联合检测CA724、CA199、CEA对胃癌诊断价值的Meta分析

摘 要：［目的］ 系统评价联合检测血清肿瘤标志物（CA724、CA199、CEA）对胃癌的诊断价值。［方法］ 计算机检索PubMed、中国知网、万方、维普等数据库,收集关于CA724、CA199、CEA在胃癌诊断中应用的相关文献。采用Meta-Disc l.4、RevMan 5.2和Stata 13.0进行Meta分析。［结果］ 纳入10篇文献,共1642例。对胃癌诊断中,单独检测CA724的敏感度为0.49(95%CI：0.45~0.53),特异度为0.91(95%CI：0.89~0.93),诊断比值比为10.97(95%CI：8.22~14.63);联合检测的敏感度为0.76(95%CI：0.73~0.79),特异度为0.82(95%CI：0.79~0.84),诊断比值比为19.85(95%CI：10.78~36.52)。单独检测CA724的曲线下面积（AUC）=0.80,Q*=0.74;联合检测的AUC=0.95,Q*=0.90。联合检测和单独检测CA724两种方式的诊断效能差异具有统计学意义（Z=4.86,P＜0.05）。［结论］ CA724联合检测的诊断效能比单独检测CA724要高,对胃癌的辅助诊断具有较高的指导意义。     

CA19-9和CA242对消化道肿瘤的诊断价值

目的研究肿瘤标志物CA19-9与CA242对消化道肿瘤的诊断价值。方法对87例消化道恶性肿瘤及90例消化道良性疾病患者进行血清CA19-9与CA242检测。结果CA19-9和CA242对胰腺癌、胆系癌有较高的阳性率,其诊断的灵敏度、特异度如下CA19-9对胰腺癌分别为84.7%和74.5%,对胆系癌分别为80%和74.5%;CA242对胰腺癌分别为66.7%和80%,对胆系癌分别为60%和80%。其它恶性肿瘤,除结肠癌外,CA19-9的阳性率均高于CA242。原发性肝癌患者血清CA19-9和CA242阳性率具有显著差异,分别为66.7%和37%,而良性肝病患者血清CA19-9和CA242阳性率分别为50%和26.8%,CA242较少受慢性肝病的影响。结论CA19-9和CA242可用于胰腺癌、胆系癌的诊断,CA242对良恶性肝病具有一定的鉴别诊断作用,并对结直肠具有一定的诊断价值。     

联合检测肿瘤标记物CA19-9、CA242在胰腺癌诊断中的应用

目的:探讨肿瘤标记物CA199和CA242对胰腺癌的诊断作用。方法:采用CanAg、CA199、CA242、EIA试剂盒检测胰腺癌23例,急性胰腺炎22例,健康者20例。结果:胰腺癌患者血清CA199和CA242较对照组显著增高(P<0.01),其中23例胰腺癌患者17例CA19蛳9阳性(73.8 %),15例CA242阳性(65.2 %)。灵敏度差异无显著性。22例急性胰腺炎10例CA199阳性(50.0 %),而CA242仅4例阳性(16.2 %)。差异有显著性(P<0.01)。20例健康者2例CA199阳性(10 %)CA242无阳性。结论:血清CA199和CA242对胰腺癌的诊断有较高的应用价值CA242的特异性优于CA199,二者联合检测可提高诊断的检出率和可靠性。     

异常凝血酶原（PIVKA-Ⅱ）对结直肠癌的辅助诊断价值

摘 要：［目的］ 评估异常凝血酶原（PIVKA-Ⅱ）在结直肠癌诊断中的应用价值。［方法］ 用化学发光法检测101例结直肠癌、25例直肠息肉、79名正常对照血清中的PIVKA-Ⅱ、癌胚抗原（CEA）、糖类抗原（CA199）及糖类抗原（CA242）浓度。绘制受试者工作特征曲线（ROC）,并进行比较分析。［结果］结直肠癌患者的血清PIVKA-Ⅱ浓度为30.19（18.51~45.85）U/L,显著高于直肠息肉患者的22.48（19.00~26.18）U/L（U=1821.0,P<0.01）以及健康对照组的22.00（18.00~24.02）U/L（U=2660.0,P=0.013）。根据ROC曲线分析,PIVKA-Ⅱ辅助诊断结直肠癌的灵敏度为33.66%,特异性为94.94%。PIVKA-Ⅱ、CEA、CA199、CA242诊断结直肠癌ROC曲线下面积分别为0.518、0.686、0.699、0.557。［结论］ PIVKA-Ⅱ检测对结直肠癌的辅助诊断具有一定的价值。联合CEA、CA199、CA242可以提高诊断灵敏度。     

血清HE4及CA125水平检测在早期卵巢恶性肿瘤诊断中的价值

目的探讨血清人附睾蛋白4（HE4）及癌抗原125（CA125）水平检测在早期卵巢恶性肿瘤诊断中的价值。方法用酶联免疫吸附试验方法（ELISA）测定150例女性血清HE4、CA125水平,其中卵巢恶性肿瘤组（45例）、卵巢良性病变组55例及健康女性50例,分析两指标单独或联合检测诊断卵巢恶性肿瘤的价值。结果①卵巢恶性肿瘤组血清HE4和CA125水平（分别为344.66±256.37 pmol/L和516.07±609.07 U/ml）,分别与卵巢良性病变组（分别为53.77±19.03 pmol/L和41.17±62.08 U/ml）和正常组（分别为39.06±16.17 pmol/L和10.36±7.28 U/ml）比较,差异均有显著性（P〈0.001）;②根据ROC曲线,当HE4在80 pmol/L时诊断指数最大（0.806）,灵敏性和特异性分别为84.4%和92.4%,ROC曲线下面积0.948（95%CI 0.900～0.997,P=0.000）;③卵巢良性病变组血清HE4单项检测的假阳性率（5.5%）明显低于血清CA125单项检测的假阳性率（21.8%,P=0.012）;④HE4对早期卵巢癌的检测阳性率（73.3%）高于CA125检测的阳性率（33.3%,P=0.031）;⑤HE4单项检测对卵巢癌预测的特异度、阳性预测值（分别为94.6%和93.2%）高于CA125单项检测的特异度、阳性预测值（分别为78.2%和72.7%,P〈0.05）。联合CA125和HE4作为卵巢癌的诊断指标时,其诊断灵敏度为88.9%,高于单项血清CA125检测灵敏度（P〈0.05）。结论 HE4可作为卵巢癌诊断的独立生物学指标,其对早期卵巢癌的诊断价值优于CA125,两者联合检测可以提高CA125对卵巢癌的诊断能力。血清HE4水平以80 pmol/L为界值点对卵巢恶性肿瘤的诊断指数最大。     

多肿瘤标志物蛋白芯片检测中CA125对恶性肿瘤的诊断价值

  目的  探讨多肿瘤标志物蛋白芯片中糖链抗原CA125对恶性肿瘤的诊断价值。  方法  收集第三军医大学大坪医院可供分析的25 076例多肿瘤蛋白芯片检测结果,分析CA125在不同人群、不同肿瘤中升高情况,以及CA125升高伴随其他检测指标升高在肿瘤中的分布情况。  结果  CA125在恶性肿瘤患者中明显高于良性病变患者及正常体检者,而且卵巢癌最高（51.92%）,其次为胰腺癌（49.25%）和肝癌（42.56%）;同时升高的指标以CEA最为常见,其次为CA199、CA242和Ferritin,CA125/CEA同时升高最常见于结直肠癌（83.87%）,其次为乳腺癌（59.72%）,CA125/CA199同时升高最常见于结直肠癌（90.97%）和胰腺癌（78.63%）,CA125/CA242伴随升高最常见于结直肠癌（92.26%）和胰腺癌（74.81%）,CA125+CEA+CA199及CA125+CEA+CA199+CA242升高均最常见于肺癌。  结论  CA125单项指标升高对卵巢癌、胰腺癌及肝癌的诊断有较高的价值,CA125伴随或联合CEA、CA199、CA242检测有利于提高结直肠癌、胰腺癌、肺癌的诊断阳性率。      

HE4、CA125及ROMA指数在早期浆液性卵巢癌诊断中的价值

摘 要：［目的］ 探讨HE4、CA125及ROMA指数在早期浆液性卵巢癌中的诊断价值。［方法］ 回顾性分析2013年7月至2015年6月期间于新疆医科大学第三附属医院初治的术后诊断为原发性浆液性卵巢癌（卵巢癌组）103 例、卵巢子宫内膜异位症患者135例和单纯性囊肿患者119例的病历资料,分析术前血清HE4、CA125水平及ROMA指数对早期浆液性卵巢癌的诊断价值。［结果］ (1)HE4和ROMA指数的阳性率随着临床分期的升高而升高,其在Ⅰ期的阳性率为68％和88%,均低于CA125的阳性率（92%）。（2）三者在早期卵巢癌中的阳性率明显高于在卵巢良性疾病中的阳性率（P＜0.01）。（3） HE4+ROMA指数联合特异性,阳性预测值、阴性预测值和诊断准确度率最高。［结论］ HE4+ROMA指数联合检测提高早期浆液性卵巢癌诊断的敏感度,降低漏诊率,有助于卵巢癌的早期诊断。     

CEA、CA199和细胞形态学联合检测对281例良、恶性胸腔积液鉴别诊断的临床意义

摘 要：［目的］ 探讨肿瘤标志物CEA、CA199、细胞形态学联合检测在鉴别良、恶性胸腔积液中的临床意义。［方法］ 收集281例胸腔积液患者,其中恶性组149例,良性组132例。采用化学发光免疫法测定患者血清及胸腔积液中CEA和CA199水平。胸腔积液经离心、推片和瑞氏染色后进行细胞形态学检查,以鉴别胸腔积液的良、恶性,并评价CEA、CA199、细胞形态学联合检测在鉴别良、恶性胸腔积液诊断中的敏感度及特异度。［结果］ 恶性组胸腔积液CEA、CA199 水平及阳性率均高于良性组（P<0.05）;恶性组血清CEA、CA199 的检测水平均高于良性组（P<0.05)。胸腔积液CEA+CA199肿瘤标志物联合检测的敏感度、特异度及ROC曲线下面积分别为73.82%、69.7%和0.720,而胸腔积液 CEA+CA199联合细胞形态学检查的敏感度、特异度及ROC曲线下面积更优,分别为85.23%、69.7%和0.777。［结论］ 联合测定胸腔积液中 CA199、CEA水平和细胞形态学分析能提高良、恶性胸腔积液的鉴别诊断价值。     

联合检测胃液中CEA 、CA199 、CA242 在胃癌诊断中的应用价值

 目的 探讨胃液中CEA、CA199、CA242联合检测在胃癌早期诊断中的价值。方法 采用化学发光和ELISA法测定28例胃癌、32例癌前疾病患者和28例对照者血清及胃液中CEA、CA199、CA242的含量。结果 胃癌组胃液中CEA、CA199、CA242测定值平均水平和检测灵敏度显著性高于血清检测灵敏度（均P〈0.01）;胃癌组血清和胃液中CEA、CA199、CA242测定值平均水平显著高于癌前病变组和对照组（P〈0.01）;血清和胃液中三种肿瘤标志物联合检测的灵敏度显著提高（P〈0.01）。结论 胃液中CEA、CA199、CA242的联合监测,有助于胃癌的早期诊断和疗效追踪,有重要的临床应用价值。     

HE4、CA125和CA199联合D-二聚体检测在卵巢癌早期诊断中的应用

目的探讨人附睾分泌蛋白4(HE4)、糖类抗原125(CA125)和糖类抗原199(CA199联合血浆D-二聚体检测在卵巢癌早期诊断中的应用价值。方法选取2014年1月至2017年12月间上海市金山区亭林医院收治的50例确诊卵巢癌患者为癌症组,50例良性卵巢肿瘤患者为良性组,另选取同期50例健康体检女性为对照组,采用化学发光法测定三组受试者血清HE4、CA125和CA199的水平,采用免疫比浊法测定血浆D-二聚体水平,分析四项指标水平对卵巢癌早期诊断价值。结果癌症组患者HE4、CA125、CA199及D-二聚体水平均高于良性组和对照组,差异均有统计学意义(均P <0. 05)。癌症组患者HE4、CA125、CA199、D-二聚体及联合检测阳性率均高于良性组和对照组,差异均有统计学意义(均P <0. 05)。单项检测中,HE4敏感性、特异性、阳性预测值、阴性预测值及诊断效率最高;联合检测敏感性、特异性、阳性预测值、阴性预测值及诊断效率均高于单项检测。结论 HE4、CA125、CA199和D-二聚体联合检测可提高卵巢癌早期诊断效率,对卵巢癌的早期诊断和治疗有重要临床价值。     

CA125、CA19.9、CA15-3联合测定对卵巢良恶性肿瘤的诊断价值

目的 评价肿瘤标志物CA125、CA19.9、CA15-3在卵巢良恶性肿瘤的诊断价值,以提高CA125单独测定的敏感性与特异性。方法应用放射免疫方法测定了21例卵巢良性肿瘤及21例卵巢恶性肿瘤的血清CA125、CA19.9、CA15-3值并进行比较分析。结果 卵巢恶性肿瘤患者血清CA125、CA15-3含量显著高于良性肿瘤组(P<0.001),单独应用CA125诊断卵巢恶性肿瘤的准确性为78.57％,优于CA15-3和CA19.9。而以三项肿瘤标记物中的任意两项阳性为标记物诊断阳性时,准确性为85.71％,较CA125单独测定诊断卵巢良恶性肿瘤有较高的准确性。结论 CA125、CA15-3、CA19.9三项肿瘤标记物联合检测,以其中任意两项同时增高作为阳性标准,对提高卵巢良、恶性肿瘤诊断及鉴别诊断的准确性有一定意义。     

Diagnostic value of CA 549 in pleural fluid. Comparison with CEA,CA 15.3 and CA 72.4

Several tumor markers have been evaluated in pleural fluid, but their clinical role has not been firmly established. The aim of this study is to determine the diagnostic value of carbohydrate antigen 549 (CA 549) levels in pleural fluid, and to compare it with another previously studied tumor markers: carcinoembryonic antigen (CEA), CA 15.3 and CA 72.4. We prospectively studied 252 patients with pleural effusion: 101 malignant (20 mesothelioma) and 151 of several benign diseases. The levels of the tumor markers were measured by immunoradiometric assays (RIA). CA 549 in pleural fluid has an acceptable sensitivity (0.49), with high specificity (0.99). The best combination of tumor markers for differentiating malignant from benign effusions was CA 549+CEA+CA 15.3, with a sensitivity of 0.65, specificity of 0.99 and accuracy of 0.85. The addition of any one tumor marker assay consistently improved the diagnostic value of cytology. In our study, none of the tumor markers was organ-specific. When mesothelioma and hematological malignancy were ruled-out, the combination of CA 549+CEA+CA 15.3, improved the results up to a sensitivity of 0.77, specificity of 1 and accuracy of 0.92. In conclusion, CA 549 assay has an acceptable sensitivity with high specificity. The best combination of tumor markers in this series with a high relative frequency of mesothelioma and low frequency of breast carcinoma was CA 549+CEA+CA 15.3. Individual tumor markers or their combination increased the sensitivity of pleural cytology.     

CEA,AFP, CA125, CA153 and CA199 in Malignant Pleural Effusions Predict the Cause

Determination of the cause of malignant pleural effusions is important for treatment and management,especially in cases of unknown primaries. There are limited biomarkers available for prediction of the cause ofmalignant pleural effusion in clinical practice. Hence, we evaluated pleural levels of five tumor biomarkers (CEA,AFP, CA125, CA153 and CA199) in predicting the cause of malignant pleural effusion in a retrospective study.Kruskal-Wallis or Mann-Whitney U tests were carried out to compare levels of tumor markers in pleural effusionamong different forms of neoplasia - lung squamous cell carcinoma, adenocarcinoma, or small cell carcinoma,mesothelioma, breast cancer, lymphoma/leukemia and miscellaneous. Receiver operator characteristic analysiswas performed to evaluate sensitivity and specificity of biomarkers. The Kruskal-Wallis test showed significantdifferences in levels of pleural effusion CEA (P<0.01), AFP (P<0.01), CA153 (P<0.01) and CA199 (P<0.01), butnot CA125 (P>0.05), among the seven groups. Receiver operator characteristic analysis showed that, comparedwith other four tumor markers, CA153 was the best biomarker in diagnosing malignant pleural effusions of lungadenocarcinoma (area under curve (AUC): 0.838 (95%confidence interval: 0.787, 0.888); cut-off value: 10.2U/ml; sensitivity: 73.2% (64.4-80.8)%, specificity: 85.2% (77.8-90.8)%), lung squamous cell carcinoma (AUC:0.716 (0.652, 0.780); cut-off value: 14.2U/ml; sensitivity: 57.6% (50.7-64.3)%, specificity: 91.2% (76.3-98.0)%),and small-cell lung cancer (AUC: 0.812 (0.740, 0.884); cut-off value: 9.7U/ml; sensitivity: 61.5% (55.0-67.8)%,specificity: 94.1% (71.2-99.0)%); CEA was the best biomarker in diagnosing MPEs of mesothelioma (AUC:0.726 (0.593, 0.858); cut-off value: 1.43ng/ml; sensitivity: 83.7% (78.3-88.2)%, specificity: 61.1% (35.8-82.6)%)and lymphoma/leukemia (AUC: 0.923 (0.872, 0.974); cut-off value: 1.71ng/ml; sensitivity: 82.8% (77.4-87.3)%,specificity: 92.3% (63.9-98.7)%). Thus CA153 and CEA appear to be good biomarkers in diagnosing differentcauses of malignant pleural effusion. Our findings implied that the two tumor markers may improve the diagnosisand treatment for effusions of unknown primaries.     

Clinical usefulness of three monoclonal antibody-defined tumor markers: CA 19-9, CA 50, and CA 125

This article reviews the clinical usefulness of three monoclonal antibody-defined tumor markers: CA 19-9 or GICA, CA 50, and CA 125. These markers have been regarded as worthwhile tools for diagnosis and monitoring the management of patients with cancers in selected sites. The CA 19-9 test in combination with the CEA test is a useful adjunct for staging in some advanced cases and for monitoring therapy in the majority of patients with carcinoma of the stomach. Sensitivity of these assays performed concurrently is comparable to CEA alone in colorectal carcinoma. The CA 19-9 test alone is useful for staging and monitoring management of patients with carcinoma of the pancreas. In colorectal carcinoma the CA 19-9 test is redundant because of significantly lower sensitivity than that of the CEA assay; the latter remains the test of choice. The CA 50 test per se is redundant since the CA 19-9 antigen is the target for both the C50 MAb and the NS 19-9 MAb. The CA 125 test contributes to staging and is a useful adjunct for monitoring management of patients with non-mucinous carcinomas of the ovary. If positive after initial surgery and chemotherapy, this test provides evidence of the presence of residual or metastatic tumor and thus may obviate the need for second-look surgery. These conclusions are based on a review of recent relevant publications as well as on our own results obtained from preoperative evaluation and postoperative follow-up of about 600 patients with cancers in relevant sites.     

CA19-9、CA50、CA242、CEA检测对胰腺癌早期诊断的意义

目的　探讨CA19- 9、CA5 0、CA2 42、CEA肿瘤标志物联合检测对早期诊断胰腺癌 (PCA)的意义。方法　采用放射免疫分析法 ,检测 5 6例PCA患者及 5 4例胰腺良性疾病患者血清CA19- 9、CA5 0、CA2 42、CEA值并进行比较分析。结果　PCA患者血清CA19- 9(10 8± 148)、CA5 0 (45± 80 )、CA2 42 (78± 5 4)、CEA(3 5± 2 7)。与对照组血清CA19- 9(2 9± 3 6) ,CA5 0 (2 0± 3 0 )、CA2 42 (2 0± 14)、CEA(2 5± 12 )比较有非常显著差别(P <0 0 1)。结果　胰腺恶性肿瘤患者中 ,血清CA19- 9、CA5 0、CA2 42、CEA标志物含量明显高于胰腺良性疾病 ,且CA19- 9阳性率较高 (76 8% )。肿瘤越大CA19- 9水平越高 ;当癌肿手术后复发、转移时 ,均有CA19- 9再度明显升高 ,可早期发现以随时调整治疗方案。PCA标志物联合检测阳性率 (92 % ) ,明显高于单检阳性率 (76 8% )。四种标志物之间有相关性及互补性 ,可显著提高PCA的早期诊断 ,并有助于与良性胰腺疾病鉴别     

CA125、CA153、CA199和SCC联合检测对宫颈癌的诊断价值

目的 探讨CA125、CA153、CA199和SCC联合检测在诊断宫颈癌中的价值.方法 将54例宫颈癌患者纳入A组,72例宫颈良性肿瘤患者纳入B组,同期健康妇女60例纳入对照组.采用电化学发光免疫分析法检测血清CA125、CA153、CA199,采用微粒子酶免疫分析法检测血清SCC.结果 宫颈癌组患者血清CA125、CA153、CA199和SCC水平均高于宫颈良性肿瘤组和对照组患者,差异有统计学意义(P＜0.05).联合CA 125、CA153、CA199和SCC检测的阳性率远高于CA153,CA199和SCC单独检测,差异有统计学意义(P＜0.05).特异性方面,联合组显著低于CA199和SCC单独检测组(P＜0.05);灵敏度方面,联合组显著高于CA125、CA153、CA199和SCC单独检测组(P＜0.05);准确性方面,联合组显著高于CA153、CA199和SCC单独检测组(P＜0.05);联合组在阳性预测值方面与各指标单独检测比较无显著差异(P＞0.05).结论 CA125、CA153、CA199和SCC四种标志物联合检测对宫颈癌具有很高的诊断价值,对宫颈癌的诊断有重要意义,可以在临床推广使用.     

血清CA125、CA153、CA242三种肿瘤标志物联合检测对肺癌诊断的价值

目的探讨CA125、CA153、CA242联合检测在肺癌筛查与临床诊断中的应用价值.方法采用CanAg诊断试剂盒,对56例肺癌患者及108例健康人血清进行CA125、CA153、CA242测定.结果肺癌患者组CA125、CA153、CA242值分别为54.97±95.70,36.02±40.38,14.38±21.99;阳性率分别为41.07%、44.64%、23.21%.健康人组CA125、CA153、CA242值分别为11.23±1.58,12.73±11.92,15.11±13.60,阳性率均为0%,肺癌患者组CA125、CA153值明显高于健康人组(P＜0.01),肺癌患者组中CA125、CA153阳性率明显高于CA242(P＜0.05),CA125、CA153联合检测阳性率明显大于单独检测(P＜0.05)、Ⅰ-Ⅱ期肺癌患者与Ⅲ、Ⅳ期肺癌患者CA125、CA153值相比有显著性差异(P＜0.05).结论 CA125、CA153联合检测对肺癌筛查与临床诊断有良好辅助价值,CA242测定对肺癌筛查与临床诊断价值不大.     

血清CA153、CA125、CA199和CEA联合检测在乳腺癌诊断中的价值

目的探讨联合检测血清CA153、CA125、CA199和CEA的含量对乳腺癌的诊断价值。方法运用电化学发光免疫分析方法检测乳腺癌68例、乳腺良性疾病50例及体检健康女性58名血清中CA153、CA125、CA199、CEA的含量,分析各肿瘤标志物诊断的灵敏度、特异度、准确度及联合检测的临床意义。结果单独检测CA153、CA125、CA199、CEA对乳腺癌诊断的阳性率分别为76．4％（52／68）、44．1％（30／68）、35．3％（24／68）、29．4％（20／68）;联合检测4种肿瘤标志物的阳性率为94．1％（64／68）。结论血清CA153、CA125、CA199和CEA联合检测具有提高乳腺癌早期诊断的价值。     

血清糖类抗原125和糖类抗原199在卵巢肿瘤诊断中的意义

目的探讨血清糖类抗原125（CA125）和糖类抗原199（CA199）在卵巢肿瘤诊断中的意义。方法采用化学发光法检测2010年1月至2011年12月收治的196例卵巢肿瘤患者（良性肿瘤组140例、交界性肿瘤组13例、恶性肿瘤组43例）和50例健康体检者（对照组）的血清CA125和CA199。比较两种肿瘤标记物单检及联检在卵巢肿瘤诊断中的敏感度和特异度。结果 （1）CA125在卵巢良性肿瘤、交界性肿瘤和恶性肿瘤的表达水平分别为（19.80±13.57）U/ml、（94.59±53.41）U/ml和（759.00±677.26）U/ml,均高于对照组水平（9.94±5.64）U/ml,各组之间差异有统计学意义（P〈0.05）;（2）CA199在卵巢良性肿瘤、交界性肿瘤和恶性肿瘤的表达水平分别为（69.13±72.08）U/ml、（167.70±19.22）U/ml和（184.00±93.26）U/ml,均高于对照组水平（13.42±11.16）U/ml,但各组之间差异无显著意义（P〉0.05）;（3）CA125在卵巢恶性肿瘤诊断中敏感度、特异度为76.7%和90.0%,均高于CA199,两者联合检测并没有明显提高敏感度,反而降低了特异度。结论 CA125可作为卵巢肿瘤诊断的生物指标,而CA199的敏感度和特异度均较低,临床意义不大,两者联合检测并没有比CA125单项检测更具优势。     

检测胸水中CEA、CA125、CA153及CA199对肺癌的诊断价值

目的　探讨检测胸水中癌胚抗原 (CEA)、癌抗原 12 5 (CA12 5 )、癌抗原 15 3 (CA15 3 )及癌抗原 199(CA199)在肺癌诊断中的应用价值。方法　采用化学发光法对 5 2例肺癌患者的胸水、血清及 5 0例非肺癌患者的胸水进行了免疫蛋白定量分析。结果　肺癌组胸水内 4项标志物水平均明显高于非肺癌组水平 (P <0 .0 1或P <0 .0 5 ) ;肺癌组胸水中 4项标志物水平明显高于血清中水平 (P <0 .0 1或P <0 .0 5 ) ;CEA与CA199联合检测其敏感性和特异性高达 96.2 %和 96.0 %。结论　检测胸水中CEA、CA12 5、CA15 3及CA199对肺癌的诊断具有重要的临床意义 ,其中CEA与CA199联合检测为最佳组合