CTA联合肿瘤标志物检测在胰腺癌诊断中的价值

目的：探讨 CTA 联合胰腺癌诊断常用肿瘤标志物 CA19-9、CA125、CEA 在胰腺癌诊断中的价值。方法：回顾性分析43例经病理证实并被诊断为胰腺癌的患者,所有患者均进行腹部 CTA、血清 CA19-9、CA125、CEA 多项检查,对检查结果进行分析。结果：CTA 诊断准确率约62.8%,血清 CA19-9、CA125及 CEA诊断阳性率分别为81.4%、32.6%、53.5%。CTA 联合 CA19-9、CA125及 CEA 三项时诊断效能最高,诊断准确率为97.7%。CTA 联合肿瘤标志物诊断效能优于单一 CTA（P <0.000）、CA19-9（P <0.03）、CA125（P <0.000）及 CEA（P <0.000）检查。结论：CA19-9在胰腺癌的诊断效能高于 CTA、CA125及 CEA。CTA 联合CA19-9、CA125及 CEA 三项可明显提高胰腺癌的诊断准确率。     

肿瘤标志物的联合检测在胰腺癌诊断中的应用

目的探讨肿瘤标志物联合检测在胰腺癌诊断中的应用价值。方法采用电化学发光法对胰腺癌患者的血清CA19_9、CA242和CEA进行检测。结果3种肿瘤标志物中敏感性和特异性以CA19_9最好,分别为82.0%和79.8%,联合检测三种肿瘤标志物可提高其敏感性,敏感性可达89.0%。结论联合检测肿瘤标志物有助于胰腺癌的早期诊断。     

多肿瘤标志物蛋白芯片检测系统在肺癌诊断中的临床评价

目的：探讨应用多肿瘤标志物蛋白芯片检测系统对肺癌的诊断临床价值。方法：临床确诊的肺癌患者117例为肺癌组,非肺癌的其他肿瘤患者507例为对照组。用多肿瘤标志物蛋白芯片检测系统检测癌胚抗原（CEA）、甲胎蛋白（AFP）、癌抗原125（CA125）、癌抗原15-3（CA15-3）、糖链抗原19-9（CA19-9）、糖链抗原242（CA242）、铁蛋白（Ferr）等12种血清肿瘤标志物,临床评价血清肿瘤标志物的组间差异。结果：CEA,Ferr,CA153这三项指标为诊断肺癌的独立相关因素（P〈0.05）,其诊断肺癌的cut-off值分别为0.39,2.06,0.96。基于上述cut-off值水平,CEA诊断肺癌的敏感性、特异性、阳性预告值分别为80.34%,59.12%,31.54%;Ferr诊断肺癌的敏感性、特异性、阳性预告值分别为80.24%,60.32%,30.99%;CA153诊断肺癌的敏感性、特异性、阳性预告值分别为69.57%,53.29%,25.48%。比较三项指标ROC曲线下面积可见,CEA,Ferr对于鉴别肺癌准确性更高。结论：在众多肿瘤标记物中,CEA,Ferr,CA153水平的升高与肺癌发生独立相关,其中CEA与Ferr具有更高的诊断准确性。     

外周血内CA19-9、CA242及CEA对胰腺癌诊断及病理分期评估的价值

目的：分析糖类抗原19-9（carbohydrate antigen 19-9,CA19-9）、CA242、癌胚抗原（carcino-embryonic anti-gen,CEA）联合检测诊断胰腺癌的临床价值及其对临床分期判断的指导作用。方法选取95例胰腺癌患者为患者组,及同期60例健康体检者为对照组,比较两组受试者血清CA19-9、CA242和CEA的表达水平,计算血清CA19-9、CA242、CEA单独检测及联合检测诊断胰腺癌的敏感度、特异度和准确性,并比较不同临床分期胰腺癌患者血清CA19-9、CA242、CEA的差异,评价上述指标对胰腺癌临床分期判断的指导作用。结果患者组血清 CA19-9、CA242、CEA水平均高于对照组,差异均具有统计学意义（均P＜0．05）。联合检测诊断胰腺癌的敏感度、特异度和准确性分别为96．8％、66．7％、85．2％,其敏感度、准确性均优于单项检测。随着患者病理分期的增加,其血清CA19-9、CA242、CEA水平均升高,差异均具有统计学意义（均P＜0．05）。患者组治疗后6个月血清CA19-9、CA242、CEA水平均较术前降低,差异均具有统计学意义（均P＜0．05）。肿瘤直径≥5 cm者、肿瘤位于胰腺体／尾部者,其血清CA19-9、CA242、CEA水平均高于肿瘤直径＜5 cm 者及肿瘤位于胰腺头部或全胰腺者,差异均具有统计学意义（均 P＜0.05）。结论联合检测血清CA19-9、CA242和CEA有助于胰腺癌的早期诊断及分期判断,具有较高的临床价值。     

早中期胰腺癌患者血清特异性糖链与CA19-9、CEA检测比较的研究

目的 通过检测并比较胰腺癌患者血清特异性N-糖链结构特征与CA19-9、CEA在早中期胰腺癌患者血清中的水平,探索血清特异性N-糖链结构特征早期诊断胰腺癌的可能性。方法 应用基于脱氧核糖核酸测序仪的荧光糖电泳技术比较并分析35例早中期胰腺癌患者血清和50例健康人群血清中N-糖链诊断早期胰腺癌的敏感度和特异性;同时检测CA19-9、CEA在早中期胰腺癌患者血清中的水平。结果 通过对血清N-糖链的分析比较,发现胰腺癌患者与健康人群的N-糖谱图基本一致,但个别糖峰下面积存在显著差异。选取升高最显著的糖峰14、17以及降低最显著的糖峰13作为特异性糖链,并进行ROC曲线分析,以log(p14×p17/p13)为指标发现曲线下面积为0.799±0.050。检测的灵敏度为84.9%,特异性为68%。CA19-9的灵敏度为61.2%,CEA的灵敏度为11.7%。结论 糖峰13、14、17有可能成为胰腺癌早期诊断的标志糖链。     

血清肿瘤标志物单项及联合检测在肺癌诊断中的临床价值

目的探讨血清癌胚抗原(Carcinoembryonic antigen,CEA)、糖类抗原19-9(CA19-9)、糖类抗原125(CA125)、细胞角蛋白19片断(Cytokeratinfragment 19,CYFRA21-1)、神经特异性烯醇化酶(Neuron-specific enolase,NSE)、鳞状细胞抗原(SCC-Ag)6种肿瘤标志物单项及联合检测在肺癌诊断中的临床价值。方法采用化学发光免疫法检测92例肺癌患者、92例肺良性疾病患者、92例健康体检者的血清CEA、CA19-9、CA125、CYFRA21-1、NSE、SCC-Ag表达水平。结果肺癌患者的血清肿瘤标志物CEA、CA19-9、CA125、CYFRA21-1、NSE、SCC-Ag的表达均明显高于肺良性疾病患者和健康体检者(P均<0.05);6种肿瘤标志物对肺癌诊断的灵敏性和准确度分别为:CEA(51.1%、73.3%)、CY-FRA21-1(58.7%、73.9%)、CA125(38.0%、71.4%))、CA19-9(27.2%、70.3%)、NSE(26.1%、65.9%)、SCC-Ag(35.9%、71.0%),而六者联合检测的灵敏性和准确度分别为92.4%和83.7%,明显高于各单项检测(P<0.05)。结论血清肿瘤标志物CEA、CA19-9、CA125、CYFRA21-1、NSE、SCC-Ag是诊断肺癌较好的标志物,六者联合检测可明显提高肺癌诊断的灵敏性和准确度。     

血清癌胚抗原联合糖类抗原19-9检测对胰腺癌筛查的临床价值评估

目的 研究血清癌胚抗原(CEA)联合糖类抗原19-9(CA19-9)检测对胰腺癌筛查的临床价值.方法 将103例胰腺癌患者作为胰腺癌组,选取同期收治的105例胰腺炎患者以及健康体检的97例健康人群作为胰腺炎组及健康对照组.对比治疗前3组血清CEA、CA19-9水平,以及手术前后胰腺癌患者血清CEA、CA19-9水平;对比血清CEA、CA19-9单独及联合检测诊断胰腺癌的灵敏度、准确度、特异度.结果 胰腺癌组与胰腺炎组患者血清CEA、CA19-9水平均高于健康对照组,胰腺癌组患者血清CEA、CA19-9水平均高于胰腺炎组,差异均有统计学意义(P﹤0.05).血清CEA联合CA19-9检测诊断胰腺癌的灵敏度明显优于CEA、CA19-9单一检测.术后3个月,胰腺癌患者血清CEA、CA19-9水平均明显低于手术前,差异均有统计学意义(P﹤0.01).结论 在胰腺癌的筛查过程中,采用血清CEA联合CA19-9检测效果显著,两者联合检测对胰腺癌诊断有较高的灵敏度、准确度,有助于提高疾病诊断率.     

血清CA19-9、CEA、CA125动态变化在判断胰腺癌同期放化疗患者疗效及预后中的应用

目的明确血清CA19-9、CEA及CA125动态变化在胰腺癌同期放化疗患者疗效、预后及随诊中的临床意义。方法采用回顾性分析的方法,通过对本院24例胰腺癌同步放化疗患者血清CA19-9、CEA及CA125治疗前后及治疗期间的动态观察,探讨其变化对临床疗效及预后的关系。结果全组患者中位生存期8.4月;CR 4例、PR 2例,有效率为25%;治疗前CA19-9≥200 ku/L、CEA≥10 μg/L 、CA125≥50 ku/L者中位生存期明显短于CA19-9<200 ku/L、CEA<10 μg/L 、CA125<50 ku/L者,分别为（8.0±1.4）月vs.（15.0±3.7）月,（6.0±1.8）月vs.（12.0±1.7）月,（6.0±1.6）月vs.（12.0±5.6）月（P< 0.05或< 0.01）;在治疗过程中,标志物呈“下降趋势”的患者有12例,中位生存期可达（15.0±3.5）月,有效率为50%;而呈“上升趋势”的12名患者中位生存期仅（6.0±0.6）月,有效率为0,P<0.001;治疗前后若异常血清标志物下降50%可能预测患者预后,中位生存期为（12.0±3.24）月,P<0.05。结论在胰腺癌同期放化疗患者中,血清CA19-9、CA125及CEA联合动态检测,可有效评价治疗效果及预后判断。     

联合检测CEA、CA19-9在D2胃癌术后随访中的价值

目的：探讨联合检测血清肿瘤标志物癌胚抗原（ CEA）和糖类抗原19-9（ CA19-9）在D2胃癌术后患者随访中的应用价值。方法：采集271例D2胃癌术后病人血清,利用免疫荧光分析法检测血清中CEA和CA19-9含量,并根据检验结果划分为CEA（-）/CA19-9（-）、CEA（﹢）/CA19-9（-）、CEA（-）/CA19-9（﹢）和CEA（﹢）/CA19-9（﹢）四个组。采用Kaplan-meier法进行生存率分析,利用Log-rank检验进行统计学差异性比较,χ2检验进行组间单因素分析。结果：两种肿瘤标志物CEA和CA19-9的联合检测时,两个同时为阳性组患者生存期远远低于单一阳性组;CEA（﹢）/CA19-9（-）组与CEA（-）/CA19-9（﹢）组比较,CEA（-）/CA19-9（﹢）组患者生存期要低于对照组,具有统计学差异（ P＜0.05）。结论：联合检测血清肿瘤标志物CEA和CA19-9在D2胃癌术后患者随访中,CA19-9阳性者提示更差的预后。     

血清肿瘤标志物联合检测在大肠癌诊断中的价值

[目的]研究血清中多种肿瘤标志物的变化及联合检测在大肠癌诊断中的价值。[方法]采用电化学发光免疫分析方法对161例大肠癌患者进行血清CEA、CA19-9、CA72-4和CYFRA21-1共4项肿瘤标志物检测,并与100例正常体检者进行对比分析其诊断价值。[结果]161例大肠癌患者的CEA、CYFRA21-1、CA72-4和CA19-9的阳性率分别为55.9%、42.2%、38.5%和36.9%,平均浓度分别为29.5±18.6、52.4±19.2、16.7±9.4和13.1±10.5,均明显高于正常对照组（P〈0.01）。采用平行联合检测可使诊断敏感度提高至80.5%,系列联合检测则使特异性提高到100%。Dukes’B、C期患者4项肿瘤标志物均明显高于Dukes’A期患者,术后4项指标均有下降。当肿瘤复发和转移时,CEA、CA72-4和CYFRA21-1再度明显升高。[结论]联合检测血清肿瘤标志物CEA、CA19-9、CA72-4和CYFRA21-1可提高大肠癌的诊断率,有助于大肠癌的早期诊断,并可用于判断大肠癌的疗效和预后。     

D-二聚体、癌胚抗原、糖类抗原199联合检测在胰腺癌诊断中的应用价值

目的探讨D-二聚体（D-D）、癌胚抗原（CEA）、糖类抗原199（CA199）联合检测在胰腺癌诊断中的临床价值。方法随机选取胰腺癌患者58例、胰腺良性疾病患者27例和健康成人40例,血清D-D以免疫比浊法检测,血清CEA、CA199采用电化学发光法检测,并对3组检测值进行分析。结果胰腺癌组与胰腺良性疾病组和健康成人组对比,血清D-D、CEA、CA199检测值均升高（P〈0.05）。在敏感性和特异性的单项指标分析中,CA199的敏感性最高,而D-D的特异性最高,分别为77.6%、82.5%。三者联合检测的特异性最高,达到97.5%。结论 D-D、CEA、CA199联合检测在胰腺癌诊断中具有较高应用价值。     

甲胎蛋白、癌胚抗原和糖链抗原19-9联合检测诊断消化系统恶性肿瘤的价值分析

目的 探讨甲胎蛋白(AFP)、癌胚抗原(CEA)和糖链抗原19-9(CA19-9)联合检测对消化系统恶性肿瘤的诊断价值.方法 回顾性分析300例消化系统恶性肿瘤患者和108例消化系统良性病变患者的临床资料,记录患者的血清AFP、CEA和CA19-9水平,评价其诊断效能.结果 肝癌患者的血清AFP、CEA和CA19-9水平均高于肝硬化患者,胃癌、胰腺癌和结直肠癌患者的血清CEA和CA19-9水平分别高于胃溃疡、胰腺炎和溃疡性结肠炎患者,差异均有统计学意义(P<0.05).单项检测中,AFP对肝癌的诊断敏感度(78.5%)高于CEA和CA19-9(P<0.05);CA19-9对胰腺癌的诊断敏感度(78.2%)高于AFP和CEA(P<0.05).对于肝癌、胃癌、胰腺癌和结直肠癌,3项联合检测的敏感度均高于单项检测(P<0.05).结论 血清AFP、CEA和CA19-9联合检测对消化系统恶性肿瘤的早期诊断具有重要意义,可提高诊断的敏感度,且不会降低特异度.     

Usefulness of a new tumor marker, Span-1, for the diagnosis of pancreatic cancer

Levels of serum Span-1, a new tumor marker for pancreatic cancer, were assayed in 64 patients with pancreatic cancer, 90 with nonpancreatic cancer, and 254 with nonmalignancies, involving 55 healthy controls. Furthermore, Span-1 was compared with other tumor markers (CA19-9, carcinoembryonic antigen [CEA], and DU-PAN-2). Frequency of elevated Span-1 levels was 81.3% in pancreatic cancer. False-positive elevations of serum Span-1 levels were rather common in liver cirrhosis (53.8%) and chronic hepatitis (26.3%). The sensitivity, specificity, and efficiency of this assay for pancreatic cancer, was 81.3%, 75.6%, and 76.5% against all subjects without pancreatic cancer, respectively. In comparison with other markers, sensitivity of Span-1 tended to be highest with similar specificity to those of CA19-9 and CEA. The Span-1 assay has a high sensitivity and specificity for pancreatic cancer. It is almost equivalent to CA19-9 assay. However, this assay is not specific for chronic liver diseases.     

CA 494—a new tumor marker for the diagnosis of pancreatic cancer

In 59 patients with ductal pancreatic cancer the monoclonal antibody (MAb) BW 494, which detects the CA 494 glycoprotein antigen, was analyzed in comparison with the reference tumor markers CA 19-9 and CEA. Eighty-one patients with non-pancreatic malignancies of the gastraintestinal (GI) tract, 95 with chronic pancreatitis, 124 with benign non-pancreatic GI diseases, 30 with diabetes mellitus (type I or type II) and I14 healthy blood donors served as controls. The sensitivity of pancreatic cancer was 90%, 44% and 90% for CA 19-9, CEA and CA 494, respectively. In chronic pancreatitis, as the most important control population for pancreatic cancer, the specificity was 85%, 72% and 94% for CA 19-9, CEA and CA 494, respectively.     

Circulating Cell Free DNA Integrity Index as a Biomarker for Response to Chemotherapy in Patients with Metastatic Colorectal Carcinoma

Objective: Assessing plasma Cell Free DNA (cfDNA) integrity index as a biomarker for response prediction and early response evaluation in mCRC patients receiving chemotherapy, in comparison to Carcinoembryonic antigen (CEA) and Carbohydrate antigen 19-9 (CA19-9), to be used as an additional tool to computed tomography (CT). Methods: CEA, CA19-9, cfDNA concentration and cfDNA integrity index (ALU 247/115) measurements were conducted on 86 subjects divided into 43 healthy volunteers and 43 mCRC patients, before starting chemotherapy and then after 6-12 weeks of therapy initiation (3-4 cycles FOLFOX) at first response assessment. Plasma cfDNA integrity index was calculated as the ratio of long to short DNA fragments (ALU 247/115) amplified and detected by real-time PCR. Serum CEA and CA19-9 were measured by chemiluminescent immunometric assay. Results: Baseline cfDNA integrity index was statistically significantly different between responders and non-responders (p=0.03). It was found that at cut off 0.608, sensitivity was 73.7%, specificity was 66.7% and diagnostic accuracy=69.77%. Markers with statistical significant difference between responders and non-responders after chemotherapy were CEA % change (p=0.035), CA19-9 (p=0.024), cfDNA integrity index (p=0.035) and cfDNA integrity index % change (p<0.001). Among these markers, cfDNA integrity index % change had the best sensitivity (84.2%), specificity (95.2%) and diagnostic accuracy (90.7%) at cut off -17.827%. Conclusion: Baseline cfDNA integrity index can be used as a potential marker to predict response to chemotherapy. cfDNA integrity index (ALU 247/115) % change rather than its absolute value is superior to CEA, CA19-9, cfDNA concentration and their % changes in early assessment of response to chemotherapy.     

同型半胱氨酸、癌胚抗原联合检测对男性贲门癌患者的诊断价值

目的 探讨同型半胱氨酸（Hcy）、癌胚抗原（CEA）联合检测对男性贲门癌患者的诊断价值.方法 检测54例贲门癌男性患者和30名健康男性体检者血清Hcy、CEA、糖类抗原（CA） 199、CA724、CA242、组织多肽特异性抗原（TPS）水平的表达,比较联合检测对贲门癌的诊断效果.结果 贲门癌组血清Hcy、CEA水平均高于健康对照组[（20.3±9.2） μmol/L比（13.7±3.1）μmol/L,（7.8±3.5）μg/L比（1.6±1.2）μg/L,均P＜0.05]; CEA、CA199、CA724、CA242、TPS联合检测的灵敏度为73.6％,特异度为64.5％,准确度为70.2％;Hcy、CEA联合检测贲门癌的灵敏度为92.5％,特异度为64.5％,准确度为82.1％,两种组合相互比较差异有统计学意义（P＜0.05）.结论 Hcy、CEA联合检测可能有助于对男性贲门癌诊断和疗效观察.     

The clinical value of serum CEA, CA19-9, and CA242 in the diagnosis and prognosis of pancreatic cancer.

AIM: Serum tumour markers carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9) and CA242 were investigated to evaluate the values of single and combined test in the diagnosis and prognosis of pancreatic cancer. METHODS: Pre-operative serum CEA, CA19-9 and CA242 were measured in 105 pancreatic cancers, 70 non-pancreatic malignancies and 30 benign pancreatic diseases. RESULTS: The sensitivity of CA19-9 alone was the highest in pancreatic cancer patients (80%), but the specificity was significantly lower than that of CEA and CA242 (P<0.01). The combination of CEA and CA242 could increase the specificity to 92%. In serum CA242 positive patients, the survival time was remarkably shorter than that of patients with negative result (P<0.01). The survival time in patients with more than two markers positive expression of CEA, CA19-9 and CA242 was obviously shorter than that of only one or no marker positive expression (P<0.05). CONCLUSION: The diagnostic rate of CA19-9 in pancreatic cancer is better than that of CEA and CA242. Combined detection of CEA and CA242 can improve the diagnostic specificity obviously. High levels of serum markers are associated with advanced stage of the disease. Patients with two or three markers positive expression of CEA, CA19-9, and CA242 simultaneously had a shorter survival time.     

Serum Human Epididymis Protein-4 (HE4) - A novel Approach to Differentiate Malignant Frombenign Breast Tumors

Background: The lack of sensitivity and specificity of existing diagnostic markers like Carbohydrate Antigen 15-3(CA15-3) and Carcinoembryonic antigen (CEA) in breast cancer stimulates the search for new biomarkers to improve diagnostic sensitivity especially in differentiating benign and malignant breast tumors. Expression of Human epididymal protein 4 (HE4) has been demonstrated in ductal carcinoma of the breast tissue. So we tried to evaluate serum HE4 levels as diagnostic marker in breast cancer patients and to comparatively assess serum HE4, CEA and CA15-3 in breast tumor patients both benign and malignant. Methods: Total 90 female subjects were included in the study. We selected 30 breast cancer cases (Malignant group) and 30 benign breast lump cases (Benign group) based on histopathology report. And other 30 were age matched apparently healthy controls (Control group). HE4, CEA and CA15-3 were analysed in serum samples of all subjects by Electrochemiluminiscence immunoassay method. Results: A significant difference in the median (IQR) of HE4 (pmol/l) was identified among malignant, benign and control groups {62.4(52.6-73.7) vs 49.3(39.8-57.4) vs 52.3(50.6-63.3) P=0.0009} respectively. The cutoff value for prediction of breast cancer was determined at >54.5 pmol/l for HE4, with a sensitivity of 73.3%, specificity of 65.3%, whereas cutoff value of CA 15-3 was >21.24 (U/ml) with a sensitivity of 56.7%, specificity of 74.5%. For CEA at cutoff value >0.99 (ng/ml) the sensitivity and specificity were 96.7 % and 62.7% respectively. AUC for HE4, CA15-3 and CEA were 0.725, 0.644 and 0.857 respectively. Conclusion: Our study demonstrated that serum levels of HE4 were significantly higher in malignant group compared to benign and control groups. There is no significant difference between HE4 levels between benign and control groups. These results indicate that HE4 appears as a useful and highly specific biomarker for breast cancer, which can differentiate between malignant and benign tumors.     

Receiver operating characteristic (ROC) curve analysis of the tumour markers CEA, CA 50 and CA 242 in pancreatic cancer; results from a prospective study.

The serum values of the tumour markers carcinoembryonic antigen (CEA), cancer-associated carboanhydrate antigens CA 50 and CA 242 were evaluated in 193 patients with hepatopancreato-biliary diseases by receiver operating characteristic (ROC) curve analysis in order to compare their diagnostic accuracy in pancreatic cancer (n = 26), and to define optimal cut-off levels for the serum values of these tumour markers in the diagnosis of pancreatic cancer. The ROC analysis showed that all marker tests are considerably sensitive (77-81%) at the specificity level of 80%. The CA 242 test was more sensitive than CEA and CA 50 at high specificity levels (> 0.90) but slightly less sensitive at low specificity levels (< 0.60). The CEA test and CA 50 test performed equally well at high and low specificity levels. According to this study, it would seem optimal to use the cut-off level of 4.1 ng ml-1 for CEA, and the level of 137 U ml-1 for CA 50, since they gave a sensitivity of 77% at the specificity levels of 83% and 84%, respectively. For CA 242 the optimal cut-off level was 21 U ml-1, which gave a sensitivity and specificity of 81%. In conclusion, the results of ROC curve analysis suggest that the CA 242 test has an advantage over CEA and CA 50 because of its higher specificity in pancreatic cancer. In addition, it would seem reasonable to use higher cut-off values than what has been recommended for CEA and CA 50 in the diagnosis of pancreatic cancer, but for CA 242 the recommended cut-off level of 20 U ml-1 seems appropriate.