四项肿瘤标志物测定对老年人良恶性胸腔积液鉴别诊断的价值

目的探讨测定癌胚抗原（ＣＥＡ）、糖类抗原（ＣＡ５０、ＣＡ１９－９、ＣＡ１２５）对老年人良恶性胸腔积液的鉴别诊断价值。方法分别测定老年良性和恶性胸腔积液患者血清和胸水的ＣＥＡ、ＣＡ５０、ＣＡ１９－９、ＣＡ１２５水平，用并联法评价多项肿瘤标志物联合应用的诊断价值。结果恶性胸腔积液患者血清和胸水中ＣＥＡ、ＣＡ５０、ＣＡ１９－９水平分别为３１．６±８．５μｇ／Ｌ、２８．０±９．５ｋＵ／Ｌ、４０．５±１６．４ｋＵ／Ｌ和４８．２±９．４μｇ／Ｌ、４５．８±７．１ｋＵ／Ｌ、５４．０±１８．４ｋＵ／Ｌ，均显著高于健康对照组和良性胸液患者，且胸水／血清比值＞１。胸水ＣＡ１２５水平在良恶性胸腔积液之间差异无显著性。ＣＥＡ和ＣＡ５０联用时敏感性为８６．４％，再加ＣＡ１９－９的３项联用，则敏感性达９７．７％。结论ＣＥＡ、ＣＡ５０、ＣＡ１９－９中二项或三项联合检测有一定诊断意义，如结合胸液／血清比值＞１，则诊断意义更大。     

纯胰液肿瘤标志物对胰腺良恶性疾病的诊断价值

目的探讨纯胰液（ＰＰＪ）肿瘤标志物ＣＥＡ、ＣＡ５０和ＣＡ１９－９对胰腺良恶性疾病的诊断价值。方法对４５例胰管像有异常及３０例（２０例取ＰＰＪ）非胰腺疾病者经ＥＲＣＰ导管提取ＰＰＪ,用放免法测定ＰＰＪ和血清标志物。结果ＰＰＪ中ＣＥＡ界限值４５μｇ／Ｌ,ＣＡ５０和ＣＡ１９－９分别为３５ｋＵ／Ｌ和５０００ｋＵ／Ｌ。诊断胰腺癌ＰＰＪ中ＣＥＡ的敏感性与血清比较差异有显著意义（Ｐ＜０．０５）,ＰＰＪ中ＣＥＡ、ＣＡ５０和ＣＡ１９－９的特异性和正确性与血清比较差异无显著意义（Ｐ＞０．０５）。非胰腺疾病ＰＰＪ中ＣＥＡ假阳性为０,ＣＡ５０和ＣＡ１９－９均为５％,慢性胰腺炎假阳性中,ＣＥＡ为１０％,ＣＡ５０为０和ＣＡ１９－９为２０％。两种以上ＰＰＪ标志物同时超过界限值为阳性时,其敏感性为４５．８％,特异性为１００％,正确性７５．９％。结论ＰＰＪ中ＣＥＡ、ＣＡ５０和ＣＡ１９－９三种标志物联合检测通过互补性对胰腺良恶性疾病有重要的诊断价值。     

纤维结合蛋白、癌胚抗原、糖链抗原19－9测定在腹水鉴别诊断中的意义

作者检测５６例良性腹水和２５例恶性腹水Ｆｎ、ＣＥＡ、ＣＡ１９－９含量。结果发现：恶性腹水Ｆｎ、ＣＥＡ、ＣＡ１９－９含量均明显高于良性腹水组，腹水Ｆｎ，ＣＥＡ、ＣＡ１９－９对区别良恶性腹水有一定意义。     

纤维结合蛋白,癌胚抗原,糖链抗原19—9在腹水鉴别诊断中的意义

作者５６例良性腹水和２５例恶性腹水Ｆｎ，ＣＥＡ，ＣＡ１９－９含量。结果发现：恶性腹水Ｆｎ，ＣＥＡ，ＣＡ１９－９含量均明显高于良性腹水组。腹水Ｆｎ，ＣＥＡ，ＣＡ１９－９对区别良恶性腹水有一定意义。     

多浆膜腔积液241例临床分析

目的：探讨多浆膜腔积液的临床特点及其与常见病因之间的关系。方法：回顾性分析北京协和医院诊断为多浆膜腔积液241例患者的临床资料。结果：多浆膜腔积液最常见病因为恶性肿瘤(31．3％)，其次为结缔组织疾病、结核、肝硬化、心功能不全等；结核的发病率较单部位积液者低。多浆膜腔积液的病因与积液部位、积液性质、性状及下肢水肿等有一定关系。结论：多浆膜腔积液病因复杂，鉴别诊断比较困难，特别是结核性积液与恶性积液在症状、体征、积液的各种性状上有重叠，因此，临床的综合判断对诊断至关重要。     

血清CA125,CA199,CA50含量对消化系肿瘤的诊断价值

目的评价血清ＣＡ１２５，ＣＡ１９９，ＣＡ５０含量对消化系肿瘤的诊断价值．方法消化系肿瘤患者１５８例，其中肝癌３８例，食管癌２１例，胃癌５６例，结直肠癌３６例，胰腺癌７例；消化系良性疾病患者１０６例，其中肝硬变５７例，消化性溃疡４９例；正常对照者４０例．全部受测对象均空腹抽静脉血，分离血清，－２０℃贮存备测．采用ＲＩＡ法测定血清ＣＡ１２５，ＣＡ１９９，ＣＡ５０含量，使用国产ＳＮ６９５型γ计数仪．数据均用ｘ±ｓ表示，以正常ｘ±２ｓ作为上限计算阳性率．结果肝癌、胃癌、胰腺癌、结直肠癌和食管癌血清（ＣＡ含量均以ｋＵ／Ｌ表达）ＣＡ１２５（分别为２２２±１１６，７９±１７，１３５±７９，６９±２３和７２±２６），ＣＡ１９９（２３７±１０８，２８１±１３２，８３８±２２４，２５２±１３６和２７３±１４６）和ＣＡ５０含量（２５±９，２０±７，１８±９，１８±８和１７±７）显著高于正常对照组及消化道良性病变组（Ｐ＜００１）．消化道肿瘤有腹腔及远处转移者，其血清ＣＡ１２５，ＣＡ１９９，ＣＡ５０含量升高更为明显．结论血清ＣＡ１２５，ＣＡ１９９，ＣＡ５０均为较好的肿瘤标记物，有助于诊断消化系统肿瘤     

86例双侧胸腔积液临床分析

目的探讨双侧胸腔积液病因及临床特点。方法对８６例双侧胸腔积液进行回顾性分析。结果①结核性４８例（５５．８％），肿瘤转移２８例（３２．５％），其他原因１０例（１１．７％）。②血性胸水在恶性胸水和结核性胸水中分别占５７％（１６／２８）和３１％（１５／４８）（Ｐ＜０．０５）。③胸水ＣＥＡ在恶性胸水和结核性胸水中阳性率分别占８０％（１６／２０）和２．５％（１／４０）（Ｐ＜０．０１）。④胸水ＡＤＡ值以≥２６Ｕ／Ｌ为阳性时，恶性胸水和结核性胸水阳性率分别占９％（２／２２）和４２．５％（１４／３３）（Ｐ＜０．０１）。⑤少量胸水占恶性胸水与结核性胸水中分别占５０％（１４／２８）和７５％（３６／４８）（Ｐ＜０．０５）。结论双侧胸腔积液多见于结核与肿瘤；少量积液多见于结核性胸水；血性胸水多见于肿瘤转移；胸水ＣＥＡ及ＡＤＡ测定对良、恶性胸水有鉴别价值。     

胸液癌胚抗原、可溶性白细胞介素－2受体浓度及核仁组成区嗜银染色计数对恶性胸液的诊断价值

本文对２４例恶性胸腔积液患者测定胸液的癌胚抗原（ＣＥＡ）、可溶性白细胞介素－２受体（ＳＩＬ－２Ｒ）浓度及核仁组成区嗜银染色（Ａｇ－ＮＯＲ）计数，并以２０例结核性胸膜炎患者做对照研究。结果表明：恶性胸液组ＣＥＡ为４７．３１±２１．３２μｇ／Ｌ，明显大于结核性胸液组（３．５８±３．０７μｇ／Ｌ）（Ｐ＜０．００１）。恶性胸液组Ａｇ－ＮＯＲ计数４．５８±１．１９个／细胞，明显大于结核性胸液组（１．５１±０．４０个／细胞）（Ｐ＜０．０１），而ｓＩＬ－２Ｒ结核组为１０６１．７８±４５５．３０ＫＵ／Ｌ，大于恶性胸液组（４４２．１９±２８３．７７ＫＵ／Ｌ），（Ｐ＜０．０１）。提示三项指标同时检测，综合分析有利于恶性胸液的诊断。     

胃癌患者血清3种肿瘤标志物测定的临床意义

对３０例胃癌患者和３０例对照组患者血清测定癌胚抗原（ＣＥＡ）及癌相关抗原（ＣＡ１９－９，ＣＡ１２５）水平。结果表明胃癌组血清中ＣＥＡ，ＣＡ１９－９及ＣＡ１２５水平显著高于对照组（Ｐ＜０．０１）。胃癌组血清ＣＥＡ，ＣＡ１９－９，ＣＡ１２５的灵敏度分别是３６．６７％，４０．００％及３３．３３％。在三者联合检测中，以ＣＡ１９－９与ＣＥＡ联合检测最佳，其灵敏度可提高至６０％，阳性似然比为６．０。由此认为，肿瘤标志物的联合检测可提高胃癌的诊断灵敏度。     

细胞角质蛋白19片段与癌胚抗原联合检测对良恶性胸腔积液的鉴别 …

目的 探讨细胞角质蛋白１９片段（ＣＹＦＲＡ２１－１）与癌胚抗原（ＣＥＡ）检测对结核性胸水与癌性胸水的鉴别诊断价值。方法 对胸水患者１０８例（癌性６８例,结核性４０例）分别测定其血清,胸中中ＣＹＦＲＡ２１－１和ＣＥＡ浓度。结果 １两种肿瘤标记物浓度在恶性胸水中明显地结核性胸水;２．癌性胸水中ＣＹＦＲＡ２１－１浓度明显高于血清浓度,而胸水中ＣＥＡ浓度与血清中浓度相比无显著性差异;３．胸水ＣＹＦＲＡ２１     

Diagnosis of malignant versus tuberculous ascites using tumor markers and globulin ratios in serum and ascites: A Fisher discriminant model

Background and study aimsThis study was conducted to investigate the significance of tumor and biochemical markers in serum and ascitic fluid in the differential diagnosis of tuberculous and malignant ascites.Patients and methodsBased on findings from natural orifice transluminal endoscopic surgery and postoperative pathology or cytology of 63 patients, they were divided into the malignant group (31 patients) and the tuberculous group (32 patients). Levels of tumor markers, albumin, globulin, and lactate dehydrogenase were measured simultaneously. Data were statistically analyzed, and a Fisher discriminant model was established. The receiver operating characteristic curve was constructed to confirm the discriminant value.ResultsThe levels of carcinoembryonic antigen (CEA), cancer antigen 125 (CA125), cancer antigen 19-9 (CA 19-9), and globulin in serum and ascitic fluid were different between the tuberculous and malignant ascites groups (P < .05). The ratios of ascites-to-serum levels of CEA, CA125, and CA 19-9, as well as the ratio of serum-to-ascites of globulin levels, were different between the two groups (P < .05). The Fisher discriminant model was established based on the ascites-to-serum ratios of CEA, CA125, and CA 19-9 levels and the serum-to-ascites ratio of globulin levels. The area under the curve was 0.908, the sensitivity was 0.838 (26/31), and the specificity was 0.875 (28/32).ConclusionA Fisher discriminant model can be established using serum and ascites tumor markers and globulin ratios, which is valuable in the differential diagnosis of tuberculous versus malignant ascites.     

联合CA19-9、CA125和CEA检测在AFP阴性的ICC鉴别诊断中的应用价值

目的探讨血清癌抗原19-9（CA19-9）、癌抗原125（CA125）和癌胚抗原（CEA）联合检测在甲胎蛋白（AFP）阴性的肝内胆管细胞癌（ICC）患者诊断中的价值。方法2014年6月~2016年6月我院收治的ICC患者60例,根据AFP检测结果,将其分为AFP阴性组和AFP阳性组,每组分别为30例。采用微阵列酶联免疫分析法（Array-ELISA）检测血清CA19-9、CA125和CEA,采用受试者工作特征曲线（ROC）下面积（AUC）分别对各标记物及联合检测诊断的灵敏度、特异度和正确率进行评估。结果30例AFP阴性组血清CA19-9、CA125和CEA水平分别为138.8（85.7~185.1）U/ml、109.6（48.4~201.8）U/ml、11.2（17.5~21.9）ng/ml,均显著高于AFP阳性组的【（38.0（16.9~75.5）U/ml、18.1（9.3~48.1）U/ml、5.5（3.1~8.5）ng/ml）,P<0.01】;两组血清肿瘤标志物诊断ICC的ROC曲线下面积均呈现出CA19-9>CA125>CEA的趋势,在AFP阴性组,各单项诊断的ROC曲线下面积分别为0.85、0.83和0.81,显著高于AFP阳性组的【（0.55、0.45和0.42）,P<0.05】;在单项诊断ICC时,血清CA19-9、CA125和CEA的最佳临床诊断截断点分别为124.89 U/ml、96.04 U/ml和11.97 ng/ml;血清CA19-9、CA125和CEA诊断ICC的灵敏度、特异度和正确率分别为（73.33%、76.67%和71.67%）、（66.67%、70.00%和68.33%）和（60.00%、70.00%和65.00%）,以CA19-9检测诊断的效能最高;两组联合检测诊断的ROC曲线下面积均高于单项指标检测的ROC曲线下面积,且都表现为（CA19-9/CA125/CEA）>（CA19-9/CA125）>（CA19-9/CEA）>（CA125/CEA）,在AFP阴性组,各联合检测诊断的ROC曲线下面积分别为0.94、0.88、0.86和0.85 ,显著高于在AFP阳性组的【（0.74、0.62、0.58和0.52）,P<0.05】;（CA19-9/CA125/CEA）、（CA19-9/CA125）、（CA19-9/CEA）和（CA125/CEA）四种联合检测诊断的灵敏度、特异度和正确率均提高,分别为（90.00%、90.00%和90.00%）、（83.33%、83.33%和81.67%）、（76.67%、83.33%和80.00%）和（70.00%、76.67%和73.33%）,以CA19-9/CA125/CEA联合检测诊断效能最高。结论我们认为,血清CA19-9、CA125和CEA联合检测可提高对AFP阴性ICC患者诊断的正确率,需要临床扩大验证。     

联合检测血清、腹水肿瘤标志物对良、恶性腹水的鉴别诊断价值

目的 探索肿瘤标志物对良、恶性腹水的鉴别诊断价值.方法 回顾性分析我院2008年12月～2013年2月收治的126例腹水患者的病历资料.根据病因将其分为恶性腹水组（58例）和良性腹水组（肝硬化腹水36例,结核性腹水32例）,比较血清和腹水中甲胎蛋白（AFP）、糖链抗原（CA） 19-9、CA125、CA72-4、癌胚抗原（CEA）在良恶性腹水患者的差异,并对有统计学意义的指标构建受试者工作特征曲线（ROC曲线）图,以期寻找最佳临界值.结果 恶性腹水患者血清及腹水中CA19-9、CA72-4、CEA含量均高于良性腹水患者,差异有统计学意义（P＜0.05）,良、恶性腹水患者腹水及血清中AFP、CA125含量差别均无统计学意义（P＞0.05）.血清CA72-4、腹水CA19-9、CA72-4和CEA的ROC曲线下面积分别为0.701、0.783、0.752和0.848,准确度最高时其临界值分别为4.03 U/ml、19.33 U/ml、1.895 U/ml和1.41 ng/ml,腹水和血清CA19-9、CA72-4、CEA 3项指标联合检测的敏感性均较单项检测指标高,差异有统计学意义（P＜0.05）,敏感性和特异性分别为48.28％、79.41％、71.43％和91.18％.结论 血清和腹水中CA19-9,CA72-4,CEA水平的检测有助于良恶性腹水的鉴别诊断,构建ROC曲线可为恶性腹水的诊断提供最佳生化指标的组合.     

ADA、CRP、CEA和CA19-9对老年结核性、癌性胸腔积液的诊断价值分析

目的分析对于老年结核性、癌性胸腔积液的鉴别诊断,联合应用腺苷脱氨酶(ADA)、C-反应蛋白(CRP)、癌胚抗原(CEA)、糖类抗原19-9(CA19-9)四个指标的临床价值。方法分别选取我院治疗的肺结核和肺癌老年患者各40例,测定患者胸腔积液中ADA、CRP、CEA和CA19-9水平,比较分析四项单独应用以及联合应用对老年结核性和癌性胸腔积液鉴别的敏感度以及特异性等,从而分析其鉴别诊断的价值高低。结果癌性组CEA水平为(67.3±8.7)μg/ml,CA125为(63.6±15.9)μg/ml,而ADA及CRP水平明显低于结核组,差异显著,具有统计学意义。CEA、CA19-9对癌性胸腔积液诊断敏感性、特异性、准确性较高,ADA、CRP对结核性胸腔积液的敏感性、特异性、准确性较高。结论 ADA、CRP、CEA和CA19-9的检测水平在老年结核性、癌性胸腔积液的判别和诊断中有重要作用,可信度高,值得在临床推广。     

肿瘤标记物在细胞学阴性的恶性腹水中的诊断价值

目的 探讨肿瘤标志物CEA 、CA199、CA125在细胞学阴性的恶性腹水中的诊断价值.方法 检测189例腹水患者的血清和腹水肿瘤标记物,评估肿瘤标记物在细胞学阴性的恶性腹水中的诊断价值.结果 在预设的临界值,细胞学阴性的恶性腹水患者血清和腹水CEA 、CA19-9阳性率明显高于良性腹水组（P ＜0.05）;CA12-5两组比较,差异无统计学意义（P＞0.05）.血清CEA 、CA19-9诊断敏感性较低;腹水CEA 、CA19-9诊断敏感性明显提高,特异性相当.腹水CEA、CA19-9的ROC曲线下面积分别为0.94、0.88.结论 肿瘤标记物CEA、CA19-9有助于细胞学阴性恶性腹水的鉴别诊断,CA12-5无诊断价值;其中腹水CEA诊断价值较高.     

Clinical evaluation of serum sialyl SSEA-1 (SLX) in diagnosis of cancers

In order to evaluate the usefulness of sialyl SSEA-1 (SLX) as a tumor marker of digestive cancers, serum levels of the antigen were determined in 334 patients with malignancies and 196 patients with benign diseases. The results indicated that positivity of the antigen in sera from malignant patients was highest in pancreatic cancer (58%) and biliary tract cancer (56%). False positive incidence of SLX in sera from benign diseases was as low as 6%, revealing low false positivity. Comparison with other tumor markers such as CA19-9, CA-50, CEA and ST-439 showed that positivity of SLX was as high as that of CEA, whereas it was lower than that of CA19-9 or CA-50. On the other hand, false positivity of SLX as well as ST-439 was lowest, and accuracy of SLX was no less high than that of CA19-9 or CA-50. In sera of pancreatic and biliary tract cancer, positive incidences of CA19-9, CEA and ST-439 were 80%, 64% and 53%, respectively, and the diagnostic efficiency increased by combined assay of SLX with CA19-9 (88%), CEA (81%) and ST-439 (71%). SLX appears to be no less useful than the other recently developed carbohydrate antigens or CEA as serum tumor marker for pancreatico-biliary cancer.     

肿瘤标志物检测对老年肝硬化患者的临床诊断价值

目的探讨肿瘤标志物(TM)糖类抗原125(CA125)、糖类抗原19-9(CA19-9)、癌胚抗原(CEA)、甲胎蛋白(AFP)单项检测及联合检测对老年肝硬化的临床诊断价值。方法选取2017年3月至2019年3月辽宁省金秋医院门诊及住院确诊的116例老年肝硬化患者为肝硬化组,另选取同时期90名体检健康者为对照组。采用电化学发光法检测2组患者血清CA125、CA19-9、CEA、AFP。比较各组及不同Child-Pugh分级肝硬化患者血清CA125、CA19-9、CEA、AFP水平;肝硬化患者肝功能生化指标正常及升高者的血清TM水平;各TM指标单项检测及联合检测老年肝硬化的灵敏度、特异度与诊断符合率,分析TM检测对老年肝硬化的诊断意义。采用SPSS 19.0软件对数据进行统计分析。结果肝硬化组患者血清CA125、CA19-9、CEA、AFP水平均高于正常组(P<0.05)。与Child-Pugh A级相比,B、C级CA125、CA19-9、AFP、CEA水平均显著升高,差异有统计学意义(P<0.05)。ALT、DBiL、TBA升高组血清CA125、CA19-9、AFP、CEA水平均高于正常组,但差异无统计学意义。单项TM指标检测老年肝硬化患者的灵敏感为42.4%~62.1%,特异度为80.0%~92.0%,诊断符合率为64.7%~74.1%。CA125、CA19-9、CEA、AFP联合检测的灵敏度为83.3%,特异度为96.0%,诊断符合率为91.4%,各TM指标联合检测对老年肝硬化具有较高的诊断价值(P<0.05)。结论血清CA125、CA19-9、CEA、AFP联合检测可明显提高老年肝硬化的检出率,且可以判断肝硬化病情的严重程度,对老年肝硬化具有较高的诊断价值。     

The assessment of biliary CA 125, CA 19-9 and CEA in diagnosing cholangiocarcinoma--the influence of sampling time and hepatolithiasis

BACKGROUND/AIMS: This study was conducted to assess the clinical value of biliary CA 19-9, CA 125 and CEA sampled in different situations for the diagnosis of cholangiocarcinoma. METHODOLOGY: Bile was obtained from patients with bile duct obstruction on the day of biliary drainage and 3 days later separately. The etiology of biliary obstruction included choledocholithiasis (N = 51), hepatolithiasis (N = 19) and cholangiocarcinoma (N = 28). Patients of the former two conditions were all complicated with cholangitis. RESULTS: The sensitivity of biliary CEA, CA 19-9 and CA 125, whenever checked were all less than 70%. The biliary CEA and CA 19-9 were elevated in the presence of cholangitis. In addition, the biliary CEA was also increased in the patients with hepatolithiasis. The specificity of CA 125 was better than those of CEA and CA 19-9 (75.7% vs. 33.3% and 60%, respectively) on the day of biliary drainage. The diagnostic efficiency was slightly improved when combining biliary CA 125 and CEA. CONCLUSIONS: As the biliary CA 125 was less affected by inflammation and hepatolithiasis, it is more useful than CEA and CA 19-9 in the diagnosis of cholangiocarcinoma. The single tumor marker test of CA 125 or combined tumor marker test of CEA and CA 125 may be used as a useful complement to other investigative methods to differentiate benign from malignant causes of the bile duct obstruction.     

肿瘤标志物和血清腹水白蛋白梯度在恶性腹水诊断中的价值

目的 探讨肿瘤标志物和血清腹水白蛋白梯度(SAAG)在恶性腹水诊断中的应用价值.方法 回顾性研究2005年1月至2008年1月收治的114例腹水患者,根据腹水病因分为恶性腹水组39例和良性腹水组105例(其中结核性腹水12例、无菌性肝硬化腹水93例).分析腹水和血清癌胚抗原(CEA)、糖链抗原(cA)19-9、CA125和SAAG在良、恶性腹水中分布的差异,并构建受试者工作(ROC)曲线.结果 在恶性和良性腹水患者中均检出肿瘤标志物.恶性腹水患者的血清CEA和CA19-9、腹水CEA和CA19-9均明显高于良性腹水患者(P<0.05).恶性腹水患者的SAAG明显低于肝硬化腹水患者(P<0.05),而与结核性腹水患者差异无统计学意义(P>0.05).恶性腹水患者的血清和腹水CA125与良性腹水患者差异均无统计学意义(P>0.05).腹水CEA、CA19-9和SAAG的曲线下面积分别为0.79、0.82和0.85;准确度最高的临界值分别是1.45 U/L、19.50 U/L和13.50 g/L,敏感度和特异度分别是66.7%和78.1%、74.4%和84.8%及82.9%和84.6%.联合检测价值最好的组合为SAAG和腹水CA19-9,其敏感度和特异度为61.54%和97.14%.结论 通过ROC曲线寻找最佳的生化指标组合鉴别良、恶性腹水是可行的.     

Alpha-fetoprotein,carcinoembryonic antigen,and carbohydrate antigen 19-9-producing gallbladder cancer

We report a rare case of alpha-fetoprotein (AFP), carcinoembryonic antigen (CEA), and carbohydrate antigen (CA) 19-9-producing gallbladder cancer with high levels of CA125 and protein induced by vitamin K absence or antagonist II (PIVKA II). A 63-year-old man was diagnosed with gallbladder cancer with metastases to the liver, based on ultrasonography and computed tomography of the abdomen showing multiple tumorous lesions in the liver and a thickened gallbladder wall. Laboratory data showed high levels of tumor markers: 4647.4 ng/ml AFP, 9987.1 ng/ml CEA, 11704.0 U/ml CA19-9, 847.6 U/ml CA125, and 0.2 AU/ml PIVKA II. AFP in the present case showed an increase in Concanavalin A-nonbinding fraction and an increase inLens culinaris lectin-binding fraction by affinity column chromatography. The patient died of hepatic failure. Autopsy revealed gallbladder cancer consisting of papillary adenocarcinoma and moderately differentiated tubular adenocarcinoma. By immunohistochemical staining, AFP was detected in the papillary adenocarcinoma portion of the primary focus and metastatic tumor cells in the liver, but was not detected in noncancerous liver tissue. CEA and CA19-9 were detected mainly in the tubular adenocarcinoma portion.