The diagnostic significance of 64-slice spiral CT combined with serological CA19-9, Bcl-2, CYFRA21-1 detection in thoracic esophageal carcinoma

BACKGROUND: To analyze the clinical value of multi-slice spiral computed tomography (MSCT) combined with carbohydrate antigen 19-9 (CA19-9), B-cell leukemia/lymphoma-2 protein (Bcl-2), and cytokeratin 19 fragment antigen 21-1 (CYFRA21-1) detection in the diagnosis of thoracic esophageal cancer. METHODS: The clinical data of 74 patients with thoracic esophageal cancer admitted to the Dazu District People’s Hospital in Chonqing, China, from December 2019 to December 2020 were collected (esophageal cancer group), and their computed tomography (CT) signs were analyzed. Another 55 healthy people who underwent physical examination during the same period in the hospital were selected for the healthy group. The serum levels of CA19-9, Bcl-2, and CYFRA21-1 in the different populations were compared, using the receiver operating characteristic (ROC) curve to analyze the value of MSCT combined with CA19-9, Bcl-2, and CYFRA21-1 detection in the diagnosis of thoracic esophageal cancer. RESULTS: The serum levels of CA19-9, Bcl-2, and CYFRA21-1 in patients of the esophageal cancer group were significantly higher than those in the healthy group (P<0.05). The serum levels of CA19-9, Bcl-2, and CYFRA21-1 in patients with poorly differentiated, stage III–IV carcinoma and lymph node metastasis were significantly higher than in those patients with moderately well-differentiated, stage I–II carcinoma and no lymph node metastasis (P<0.05). The CT scans of patients in the esophageal cancer group showed esophageal walls with irregular, needle-shaped, circular, or localized eccentric thickening and narrowed lumens, which were dilated above the cancerous lesions. Some tumors compressed adjacent organs to deform and shift the organs, resulting in the disappearance of surrounding fat layers. Enhanced scans showed mild or moderate enhancement, with large-diameter lesions unable to enhance central, low-density, necrotic areas. The ROC curve showed that the area under the curve (AUC) and the sensitivity and specificity of MSCT combined with CA19-9, Bcl-2, and CYFRA21-1 detection were all higher than for esophageal lesions detected by individual indicators. CONCLUSIONS: CA19-9, Bcl-2, and CYFRA21-1, which are abnormally expressed in patients with esophageal cancer, may be related to the occurrence and development of esophageal cancer. MSCT combined with CA19-9, Bcl-2, and CYFRA21-1 detection appears to enhance the diagnosis of esophageal cancer.