【作者】 邢汝东； 冯晓宇； 李建华； 李华； 李金忠； 韩正学；

【机构】 首都医科大学口腔医学院口腔颌面外科；

【摘要】 目的:检测口腔颌面部恶性肿瘤患者血清中鳞状细胞癌相关抗原(SCCA)、细胞角蛋白19可溶性片段(Cyfra21-1)、表皮生长因子受体(EGFR)、细胞周期素D1(CyclinD1)的含量,探讨它们的联合检测对口腔颌面部恶性肿瘤的诊断价值,以及它们与口腔颌面部恶性肿瘤临床分期、病理分级和淋巴结转移的关系,并观察手术前后这四种物质的含量变化。方法:选择住院治疗的口腔颌面部恶性肿瘤患者92例,健康人72例,肿瘤患者于术前取空腹静脉血2ml,对其中20例患者于术后1周再次取空腹静脉血2ml,正常对照组于常规体检时取空腹静脉血2ml。酶联免疫吸附法测定所有标本血清中SCCA、Cyfra21-1、EGFR、CyclinD1的含量。结果:口腔颌面部恶性肿瘤患者术前血清中SCCA、EGFR、CyclinD1的含量明显高于健康人,而Cyfra21-1的含量与健康人相比无显著差异。患者术后1周血清中SCCA的含量明显降低,而Cyfra21-1、EGFR、CyclinD1的含量与术前相比无显著差异。口腔颌面部恶性肿瘤患者术前血清中SCCA、Cyfra21-1、EGFR、CyclinD1的含量与肿瘤的临床分期、分化及淋巴结转移无关。单独检测SCCA、EGFR、CyclinD1时,EGFR对口腔颌面部恶性肿瘤诊断的灵敏度、特异性和准确性最高;SCCA、EGFR、CyclinD1任意两种联合检测时,EGFR与CyclinD1联合检测对口腔颌面部恶性肿瘤诊断的灵敏度、特异性和准确性最高,其次是SCCA与EGFR联合检测;SCCA、EGFR、CyclinD1联合检测的灵敏度、特异性和准确性与EGFR、CyclinD1联合检测一样。联合检测EGFR与CyclinD1对口腔颌面部恶性肿瘤的诊断价值最高。结论:口腔颌面部恶性肿瘤患者血清中SCCA、EGFR、CyclinD1的含量升高;手术后患者血清中SCCA的含量明显下降,可用于监测治疗效果;联合检测EGFR与CyclinD1可提高对口腔颌面部恶性肿瘤诊断的灵敏度、特异性和准确性,对口腔颌面部恶性肿瘤有辅助诊断价值。更多还原

【Abstract】 Objective:To determine the levels of SCCA,Cyfra21-1,EGFR and CyclinD1 in serum of patients with oral and maxillofacial malignancy,and to investigate their relationship with clinical stage,pathological grade and lymph node metastasis,their level changes before and after surgery.Methods:Ninety-two hospitalized patients with oral and maxillofacial malignancy,seventy-two healthy individuals were included in this investigation.Venous blood was collected from these patients and the healthy individuals before therapy.One week after therapy,venous blood was collected once again in 20 patients with oral and maxillofacial malignancy.Serum samples were detected by using enzyme linked immunosorbent assay(ELISA).Results:The serum SCCA,EGFR and CyclinD1 concentrations were significantly higher in patients with oral and maxillofacial malignancy than in healthy controls,while there was no significant difference in the Cyfra21-1 level between patients and healthy individuals.The serum SCCA level was significantly reduced one week after surgery, but there were no significant differences in the serum Cyfra21-1,EGFR and CyclinD1 levels before and after surgery.None of the serum SCCA,Cyfra21-1,EGFR and CyclinD1 level was correlated with the clinical stage,pathological grade and lymph node metastasis.If SCCA, EGFR and CyclinD1 were detected independently,EGFR had the highest sensitivity,specificity and accuracy in diagnosis;if any two of the three were dected in combination,the combined detection of EGFR and CyclinD1 had the highest sensitivity,specificity and accuracy. Conclusion:SCCA,EGFR,CyclinD1 may prove to be useful tumor markers in oral and maxillofacial malignancy.SCCA serum level was decreased significantly after surgery,which can be used to monitor therapeutic efficacy.The combined determinnation of EGFR and CyclinD1 may be of value in the adjuvant diagnosis of oral and maxillofacial malignancy.更多还原