Clinical Significance Of Combined Detection Of Serum CEA, SCC, CYFRA21-1 And Using SELDI To Detect The Serum Protein Change Before And After Radiotherapy In Esophagus Carcinoma

Objective To investigate the clinical significance of combined detection serum CEA,SCC,CYFRA21-1 and using SELDI to detect the serum protein change and explore some specific markers in diagnosis,prediction of treatment and prognosis for esophagus carcinoma by detecting the change of serum CEA,SCC, CYFRA21-1 and serum protein before and after radiotherapy in esophagus carcinoma.Methods 226 cases of esophagus carcinoma patient and 50 cases of healthy control were collected in Shanxi Cancer Hospital from November,2006 to December,2008.ELISA was used to detect the serum CEA,SCC and CYFRA21-1 of patients with esophagus cancer before and after radiotherapy and healthy control subjects.At the same time,SELDI was used to detect the serum protein of 30 patients in same group were analyzed by Ciphergen PBS IIc reader.SPSS13.0 and Biomarker wizard was used for the statistical analysis.Results The positive rate of CEA,SCC and CYFRA21-1 was 11.1%,16.8%,27.4%, respectively and the combined positive rate was 39.8%from 226 patient serums before radiotherapy.Compared with the healthy control group,the mean value of serum CEA and CYFRA21-1 was statistically different(p＜0.01).The longer the lesion length,the later the clinical stage,the deeper the tumor invasion,the higher the mean value of serum CEA,SCC,CYFRA21-1 was.The mean value was lower in the early stage.The mean value of CEA,SCC and CYFRA21-1 was found to be well correlated with tumor size,TNM stage and depth of tumor invasion.Among three tumour biomarkers,the individual difference of CEA and CYFRA21-1 was bigger and the correlation of CYFRA21-1 was the best.The biomarker value dropped to the level below the normal in 76.7%patient in the 90 cases after radiotherapy. According to P＜0.05,11 proteomic peaks were found from 30 cases of patients with esophagus cancer before and after radiotherapy and their M/Z value was 2764, 2513,2787,2950,3401,3885,3472,2820,3267,2742,2923,respectively.Their proteomic peak before radiotherapy was higher than that after radiotherapy.The proteomic peak might rise again in the recurrent patients.The same proteomic peak was also observed in the patients below the normal level of CEA,SCC, CYFRA21-1.Conclusion The combined detection of serum CEA,SCC,CYFRA21-1 may be used as adjuvant diagnosis for esophagus cancer and has better clinical value for prediction to treatment and prognosis,in which CYFRA21-1 has the best clinical value.The serum proteomic finger print spectrum may be more sensitive in the diagnosis and treatment for esophagus cancer than serum CEA,SCC, CYFRA21-1.Their combined detection can improve the diagnostic rate in the early stage and be better indicator to treatment and prognosis for esophagus cancer.