CA72-4、CA19-9、CEA联合检测在胃癌诊断中的应用

目的探讨CA72-4、CA19-9、CEA联合检测在胃癌诊断中的应用价值。方法对124例胃癌病人联合检测CA72-4、CA19-9、CEA。结果124例胃癌病人的CA72-4、CA19-9、CEA及联合检测的阳性率分别为41.9%、38.7%、30.6%、70.9%。结论CA72-4、CA19-9、CEA联合检测可提高胃癌病人的阳性检出率,有一定的应用价值。     

血清CA153、CA125及CA19-9检测对乳腺癌的诊断价值

目的探讨血清CA153、CA125和CA19-9检测对乳腺癌早期诊断的价值。方法采用化学发光免疫法分别检测乳腺癌、乳腺良性疾病患者及正常健康体检者血清CA153、CA125和CA19-9的水平。结果乳腺癌患者血清的CA153、CA125和CA19-9的表达水平及表达阳性率均明显高于正常对照者和乳腺良性疾病患者(P<0.01);乳腺癌患者术后CA153、CA125及CA19-9表达水平较术前明显下降(P<0.01),与正常对照者比较差异无统计学意义(P>0.05)。结论肿瘤标志物CA153、CA125及CA19-9对乳腺癌有一定的诊断价值,且可作为监测乳腺癌病情进展、评估治疗疗效及预后的指标。     

胃癌病人中血清CA72-4和CA19-9值的比较以及与复发的相关性

癌胚抗原(CEA)检测胃癌的特异性不高,CA19-9的敏感性变异很大,可在15%～72%之间,联合测定CEA和CA19-9也不提高其敏感性.近期发现一种新的肿瘤相关糖蛋白抗原TAG-72,可在胃肠道腺癌病人的血清中检出,现用的药盒用CA72-4分析,应用单克隆抗体B72.3和CC49的双重决定因子免疫分析法.初步报告CA72-4是胃癌的可靠肿瘤标记物,并可补充CA19-9测定的效果.取32例经内镜和病理证实的胃良性病变和52例经手术切除的胃腺癌病人进行测定,两组病人的中位值年龄分别为36岁和61岁.胃癌病人中,属TNMⅠ、Ⅱ、Ⅲ和Ⅳ期分别占7、5、11和29例.结果凡CA72-4和CA19-9的血清值分别超过6.7kU/L和22kU/L者列为阳性结果.在32例良性胃病变中,CA72-4和CA19-9的阳性率分别为0和28%;而在52例胃癌病人中,则分别为42%和46%,这两种肿瘤标记物具有相似的敏感性,但CA19-9的特异性较低.进一步分析示良性病变者的CA19-9血清值变异较CA72-4为大.在Ⅰ、Ⅱ期和Ⅲ、Ⅳ期胃癌中,CA72-4的阳性率分别达25%和48%,CA19-9的阳性率分别为17%和55%,     

胃蛋白酶原及其亚群与CA72-4联合检测对早期胃癌诊断及预后判断的意义

目的探讨血清胃蛋白酶原(PG)及其亚群PG Ⅰ、PGⅡ和CA72-4与胃癌患者早期诊断及术后复发的关系。方法采用RIA法测定62例胃癌及其他胃部疾病患者和72例胃癌手术患者及对照组的血清PG Ⅰ、PGⅡ及CA72-4值,并对两者联合检测诊断胃癌及其预后判断的临床价值进行综合评价。结果早期与进展期的胃癌患者血清PG含量明显低于正常对照组(P<0.01)。在早期胃癌的诊断上,胃癌患者的血清CA72-4值与正常人无显著性差异(P>0.05),而进展期胃癌患者的CA72-4含量则显著升高(P<0.01)。胃癌手术前后PG Ⅰ、PGⅡ及CA72-4含量变化均有显著性差异(P<0.01)。其中全胃切除者血清PG Ⅰ及PGⅡ的含量均明显低于胃次全或大部分切除者(P<0.05),全胃切除术后患者血清胃蛋白酶原含量很低,但当胃癌复发后PG Ⅰ、PGⅡ及CA72-4值均明显升高;胃次全或大部分切除者复发前后PG Ⅰ及PGⅡ变化不显著(P>0.05),CA72-4却有明显变化(P<0.05),联合检测特异性更高(P<0.01)。结论检测PG含量变化,尤其是PG Ⅰ、PG Ⅰ／PGⅡ下降对早期胃癌筛选有一定意义。PG和CA72-4联合检测,可显著提高检测的灵敏度及特异性,有望适用于胃癌术后复发的监控。     

血清CA19-9水平与胰腺癌转移及手术切除率关系的初步探讨

目的　探讨血清 CA19- 9水平与胰腺癌病程的关系。方法　测定 5 0例病理检查确诊的胰腺癌血清 CA19- 9水平 ,分析 CA19- 9水平与胰腺癌有无远处转移、血管侵犯及手术切除率的关系。结果　高血清 CA19- 9水平 (>2 0 0 U/ ml)组合并远处转移率 (14例 ,5 6 % )明显高于低血清 CA19- 9水平组 (5例 ,2 0 % ) (P<0 .0 1) ,而合并血管受侵率 (14例 ,5 6 % )与低血清 CA19- 9水平组 (9例 ,36 % )相比差异不大 (P>0 .0 5 )。高血清 CA19- 9水平组患者的根治性肿瘤切除率 (3例 ,12 % )明显低于低血清 CA19- 9水平组 (11例 ,4 4 % ) (P<0 .0 1)。结论　血清 CA19- 9水平可作为提示胰腺癌有无远处转移及血管受侵的辅助指标     

血清CA199、CA242、CA125联合检测对胆囊癌患者诊断的临床价值研究

目的探究血清糖类抗原199(CA199)、糖类抗原242(CA242)、糖类抗原(CA125)联合检测对胆囊癌诊断的临床价值。方法选取我院于2010年1月~2015年1月收治的胆囊癌患者35例,设为恶性组,另选同期于我院就诊的50例良性胆囊疾病患者和50例健康体检者,分别设为良性组和对照组,用固相双位点夹心免疫放射度量分析法经全自动化学发光免疫分析仪检测研究对象血清CA199、CA242、CA125浓度并计算项指标单独及联合检测的灵敏度、特异度、预测值、符合率及约登指数,然后行统计学分析。结果三组患者CA199、CA242、CA125水平的差异有统计学意义(F=12.347,P0.05);恶性组患者CA199、CA242、CA125的水平高于良性组(q=15.354,P0.05;q=13.247,P0.05;q=16.498,P0.05)及对照组(q=16.247,P0.05;q=14.578,P0.05;q=17.244,P0.05);良性组与对照组患者CA199、CA242、CA125的水平接近(q=1.459,P0.05;q=1.687,P0.05;q=1754,P0.05);恶性组患者CA199、CA242、CA125阳性率分别为74.29%、65.71%、45.71%,高于良性组的6.00%、4.00%、4.00%(χ2=9.547,P0.05;χ2=11.215,P0.05;χ2=10.241,P0.05)及对照组的4.00%、2.00%、2.00%(χ2=12.549,P0.05;χ2=15.489,P0.05;χ2=13.492,P0.05);良性组与对照组患者CA199、CA242、CA125的阳性率相当(χ2=1.957,P0.05;χ2=1.824,P0.05;χ2=1.824,P0.05);恶性组患者三者联合检测的阳性率为91.43%,高于良性组的12.00%(χ2=15.498,P0.05)及对照组的8.00%(χ2=16.488,P0.05);良性组和对照组患者联合检测的阳性率相近(χ2=1.548,P0.05);对胆囊癌诊断而言,单一指标检测时,CA199对GBC诊断的灵敏度、阳性预测值、阴性预测值、符合率、约登指数最高,但特异性不高;两种指标联合检测时,含有CA199时对GBC的诊断价值更大;三种指标联合检测时,灵敏度、阳性预测值、阴性预测值、符合率、约登指数高于单一指标或两种联合检测。结论联合检测CA199、CA242、CA125可提高胆囊癌的诊断率,且两种联合检测时与CA199联合更具有诊断意义,临床可考虑推广应用。     

几种消化道肿瘤患者血清肿瘤相关性物质水平的初步分析

目的　初步评价血清肿瘤相关性物质 (TSGF)水平在胃癌、结直肠癌和食道癌的临床诊断和术后监测中的意义。方法　对 12 4例胃癌、结直肠癌和食道癌及消化道良性疾病患者检测其血清TSGF水平 ,并与同时检测的CEA、CA1 9- 9、TAG72 、CA2 4 2 水平情况对比 ,各组患者检测结果与正常参考组作比较。结果　胃癌、结直肠癌和食道癌术前患者和胃、结直肠癌术后复发患者TSGF检测值与正常对照组检测值差异均有显著意义 (P <0 .0 5 ) ;胃、结直肠癌术后复发组与术后情况稳定组TSGF检测值的差异有显著意义 (P <0 .0 5 ) ;胃癌、结直肠癌、食道癌术前患者TSGF检出阳性率依次为 35 .7%、4 8.6 %和 71.4 % ;胃癌Ⅰ+Ⅱ期、结直肠癌Duke’SA +B期TSGF的检出阳性率为 32 .3% ,而胃癌Ⅲ +Ⅳ期、结直肠癌Duke’sC +D期患者检出阳性率为 35 .9%。结论　TSGF对食道癌诊断有较高的敏感性 ,明显地高于CEA、CA1 9- 9、TAG72或CA2 4 2 ;对胃癌、结直肠癌的诊断和术后病情监测有一定的作用 ,对胃癌、结直肠癌的早期诊断效能明显优于CEA、TAG72 。因此是一项有重要临床应用价值的肿瘤新标志物     

良性胆道疾病患者CA19-9升高原因探讨

目的 探讨良性胆道疾病患者CA19-9升高的原因. 方法 选取CA19-9升高的良性胆道疾病病例56例,检测血清CA19-9及血清总胆红素水平. 结果 黄疸程度不同的患者CA19-9水平存在差异(P<0.05).梗阻性黄疸患者总胆红素水平和CA19-9水平之间呈正相关(r=0.5764),而没有明显黄疸的患者,两者间无直线相关关系(r=-0.1033). 结论 CA19-9升高与胆道感染、狭窄致胆道梗阻,肝硬化肝功能异常等多种原因有关.     

肿瘤标志物在胃癌患者中的诊断及预后价值

目的 探讨肿瘤标志物CEA、CA19-9、CA72-4及CA242在胃癌诊断及预后判断中的应用价值.方法 回顾性分析2002-2007年间在北京肿瘤医院就诊的160例胃癌患者血清肿瘤标志物、临床病理参数以及预后资料.结果 160例胃癌患者中CEA、CA19-9、CA72-4及CA242的初诊阳性率分别为37.7％、26.7％、37.6％及21.3％,4种标志物联合检测阳性率为62.9％.CEA阳性与淋巴结转移有关（P=0.029）;CA72-4阳性与脉管浸润及Ⅲ、Ⅳ期胃癌有关（P=0.039,P=0.011）.CA19-9阳性和阴性患者中位生存期分别为17.0和32.0个月,CA72-4阳性和阴性患者中位生存期分别为14.8和37.5个月,差异有统计学意义（P＜0.01）.多因素生存分析提示,CA72-4可以作为独立预后因子（P=0.012）,CA72-4阳性患者的死亡危险系数是阴性患者的2.147倍.结论 肿瘤标志物CEA、CA19-9、CA72-4及CA242在胃癌患者的诊断和预后判断中有重要价值,联合检测可提高阳性率;其中CA72-4可以作为独立预后因子,CA19-9及CA72-4与胃癌患者预后相关.     

血清CEA、CA72-4、CA19-9及胃蛋白酶原水平对胃癌早期诊断的临床价值

目的：探讨血清癌胚抗原（CEA）、糖类抗原72-4(CA72-4)、糖链抗原19-9(CA19-9)、胃蛋白酶原Ⅰ（PGⅠ）、胃蛋白酶原Ⅱ（PGⅡ）及PGⅠ/PGⅡ比值（PGⅠ/PGⅡ,PGR）水平在胃癌患者中的表达情况及其早期诊断的临床价值。方法：选取胃癌患者117例,根据胃癌病情进展及临床病理分期分为早期胃癌组（n=63）和进展期胃癌组（n=54）及Ⅰ～Ⅱ期组（n=67）和Ⅲ～Ⅳ期组（n=50）。另选择60例胃良性病变患者和50例健康对照者。采用化学发光法测定各组血清CEA、CA72-4及CA19-9水平,酶联免疫吸附法检测PGⅠ、PGⅡ及PGR水平。应用受试者工作特征（ROC）曲线分析CEA、CA72-4、CA19-9、PGⅠ、PGⅡ及PGR水平对早期胃癌的诊断价值。结果：胃癌组血清CEA、CA72-4及CA19-9水平均明显高于良性病变组和健康对照组（均P<0.001）,而血清PGⅠ及PGR水平均明显低于良性病变组和对照组（均P<0.001）。进展期胃癌组血清CEA[(44.56±13.75)ng/m L比（25.70±7.42）ng/m L]、CA72-4 [(5...     

血清CA19-9、CA242、CEA及CA125在胰腺癌诊断和预后中的价值

目的探讨CA19-9、CA242、CEA和CA125四种肿瘤标志物单独检测或联合检测在胰腺癌诊断和预后中的价值。方法测定并分析我院2007年1月至2009年12月期间收治的63例胰腺癌患者、33例胆管癌和27例胰腺良性疾病患者血清中CA19-9、CA242、CEA和CA125水平,并对术后胰腺癌患者进行随访。结果胰腺癌患者血清中CA19-9、CA242、CEA和CA125水平明显高于胰腺良性疾病患者和胆管癌患者(P<0.05)。单项检测中血清CA19-9的敏感性最高,达79.4%(50/63),但其特异性(61.7%)低于CA242(83.3%)和CEA(80.0%)。联合检测CA19-9+CA242+CEA的特异性最高,达93.3%(56/60)。当肿瘤位于胰腺体/尾部时CA19-9水平显著高于其在胰腺头部或全胰腺时(P<0.05)。胰腺癌Ⅳ期患者的CA19-9和CA242水平显著高于Ⅰ或Ⅱ/Ⅲ期患者(P<0.05)。本组失访15例,48例获得随访,随访时间平均6个月(2~12个月)。胰腺癌患者术后0.5及3个月血清中CA242、CA19-9较术前明显降低(P<0.05)。结论单项检测CA19-9可以提高胰腺癌诊断的敏感性,联合检测CA19-9+CA242+CEA可以提高胰腺癌诊断的特异性,CA19-9和CA242对胰腺癌的治疗效果及预后判断更具有价值。     

Serum CA 19-9 and CA 50 antigens in hemodialysis patients

Serum concentrations of monoclonal antibody-defined tumor markers CA 19-9 and CA 50 were measured in 64 uncomplicated hemodialysis patients (Group 1) and in 8 hemodialysis patients with cancer (Group 2) in comparison with corresponding CEA determinations. From our results in Group 1 patients it appears that both CA 19-9 and CA 50 maintained an excellent specificity in these patients. As to the sensitivity of these tests, our findings in Group 2 patients are comparable with those reported in patients with cancer and normal renal function. It is concluded that, unlike CEA, these new tumor markers maintain their clinical value in chronic renal failure.     

肿瘤标志物CA19-9、CA242、CEA和CA125联合检测在胰腺癌诊断中的意义

目的 探讨肿瘤标志物CA19-9、CA242、CEA和CA125单项检测和联合检测对胰腺癌患者的临床诊断价值.方法 检测48例胰腺癌患者以及48例健康体检者外周血清中四种肿瘤标志物的水平,并对结果进行分析.结果 胰腺癌患者血清中CA19-9、CA242、CEA与CA125的含量显著高于正常时照组,两者比较差异有统计学意义(P<0.01).单项检测时CA19-9、CA242、CEA与CA125的敏感性分别为79.2%、54.2%、50.0%和35.4%.特异性分别为87.5%、89.6%、79.2%和70.8%.联合检测时敏感性为93.8%,特异性为100%.结论 CA19-9、CA242、CEA与CA125联合检测敏感性和特异性都明显高于单项检测.联合检测较单项血清标志物检测能提高胰腺癌的诊断率.     

CA125 is Superior to CA19-9 in Predicting the Resectability of Pancreatic Cancer

Background

Although carbohydrate antigen 19-9 (CA19-9) has been reported as a biomarker to predict the resectability of pancreatic cancer, several limitations have restricted its clinical use.

Methods

The potential of several serum tumor markers (CA19-9, CA125, CA50, CA242, CA724, carcinoembryonic antigen (CEA), and alpha-fetoprotein (AFP)) to predict the resectability of pancreatic cancer was evaluated by receiver operating characteristic (ROC) analysis in a series of 212 patients with proven pancreatic cancer.

Results

Compared with other tumor markers including CA19-9, CA125 has a superior predictive value (CA19-9, ROC area 0.66, cutoff value 289.40 U/mL; CA125, ROC area 0.81, cutoff value 19.70 U/mL). In addition, for patients with unresectable diseases misjudged by CT as resectable, the percentage of CA125 over selected cutoff value was higher than that of CA19-9 (CA19-9, 70.27 %; CA125, 81.08 %).

Conclusion

CA125 is superior to CA19-9 in predicting the resectability of pancreatic cancer. Aberrant high levels of CA125 may indicate unresectable pancreatic cancer.     

Significance of Serum Tumor Markers Carcinoembryonic Antigen, CA 19-9, CA 125, and CA 15-3 in Pre-Orthotopic Liver Transplantation Evaluation

Tumor markers are elevated in a variety of nonneoplastic clinical situations, including liver diseases. Their sensitivity and specificity are lower for tumor screening in these cases. In this study, we investigated the frequency and significance of elevated tumor markers in the pre-orthotopic liver transplantation (OLT) evaluation among patients with end-stage liver disease who did not develop tumors after a long follow-up post-OLT. We performed a retrospective analysis of clinical and biological parameters of 100 OLT candidates comparing data for CA 125, CA 19-9, CA 15-3, and carcinoembryonic antigen (CEA) levels. CA 125, CA 19-9, CA 15-3, and CEA levels were elevated in 59%, 53%, 29%, and 28% of cases, respectively. CA 125, CA 15-3, and CEA were associated with disease severity (Child-Pugh classification). CA 125 was also elevated among patients with ascites, esophageal varices, or alcohol-related cirrhosis. Elevated CA 19-9 levels were associated with increased CA 15-3 and CEA levels. CA 15-3 levels were also increased among patients with elevated alkaline phosphatase, while elevated CEA was related to ascites, bilirubin, and prothrombin time (PT) levels, as well as alcohol-related cirrhosis. There was no association between hepatocellular carcinoma and tumor markers. In conclusion, CA 125, CA 19-9, CA 15-3, and CEA were frequently elevated among end-stage liver disease patients. These elevations were not associated with tumor diseases in this population.