag and 73 years for CYFRA. In conclusion, decreased renal function should be taken into account when evaluating tumour markers in oral cancer. In addition, tumour markers are likely to be overestimated in patients over the age of 72-73 years.
鳞状细胞癌抗原（SCC-Ag）和细胞角蛋白19片段（CYFRA）用于筛查和监测口腔癌患者。然而，最近的研究报告称，无论肿瘤进展如何，肿瘤标志物都会随着肾功能下降而升高。对423例口腔癌患者进行了一项回顾性研究，这些患者在10年期间接受了这些肿瘤标志物及其他血液分析物的血液检测。SCC-Ag和CYFRA的值随着肾功能下降而显著升高（P < 0.01），在估计肾小球滤过率（eGFR）值< 30 ml/min/1.73 m²的组中，SCC-Ag的中位值为2.6 ng/ml，CYFRA的中位值为4.7 ng/ml时，这些值异常。与肿瘤标志物变化相关的因素是白蛋白和肌酐。SCC-Ag的eGFR临界值为59.7 ml/min/1.73 m²，CYFRA为63.6 ml/min/1.73 m²，由于肾功能影响肿瘤标志物可能升高的临界年龄，SCC-Ag为72岁，CYFRA为73岁。总之，在评估口腔癌患者的肿瘤标志物时应考虑肾功能下降。此外，72 - 73岁以上患者的肿瘤标志物可能被高估。
