ABSTRACT
Objective To study the clinical significance of the novel tumor marker Cytokerantin?19?fragment( CYFRA 21?1) of peripheral blood in patients with esophageal cancer. Methods The CYFRA 21?1 level in peripheral blood of 72 patients with benign tumor of esophagus or reflux esophagitis and 60 patients with esophageal cancer was examined before and 7 days after operation by enzyme?linked immuno sorbent assay ( ELISA) . At the same time, patients with esophageal cancer were followed up for 3 years, and the level of CYFRA21?1 was examined. Results (1)Before the operation,the level of CYFRA 21?1 was 0-3. 30 μg/L in 51. 67%( 31/60 ) of the patients with esophageal cancer, higher than that of the control group ( 16. 67%(12/72),χ2=3. 88,P0. 05). The level of CYFRA21?1 with the palliative resection of esophageal cancer was (3. 31±0. 66) μg/L,and the difference was significant compared with the control group(t=4. 33,P<0. 05) . ( 4 ) After 3 years of follow?up, the factors affecting the survival rate of esophageal cancer were as following:the pathologic stages of tumor(OR 4. 423,95%CI 1. 943-4. 972,P<0. 05),types of operation(OR 0. 023,95%CI 0. 012-0. 036,P<0. 05),the level of CYFRA21?1 before operation(OR 6. 798,95%CI 4. 328-8. 105,P<0. 05),and the decreased level of CYFRA21?1 after operation(OR 0. 117,95%CI 0. 074-0. 202,P<0. 05) . ( 5) During the follow?up period,the level of CYFRA21?1 in patients with local recurrence and distant metastasis of esophageal carcinoma was (7. 97±0. 44) μg/L,significantly more than that of the control group(t=5. 11,P <0. 05) . Conclusion CYFRA21?1 is a useful tumor marker in the positive rate of preoperative diagnosis of esophageal cancer, postoperative monitoring of recurrence, distant metastasis and prediction of prognosis.