膀胱癌患者血清CK-19、CYFRA21-1的表达及其临床意义

The expression and clinical significance of CK-19 and CYFRA21-1 in serum of patients with bladder cancer

摘要:

目的 探讨膀胱癌（BC）患者血清肿瘤异常糖链蛋白（CK-19）及细胞角蛋白片段19抗原21-1（CYFRA21-1）的表达及其临床意义。方法 选取2020年1月—2021年6月西南医科大学附属中医医院诊治的83例BC患者作为BC组。选取同期该院诊治的60例泌尿系统良性疾病患者作为良性疾病组。选取同期在该院体检的60例健康群众作为对照组。应用化学发光免疫法检测血清CYFRA21-1水平，ELISA检测血清CK-19水平，统计学分析各组CK-19及CYFRA21-1水平差异及两指标与临床特征的关系。Pearson分析CK-19与CYFRA21-1水平的相关性。受试者工作曲线（ROC）预测CK-19、CYFRA21-1及联合检测对膀胱癌的诊断价值。结果 BC组CK-19、CYFRA21-1水平高于良性疾病组和对照组（P <0.05），良性疾病组CK-19、CYFRA21-1水平高于对照组（P <0.05）。肿瘤分期Ⅲ、Ⅳ期CK-19、CYFRA21-1水平高于肿瘤分期Ⅰ、Ⅱ期（P <0.05）。不同性别、年龄、肿瘤大小、浸润深度和有无病理分级BC患者的CK-19、CYFRA21-1水平比较，差异无统计学意义（P >0.05）。Pearson相关性分析显示，BC患者CK-19与CYFRA21-1水平呈正相关（r =0.578，P <0.05）。联合检测的诊断价值大于CK-19或CYFRA21-1单独检测（P <0.05）。结论 BC患者血清中CK-19及CYFRA21-1水平升高，两者表达与肿瘤分期有关，联合检测CK-19及CYFRA21-1有望成为诊断BC的新肿瘤标志物。

Abstract:

Objective To explore the expression of cytokeratin 19 (CK-19) and cytokeratin 19 fragment antigen 21-1 (CYFRA21-1) in serum of patients with bladder cancer (BC) and their clinical significance.Methods Clinical data of 83 BC patients (BC group) diagnosed and treated in our hospital from January 2020 to June 2021 were selected. In addition, 60 cases of benign diseases of the urinary system were enrolled as benign disease group, and 60 healthy patients undergoing physical examinations were enrolled as healthy control group. Chemiluminescence immunoassay was used to detect the serum CYFRA21-1 level, and enzyme-linked immunosorbent assay was used to detect the serum CK-19 level. The differences in the expression of CK-19 and CYFRA21-1 among the groups and the relationship between the two indicators and clinical characteristics were statistically analyzed. The correlation between CK-19 and CYFRA21-1 expression was analyzed by Pearson correlation method. The diagnostic value of CK-19, CYFRA21-1 and the combined detection of the two for BC were analyzed by receiver operating characteristic (ROC) curve.Results Compared with the benign disease group and healthy control group, serum CK-19 and CYFRA21-1 levels were significantly increased in BC group (both P < 0.05). The serum levels of CK-19 and CYFRA21-1 were higher in the benign disease group than those in the healthy control group (both P < 0.05). The expression of CK-19 and CYFRA21-1 in serum was higher in patients with stage Ⅲ and Ⅳ BC relative to those in patients with stage Ⅰ and Ⅱ BC (all P < 0.05). However, gender, age, tumor size, depth of invasion, and histologic grade were not associated with the expression of CK-19 and CYFRA21-1 in BC patients (all P > 0.05). Pearson correlation analysis demonstrated that the CK-19 expression was positively correlated with the CYFRA21-1 expression in BC patients (r =0.578, P < 0.05). The diagnostic value of the combined detection was greater than that of CK-19 or CYFRA21-1 alone for BC (P < 0.05).Conclusions The levels of CK-19 and CYFRA21-1 in serum of patients with BC are elevated, and the expression of them is related to the tumor stage. Thus, the combined detection of CK-19 and CYFRA21-1 is expected to become a new diagnostic marker for BC.