胃癌患者手术治疗前后血清CEA、CA242、CA72-4和CA19-9检测的临床意义

目的：探讨了胃癌患者手术治疗前后血清CEA、CA242、CA72-4和CA19-9水平的变化及意义。方法：应用放射免疫分析对31例胃癌患者进行了手术治疗前后血清CEA、CA242、CA72-4和CA19-9检测,并与35名正常健康人作比较。结果：在手术前,胃癌患者血清CEA、CA242、CA72-4和CA19-9水平均非常显著地高于正常人组（P〈0.01）经手术治疗后3个月则与正常人组比较无显著性差异（P〉0.05）。结论：检测胃癌患者手术治疗前后血清CEA、CA242、CA72-4和CA19-9水平的变化对了解病情、观察预后均有重要的价值。     

CA19-9、CA72-4和CEA在阿帕替尼治疗胃癌患者中的变化及意义

目的 探讨阿帕替尼治疗前后胃癌患者血清糖链抗原19-9(carbohydrate antigen 19-9,CA19-9)、糖链抗原72-4(carbohydrate antigen 72-4,CA72-4)和癌胚抗原(carcinoembryonic antigen,CEA)的变化及其与临床疗效的关系.方法 选取我院收治的62例晚期胃癌患者作为研究对象,回顾性分析阿帕替尼治疗前后患者血清中CA19-9、CA72-4和CEA的水平,并根据临床疗效部分缓解(PR)、稳定(SD)和进展(PD)的例数,计算疾病缓解率(RR)和疾病控制率(DCR),并分为疾病控制(DC)组和非DC组,比较各组治疗前后血清CA19-9、CA72-4和CEA水平变化,并比较两组之间治疗前后各指标水平差异.结果 阿帕替尼治疗后血清CA19-9和CA72-4水平显著降低(P＜0.05),而CEA无显著性变化(P＞0.05).阿帕替尼治疗晚期胃癌的PR率为3.22％,SD率为41.94％,PD率为54.84％.阿帕替尼治疗后,DC组血清CA19-9、CA72-4和CEA水平显著下降(P＜0.05),而非DC组CA19-9、CA72-4无显著性差异(P＞0.05),CEA水平显著升高(P＜0.05).治疗前,DC组和非DC组CA19-9、CA72-4和CEA水平无显著性差异(P＞0.05),治疗后DC组三个指标水平均显著低于非DC组(P＜0.05).对患者用药不良反应发生率分析,结果显示无严重不良反应终止治疗病例.结论 血清CA19-9、CA72-4和CEA水平在阿帕替尼治疗后病情得到控制的胃癌患者中显著降低,可用于阿帕替尼治疗胃癌的效果评价.     

胃癌患者血清CEA、CA19—9及CA72—4联检的临床价值探讨

目的：探讨血清CEA、CA19—9及CA72—4联检在胃癌诊断、病情监测及疗效观察中的价值。方法：采用电化学发光技术检测36例正常对照组、42例良性胃病、55例胃癌患者血清CEA、CA19—9、CA72—4的含量，并对胃癌患者进行治疗前后三种肿瘤标志物的含量变化监测随防。结果：胃癌患者血清CEA、CA19—9、CA72—4的阳性率明显高于正常对照组及良性胃病组，差异有显著性（P〈0．01）。胃癌患者治疗后三种肿瘤标志物含量及阳性率较治疗前有明显下降，差异有显著性（P〈0．01）。三者联检的敏感性、准确性均显著提高（P〈0．01）。结论：血清CEA、CA19-9、CA72—4联检有助于提高胃癌诊断的敏感性、同时对疗效观察及术后监测有重要意义。     

多项肿瘤标志物联检对胃恶性肿瘤诊断的临床价值

目的:本文报告CEA、CA19-9、CA72-4三项肿瘤标志物,单项与联检诊断胃恶性肿瘤的临床价值.方法:应用免疫放射分析(IRMA).结果:本文单项检测阳性率在70%以上,但以CA72-4阳性率最高(84.21%),次为CA19-9(75.43%).作为单项应用首选CA72-4,次为CA19-9.全文仅4例三项均阴性(假阴性率为1.75%),故三项联检可使阳性率提高到98.25%.本文分三组双项组合检测,按双阳性分析,结果显示A组阳性率最高(61.84%),次为B组(51.31%),C组(48.24%).结论:单项筛选检测,首选CA72-4,双项组合检测仍以CA72-4 CA19-9为宜,随访可按组织学类型选用.     

IL-6、CEA、CA19-9和CA72-4对胃癌的诊断价值

探讨血清IL-6、CEA、CA19-9和CA72-4单独或联合检测对胃癌诊断的临床价值。采用电化学发光法分别检测73例胃癌患者（胃癌组）、50例良性胃病患者（良性胃病组）、52名健康者（对照组）血清中IL-6、CEA、CA19-9和CA72-4水平,分析4种指标对胃癌诊断的临床价值及其与临床病理因素之间的关系。在胃癌组,4种标志物血清浓度均显著高于良性胃病组和对照组,并且与肿瘤的组织学分型、浸润深度、淋巴结转移以及远端转移相关。4种标志物平行法联合检测可使诊断的灵敏度提高至86.3%,系列法联合检测可使特异性提高至98.1%。血清IL-6、CEA、CA19-9和CA72-4水平对胃癌的诊断和临床分期具有重要意义,联合检测可提高诊断灵敏度和特异性。     

胃癌患者手术前后血清SE-CAD、CEA和CA19-9检测的临床意义

目的:探讨了胃癌患者手术治疗前后血清SE-CAD、CEA和CA19-9水平的变化及意义.方法:分别应用酶免法和放免法测定了32例胃癌患者手术治疗前后血清SE-CAD、CEA和CA19-9水平的变化,并与30名正常健康人作比较.结果:胃癌患者手术前血清SE-CAD、CEA和CA19-9水平显著地高于正常人组(P＜0.01),手术治疗后6个月则与正常人组比较无显著性差异(P＞0.05).结论::检测胃癌患者血清中SE-CAD、CEA和CA19-9水平的变化对临床观察预后有重要的临床价值.     

Combined detection of preoperative serum CEA,CA19-9 and CA242 improve prognostic prediction of surgically treated colorectal cancer patients

We assessed the prognostic significance of preoperative serum carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9) and carbohydrate antigen 242 (CA242) levels in surgically treated colorectal cancer patients. The relationship of preoperative serum CEA, CA19-9 and CA242 levels with disease characteristics was investigated in 310 patients. Correlation between tumor markers was investigated using Pearson correlation test. Univariate and multivariate survival analyses were used to study the relationship between preoperative tumor markers and prognosis [disease free survival (DFS) and overall survival (OS)]. Kaplan-Meier analysis with log rank test was used to assess the impact of tumor marker levels on survival. Positive rate of preoperative serum CEA, CA19-9 and CA242 were 54.84%, 47.42% and 37.10%, respectively. High preoperative CEA level was associated with tumor size (P = 0.038), T stage (P < 0.001) and AJCC stage (P = 0.002). High preoperative CA19-9 level was associated with tumor AJCC stage (P = 0.023). Preoperative CA242 positively correlated with CEA (P < 0.001) and CA19-9 (P < 0.001). Combining the three markers was of independent prognostic value in CRC (HR = 2.532, 95% CI: 1.400-4.579, P = 0.002 for OS; and HR = 2.366, 95% CI: 1.334-4.196, P = 0.003 for DFS). Combined detection of preoperative serum CEA, CA19-9 and CA242 is of independent prognostic value for management of CRC patients treated surgically.     

The clinical validity of circulating tumor-associated antigens CEA and CA 19-9 in primary diagnosis and follow-up of patients with gastrointestinal malignancies

Summary The clinical validity of monitoring the tumor markers carcinoembryonic antigen (CEA) and CA 19-9 were investigated in 602 patients with colorectal, gastric, and pancreatic carcinomas. Sensitivity and specificity of the tests were evaluated preoperatively as well as in the postoperative follow-up for early detection of disease progression and recurrence. At a 95% level of specificity as calculated from a group of 150 patients with benign diseases, the CEA test with monoclonal antibody had a preoperative sensitivity of 39% in colorectal cancer and 21% in gastric cancer. On the other hand, CA 19-9 had a sensitivity of 19% in colorectal cancer, 21% in gastric cancer, and 89% in pancreatic cancer. In the postoperative follow-up it was found that a combination of both tumor marker tests was most profitable in gastric carcinomas, yielding an increase of sensitivity from 59%–94%, showing a high degree of complementarity. The gain in sensitivity provided by the CA 19-9 test over the CEA-test in colorectal cancer was very low. The gain in sensitivity, however, provided by the CEA test over the CA 19-9 test in pancreatic carcinoma was also very low. On the basis of these results it has to be recommended that cases with pancreatic carcinoma are to be monitored most efficiently with the CA 19-9 test, whereas in cases with colorectal cancer the CEA test should be used primarily. However, in gastric cancer the combined use of CEA and CA 19-9 represents a highly valuable basis for monitoring the course of disease.Abbreviations CEA carcinoembryonic antigen - AFP alphafetoprotein - HCG human chorionic gonadotrophin - UICC International Union Against Cancer - RIA radio-immunoassay - EIA-m enzyme-immunoassay with monoclonal antibody - ROC-curves receiver operating characteristic curves     

胃癌患者手术前后血清CA72-4和CEA的变化及临床意义

目的：探讨血清糖类抗原72-4（CA72-4）和癌胚抗原（CEA）在胃癌患者手术前后的水平变化及临床意义。方法：选择胃癌患者102例,胃良性病变患者54例。采用电化学发光法检测了手术前后血清CA72-4和CEA水平。结果：胃癌组血清CA72-4和CEA水平高于胃良性疾病组,差异显著（P〈0.01）。胃癌患者术前组血清CA72-4、CEA水平高于术后组,差异显著（P〈0.01）。胃癌患者有淋巴结转移组血清CA72-4、CEA水平高于无淋巴结转移组,差异显著（P〈0.01）。胃癌患者行根治性手术组术后血清CA72-4、CEA水平低干姑息性切除组,差异显著（P〈0.01）。结论：手术切除肿瘤特别是行根治性切除术后,血清CA72-4、CEA水平显著降低,动态观察CA72-4、CEA水平及其变化,对胃癌的筛选、疗效观察及诊断有无转移有重要的价值。     

血清CEA、CA72-4、TSGF联检对胃癌的诊断价值

目的:探讨了癌胚抗原(CEA)、糖类抗原CA72-4(CA72-4)、肿瘤特异性生长因子(TSGF)联检对胃癌的临床评价.方法:应用放射免疫分析和生化法对31例胃癌患者进行了血清,CEA、CA72-4和TSGF水平测定,且与35名正常健康人作比较.结果:以单一指标阳性作为诊断标准,CEA、CA72-4、TSGF对胃癌的敏感性分别为23.0%、38.0%、48.0%,特异性分别为74.0%、85.0%、82.0%,联检结果二项或二项以上阳性作为标准,则本文患者的诊断灵敏度为67.0%,特异性为88.0%.结论:联检血清CEA、CA72-4、TSGF对胃癌的辅助诊断有较高的临床应用价值.     

血清CA19—9、CA125、CA242、CEA联检诊断胰腺癌的临床价值

目的：评价血清糖类抗原19—9（CA19—9），糖类抗原125（CA125），糖类抗原242（CA242）及癌胚抗原（CEA）四项指标联检对胰腺癌的诊断价值。方法：四项标志物均应用全自动化学免疫分析检测。结果：胰腺癌患者血清CA19—9、CA125、CA242、CEA水平明显高于胰腺良性病组，差异均有显著性（P〈0．01）。四项指标联检诊断胰腺癌的敏感性为91．7％，特异性92．1％。结论：血清CA19—9、CA125、CA242及CEA单项检测在胰腺癌诊断中特异性均偏低，且四项联检可提高胰腺癌的敏感性及特异性，临床诊断价值更大。     

血清CA125、CA19-9、CA72-4和EMA联检对卵巢癌的诊断价值

目的:探讨血清CA125、CA19-9、CA72-4和上皮膜抗原(EMA)联检对卵巢癌的诊断价值.方法:选择卵巢癌80例,正常对照50例,分别采用ELISA测定.结果:卵巢癌组血清CA125、CA19-9、CA72-4、EMA与对照组相比,两者具有明显差异(P＜0.05).卵巢癌组血清CA125、CA19-9、CA72-4和EMA单测阳性率分别为62.5%、50.0%、38.8%、75.0%,联检阳性率为97.5%.结论:血清CA125、CA19-9、CA72-4和EMA联检可提高诊断阳性率,对卵巢癌的临床辅助诊断有一定价值.     

Diagnostic significance of soluble human leukocyte antigen-G for gastric cancer

Human leukocyte antigen-G (HLA-G) is a novel tumor marker. Increased level of soluble HLA-G (sHLA-G) in various tumor types has been reported. However, the potential diagnostic value of sHLA-G with other tumor markers in gastric cancer (GC) diagnosis is yet to be explored. In this study, plasma level of sHLA-G was measured in 81 GC patients, 53 benign gastric disease patients and 77 normal controls by ELISA. The serum levels of alpha fetoprotein (AFP), carcinoembryonic antigen (CEA), cancer antigen 125 (CA125), cancer antigen 19-9 (CA19-9) and cancer antigen 72-4 (CA72-4) were also determined. Data showed that plasma level of sHLA-G in GC was dramatically increased compared with normal controls and benign gastric disease patients (both p < 0.001). The AUC for sHLA-G was 0.730 (p < 0.001), superior to serum AFP, CEA, CA125, CA19-9 and CA72-4. After evaluating three cut-offs of sHLA-G, we concluded sHLA-G (cut-off at 128 U/ml) plus CA125 in two-biomarker panel test and CA125 plus CA199 plus sHLA-G or CA125 plus CA724 plus sHLA-G in three-biomarker panel test were better choices for GC discrimination. Our findings indicated that sHLA-G was a potential biomarker for GC diagnosis and the combination of sHLA-G with CA125, CA19-9 and CA72-4 can improve the clinical screening and diagnosis for GC.     

多项肿瘤标志物联合检测在胃肠道肿瘤诊断中的价值

目的探讨血清癌胚抗原(carcino-embryonic antigen,CEA)、CA19-9、CA72-4、胃蛋白酶原(pepsinogen,PG)联合检测在胃肠道肿瘤诊断中的价值。方法以2015年6月至2018年12月在中山大学附属第一医院东院收治的54例胃癌、110例结直肠癌住院患者为研究对象,所有患者均经过影像、胃镜、肠镜或组织病理学确诊,以同期健康体检非肿瘤人群53例作为健康对照组,同期收治的281例非胃癌、结直肠癌的消化道肿瘤(包括肝癌、食道癌、胆管癌)患者作为疾病对照组。采用直接化学发光法检测血清CEA、CA19-9、PG水平,并计算PGⅠ/PGⅡ比值(PGR);采用电化学发光法检测血清CA72-4水平。使用SPSS 25.0进行数据统计处理,结果以P<0.05为差异有统计学意义。结果(1)在胃癌、结直肠癌组中,CEA、CA19-9、CA72-4的测定值明显高于健康对照组;CEA、CA72-4的测定值明显高于疾病对照组;PGⅠ在胃癌、结直肠癌中的测定值明显低于健康对照组;(2)在胃癌组中,PGR的测定值与阳性率与两个对照组比较均有明显差异,PGⅡ的测定值则与两个对照组比较差异均无统计学意义;在结直肠癌组中,PGⅠ、PGⅡ的测定值与健康对照组比较差异有统计学意义,PGR的测定值与阳性率与两个对照组比较差异均无统计学意义。(3)血清肿瘤标志物单项检测对胃肠道肿瘤检测灵敏度不高,但PGR对于胃癌诊断特异性达95%,可作为阴性排除的依据。(4)肿瘤标志物联合检测对胃癌、结直肠癌检测的灵敏度均明显增高,特异性有所下降。其中以四项肿瘤标志物联合检测对胃肠道肿瘤诊断效能较好,ROC曲线下面积均达0.8。结论CEA、CA19-9、CA72-4、PG是诊断胃癌、结直肠癌的可靠指标;CEA、CA19-9、CA72-4、PG联合检测对胃肠道肿瘤的早期辅助诊断有意义,且能明显提高检出率。     

CA125、CA72-4与CEA检测在卵巢肿瘤早期诊断中的临床价值

联合检测血清CA125、CA72-4与CEA水平对卵巢癌早期诊断的价值。对112例卵巢癌患者,185例卵巢良性肿瘤患者及对照组100名健康妇女,应用电化学发光免疫法测定血清CA125、CA72-4与CEA水平,然后进行统计分析。结果表明：健康妇女组和卵巢肿瘤组比较,卵巢癌组患者血清CA125、CA72-4与CEA水平及阳性率明显升高（P〈0.01）,三项标志物的阳性率分别为86.61%,67.86%,49.11%,三项联合检测阳性率为91.96%。血清CA125、CA72-4与CEA联检可以提高卵巢癌早期诊断的阳性率,对卵巢肿瘤的良恶性辅助诊断及鉴别诊断具有一定应用价值。     

血清CEA、CA19-9、CA125联合黏膜端粒酶检测对上消化道肿瘤的诊断价值

目的：探讨血清CEA、CA19-9、CA125和黏膜端粒酶单项或多项联检对上消化道肿瘤的诊断价值。方法：确诊的64例食管癌和66例胃癌患者和32例良性病变及38例健康人血清中的CEA、CA19-9、CA125和黏膜端粒酶含量并分析敏感性、特异性。结果：胃癌,食管癌患者血清CEA、CA19-9、CA125和黏膜端粒酶含量显著高于正常对照组及慢性胃炎组（P〈0.05）,联检其敏感性和特异性明显高于单项检测（P〈0.05）。结论：血清CEA、CA19-9、CA125和黏膜端粒酶联检具有很好的临床应用价值。     

Comparison between clinical significance of serum proinflammatory proteins (IL-6 and CRP) and classic tumor markers (CEA and CA 19-9) in gastric cancer

Gastric cancer (GC) is a second most common cause of cancer-related death and represents an inflammation-driven malignancy. It has been suggested that interleukin 6 (IL-6) and C-reactive protein (CRP) play a potential role in the growth and progression of GC. The aim of the present study was to compare clinical significance of IL-6 and CRP with classic tumor markers—carcinoembryonic antigen (CEA) and carbohydrate antigen (CA 19-9) in GC patients. The study included 92 patients with GC and 70 healthy subjects. The serum concentrations of IL-6, CEA and CA 19-9 were determined using immunoenzyme assays, whereas CRP using immunoturbidimetric method. We defined the diagnostic criteria and prognostic value for proteins tested. In GC patients, the serum concentrations of all the proteins tested were significantly higher than in healthy subjects. The IL-6, CEA and CA 19-9 levels correlated with nodal metastases, while CRP with tumor stage, gastric wall invasion, presence of nodal and distant metastases. Diagnostic sensitivity of IL-6 was higher (85%) than those of other markers (CRP 66%, CA 19-9 34%, CEA 22%) and increased in combined use with CRP or CEA (88%). The area under ROC curve for IL-6 was larger than those of CRP and classic tumor markers (CEA and CA 19-9). None of the proteins tested was independent prognostic factor for the survival of GC patients. Our findings indicate better usefulness of serum proinflammatory proteins—IL-6 and CRP than classic tumor markers—CEA and CA 19-9 in the diagnosis of GC.     

血清肿瘤标志物CEA、CA724、CA242、CA19-9联合检测诊断肺癌的临床价值分析

目的 分析血清肿瘤标志物癌胚抗原(CEA)、糖类抗原724(CA724)、糖类抗原242(CA242)、糖类抗原19-9(CA19-9)联合检测与肺癌诊断及预后的相关性.方法 选取2014年5月至2017年1月我院收治的肺癌患者120例为研究对象,并纳入观察组,以同期入院体检的良性肺疾病患者55例为对照组,测定两组血清CEA、CA724、CA242、CA19-9水平,对比四种肿瘤标志物在不同病理类型肺癌中表达水平,分析CEA、CA724、CA242、CA19-9联合检测与单项、2联、3联检测诊断肺癌的灵敏度、特异度、准确度、阳性预测值、阴性预测值,比较CEA、CA724、CA242、CA19-9阳性或阴性患者在预后随访中无复发生存率、远处转移率.结果 观察组血清CEA(30.24±1.75)μg/L、CA724(14.85±1.11)kU/L、CA242(38.18±1.05)kU/L、CA19-9(41.24±1.57)kU/L均较对照组高(P<0.05);CEA、CA242在腺癌中表达水平最高,CA724、CA19-9在腺癌与鳞癌中表达水平差异无统计学意义(P>0.05);CEA、CA724、CA242、CA19-9联合检测诊断肺癌的灵敏度98.18%、准确度80.00%、阴性预测值80.00%,均高于上述指标单项或2联、3联检测(P<0.05);CEA、CA724、CA242、CA19-9阳性患者与阴性患者比较,无复发生存率明显较低,远处转移率显著较高(P<0.05).结论 血清肿瘤标志物CEA、CA724、CA242、CA19-9联合检测诊断肺癌的灵敏度、准确度较单项、2联及3联检测明显提高,且上述指标可用于预测预后,值得在临床推广应用.     

联合检测胃蛋白酶原、胃泌素-17及CEA、CA19-9在胃癌诊断中的应用

目的 探讨胃蛋白酶原Ⅰ、Ⅱ(PG Ⅰ、PGⅡ)及PG Ⅰ/PGⅡ的比值(PGR)、胃泌素-17(G-17)和CEA、CA19-9几项指标联合检测在胃癌诊断中的临床价值.方法 选择瑞金医院卢湾分院经胃镜检查确诊的185例胃疾病患者为研究对象,以组织病理学检查结果将受检者分为3组,即浅表性胃炎组85例、萎缩性胃炎组50例、胃癌组50例.采用时间分辨荧光免疫分析法检测PG Ⅰ和PGⅡ,然后计算出PGR的值,采用放射免疫分析法检测G-17,采用电化学发光免疫分析法检测CEA及CA19-9.比较不同分组间各指标的差异,最后绘制各指标检查胃癌及胃炎的ROC曲线.结果 在PG Ⅰ、G-17、CEA及CA19-9这四项指标中,浅表性胃炎组和萎缩性胃炎组与胃癌组的差异均有统计学意义(P＜0.05),而浅表性胃炎组与萎缩性胃炎组的差异均无统计学意义(P＞0.05).在PGⅡ和PGR这两项指标中,各组间的差异均无统计学意义(P＞0.05).将PG Ⅰ、G-17及CEA、CA19-9单独测定对胃癌的诊断价值的结果与联合测定对胃癌的诊断价值的结果进行比较并用ROC曲线进行分析,线下面积分别为0.742、0.699、0.614、0.520和0.850.结论 PG Ⅰ、G-17及CEA、CA19-9联合检测可提高胃癌的诊出率,对胃癌的诊断具有较为重要的临床意义.     

血清AFP、CEA、CA19-9、CA125、TSGF联检对卵巢癌的诊断价值

目的：探讨血清AFP、CEA、CA19-9、CA125、TSGF联检对卵巢癌的诊断价值。方法：卵巢病变患者共109例（卵巢癌45例,卵巢良性病变64例）,采用分光光度法测定TSGF,采用全自动化学发光法测定AFP、CEA、CA19-9和CA125。结果：卵巢癌组单项阳性率依次为：TSGF 73.33%（33/45）、CA125 60.00%（27/45）、CA19-9 35.56%（16/45）、CEA8.89%（4/45）、AFP 2.22%（1/45）。去除AFP、CEA后,CA19-9、CA125、TSGF三项联检阳性率为91.11（41/45）。结论：CA19-9、CA125、TSGF联检有助于提高卵巢癌的检出率。