43例胰腺癌患者血清CA19-9、CA125、CEA水平检测及分析

目的 探讨血清肿瘤标志物CA19-9、CA125及癌胚抗原（CEA）联合检测对胰腺癌诊断及疗效监测的价值.方法 采用全自动电化学发光分析仪测定43例胰腺癌患者（胰腺癌组）及40例健康查体者（对照组）血清CA19-9、CA125及CEA水平,其中胰腺癌组手术前及术后1个月各测定1次;根据试剂厂家提供的参考值计算三种标志物诊断胰腺癌的敏感性、特异性及准确性.结果 胰腺癌组手术前后血清CA19-9、CA125及CEA水平均显著高于对照组（P＜0.01）,尤以术前为著（P＜0.05）;三种肿瘤标志物术后阳性率均显著低于术前（P＜0.05）,联合检测上述三种肿瘤标志物诊断胰腺癌的敏感性、特异性及准确性均显著高于单一标志物检测（P＜0.05）. 结论联合检测血清CA19-9、CA125、CEA水平对胰腺癌的辅助诊断、疗效判定、病情监测等均有重要价值.     

消化系统恶性肿瘤患者肿瘤标志物癌胚抗原及癌抗原19-9和癌抗原242联检的临床意义

[目的]探讨消化系统恶性肿瘤患者血清中癌胚抗原（CEA）、癌抗原19-9（CA19-9）、癌抗原242（CA242）水平的变化及联合检测的临床意义。[方法]应用化学发光法和酶联免疫法测定178例消化系统恶性肿瘤患者（肿瘤组）血清中CEA、CA19-9、CA242水平,并与204例消化系统良性疾病（对照组）作比较。[结果]肿瘤组血清CEA、CA19-9、CA242水平显著高于对照组（P〈0.05）,3项联合检测可提高肝癌、胃癌、胰腺癌、结直肠癌的特异性（P〈0.05）,敏感性未见增加。[结论]联合检测消化系统恶性肿瘤患者血清CEA、CA19-9、CA242水平,对临床诊断和疗效观察具有重要的价值。     

血清CEA、CA19-9和IL-8联合检测在大肠癌诊断中的应用价值

目的探讨肿瘤标志物癌胚抗原（CEA）、糖类抗原19-9（CA19-9）及白介素-8（IL-8）联合检测在大肠癌早期诊断中的价值。方法选择大肠癌患者70例作为大肠癌组,选择在我院行纤维结肠镜筛查的正常人55例作为对照组,抽取两组空腹静脉血3 mL,采用化学发光免疫法测定血清CEA、CA19-9水平,采用化学发光免疫法测定血清IL-8水平。比较两组血清CEA、CA19-9及IL-8水平,计算3种肿瘤标志物单项及联合检测时的敏感性、特异性。结果大肠癌组患者血清CEA、CA19-9及IL-8水平均高于对照组（P均〈0.05）。单独检测时,IL-8的敏感性、特异性高于CEA及CA19-9。CEA＋CA19-9＋IL-8三项联合检测时的敏感性、特异性最高,分别为94.89%和98.3%。结论大肠癌患者血清CEA、CA19-9及IL-8水平增高,CEA、CA19-9及IL-8联合检测应用于大肠癌的诊断效果优于单一肿瘤标志物,可以提高筛查的敏感性及特异性。     

血清肿瘤标志物和肝功能指标联合检测在胰腺癌肝转移诊断中的价值

目的探讨肿瘤标志物和肝功能指标联合检测在胰腺癌肝转移早期诊断中的临床价值。方法选取125例胰腺癌患者,其中肝转移58例,无肝转移67例。检测患者血清肿瘤标志物和肝功能指标水平,并对结果进行分析。结果胰腺癌肝转移者血清中癌胚抗原（CEA）、糖类抗原19-9（CA19-9）、糖类抗原242（CA242）和乳酸脱氢酶（LDH）水平显著高于无肝转移者（P〈0.05）。ROC曲线分析显示CEA、CA19-9、CA242与LDH诊断肝转移的最佳上限为6.0μg/L、842 U/m l、64.48 U/L与220 U/L。CEA和LDH单独检测肝转移的敏感性为64.2%和51.9%,特异性为71.4%和74.2%。而CEA与LDH联合检测的敏感性和特异性为77.6%和93.5%。结论肿瘤标志物和肝功能指标联合检测特异性高,有助于胰腺癌肝转移的早期诊断。     

肿瘤标志物联合检测在肺癌早期诊断中的应用

目的：探讨外周血肿瘤标志物癌胚抗原（CEA）、神经元特异性烯醇化酶（NSE）、细胞角质蛋白19片段（CYFRA21-1）、糖链抗原125（CA125）、糖链抗原19-9（CA19-9）、糖链抗原15-3（CA15-3）联合检测在肺癌早期诊断中的应用价值。方法：采用Elecsys2010电化学发光仪检测80例肺癌患者,55例肺部良性疾病患者,40例健康人血清中CEA、NSE、CYFRA21-1、CA125、CA19-9、CA153等肿瘤标志物的水平。结果：肺癌患者中CEA、NSE、CYFRA21-1、CA125、CA19-9、CA153等6种标志物显著高于正常对照组及肺部良性疾病组,差异有统计学意义（P〈0.01）。6项标志物不同组合对不同分期肺癌检出的敏感性均高于单项标志物。其中第6种CY-FRA21-1＋CA125＋NSE和第7种CYFRA21-1＋CA125＋NSE＋CEA组合的敏感性较其他组合均高,特别是对早期患者检出率明显提高,但第7种方式成本较高且6、7两种方式检出率差异无统计学意义。结论：CYFRA21-1＋CA125＋NSE联合检测能提高肺癌的早期诊断率。     

探讨胆汁肿瘤标志物对胆管良恶性疾病的诊断价值

目的探讨胆汁肿瘤标志物对胆管良恶性疾病的诊断价值。方法160例因胆道疾病需要ERCP治疗者,ERCP时取胆汁检测胆汁肿瘤标志物（CA19-9、CEA和CA242）和细菌培养。结果恶性狭窄组与良性疾病组间胆汁和血清CA19-9、CEA、CA242水平差异均有统计学意义（P〈0．05）;根据ROC曲线制定恶性狭窄的胆汁肿瘤标志物界限值：CA19-9239ku／L,CEA40ng／ml,CA24260ku／ml。CEA敏感度、准确度、阴性预测值与血液标志物比较差异有统计学意义（P〈O．05）。3种胆汁标志物的特异性与血清比较差异无统计学意义。胆管癌、胰腺癌、十二指肠乳头癌与胆管旁转移癌、肝癌比较CA19-9水平差异有统计学意义（P〈0．05）;无论是恶性狭窄组还是良性疾病组,细菌阳性胆汁与阴性胆汁组间CA19-9水平比较差异均有统计学意义（P〈0．05）。结论胆汁CA19-9、CEA、CA242水平对鉴别胆道良恶性疾病有一定帮助,但并不明显优于血清标志物。胆汁细菌感染可引起胆汁CA19-9水平升高,但不影响良恶性诊断结果。     

血清TSGF、CA242、CA19-9对老年胰腺癌患者诊断作用的临床研究

目的 评价血清中肿瘤标志物恶性肿瘤相关物质(TSGF)、糖类抗原CA242和CAl9-9对老年胰腺癌患者的诊断作用。方法 采用生化比色法与酶免法分别检测200例健康人、52例胰腺炎及96例胰腺癌患者的TSGF、CA242和CAl9-9含量。结果 TSGF、CA242和CAl9-9阳性似然比依次为5．4、12．6和6．3，阴性似然比依次为0．10、0．19和0．17。单项肿瘤标志物对胰腺癌诊断：TSGF敏感性高达91．6％，CA242特异性高达93．5％。以3项均为阳性诊断胰腺癌：敏感性为77．1％，特异性和阳性预测值皆为100．0％。胰头癌TSGF与CA242水平显著高于胰体癌、胰尾癌及全胰癌，而CAl9-9的表达与其部位无相关性。TSGF、CA242与CAl9-9随着临床分期的进展而敏感性增加，Ⅰ期者TSGF的敏感性显著高于CA242与CAl9-9，因此TSGF可以作为胰腺癌早期筛选的肿瘤标志物。结论 应用TSGF、CA242和CAl9-9联合诊断胰腺癌可以提高特异性，其表达对胰腺癌的不同组织分型起到重要作用，3项标志物联合检测可助早期诊断胰腺癌。     

联合检测血清TK1、CA19-9对胰腺癌和胰腺炎鉴别诊断的价值

目的 探讨联合检测血清胸苷激酶1（TK1）、糖类抗原19-9（CA19-9）对胰腺癌和胰腺炎鉴别诊断的价值.方法 选择胰腺癌患者37例（胰腺癌组）、胰腺炎患者40例（胰腺炎组）及健康体检者50例（对照组）,采用化学增强发光印迹法检测其血清TK1,直接化学发光法检测血清CA19-9.结果 胰腺癌组、胰腺炎组血清CA19-9水平明显高于对照组（P均＜0.05）,但胰腺癌组与胰腺炎组比较差异无统计学意义.胰腺癌组血清TK1水平明显高于胰腺炎组、对照组（P均＜0.05）,而胰腺炎组与对照组比较差异无统计学意义.两者联合检测能明显提高诊断胰腺癌的敏感性（92.7％）.结论 联合检测血清CA19-9、TK1有助于胰腺炎和胰腺癌的鉴别诊断.     

肿瘤标志物检测在胰腺癌诊断和预后评估中的价值研究

目的评价胰腺癌肿瘤标志物对胰腺癌诊断及预后的影响。方法收集2007年1月至2011年12月沈阳军区总医院胰腺癌住院患者198例,良性胰腺病50例,正常对照组61名。采用放射免疫分析法检测血清肿瘤标志物CA19-9、CA242、CA50、CA125、CEA。分析回访到生存期的120例胰腺癌患者预后影响因素。结果胰腺癌患者肿瘤标志物CA19-9、CA242、CA125明显增高,与正常对照组及良性胰腺病变组比较差异有统计学意义(P0.05);CA19-9、CA242、CA125、CA50和CEA灵敏度分别为80.84%、72.50%、56.67%、56.12%、45.31%,特异度分别为76.80%、69.32%、72.96%、65.33%、57.40%。联合检测灵敏度有提高,但特异度降低。胰腺癌患者中位生存期5.5个月,胰体尾癌及全胰腺癌较胰头癌生存期短,CA19-9、CA242、CA125升高的患者生存期短(P0.05)。多因素Cox比例风险回归分析显示,CA19-9、CA242是独立预后因素(P0.05)。结论胰腺癌血清肿瘤标志物检测有助于胰腺癌的早期诊断。联合检测肿瘤标志物有助于提高对胰腺癌的诊断效率,胰腺体尾部肿瘤、CA19-9、CA242、CA125升高的患者生存期短。CA19-9、CA242是胰腺癌的独立预后因素,有助于评估预后。     

CEA、CA19—9、CA50水平与胰腺癌分期和肿瘤大小的关系

目的探讨血清肿瘤标志物CEA、CA19-9、CA50水平与胰腺癌分期和肿瘤大小的关系。方法分别测定35例胰腺癌和36例慢性胰腺炎患者血清CEA、CA19—9与CA50水平。外科手术和（或）病理学判定TNM分期和肿瘤大小．分析两者之间的关系。结果血清CEA、CA19—9、CA50对胰腺癌诊断的敏感性分别为12％、82％、74%。特异性分别为75%、83％、77％。Ⅲ-Ⅳ期的CA19—9和CA50水平明显高于Ⅰ-Ⅱ期患者（P〈0.05）．CEA超过正常值者仅见于Ⅲ期以上胰腺癌患者。TS3-TS1组的CEA、CA19-9、CA50水平比TS1-TS2组明显增高（P〈0．05）。结论胰腺癌血清CEA、CA19—9、CA50水平与胰腺癌分期和肿瘤大小有一定相关性．对手术前判断胰腺癌的可切除性有一定的参考价值。     

胰腺癌患者血清CEMIP、CA19-9和CA242水平变化及其临床意义*

目的 研究胰腺癌患者血清CEMIP、CA19-9和CA242水平变化及其临床意义。方法 2013年4月～2016年8月我院诊治的92例胰腺癌患者、105例胰腺良性疾病患者和选择的83例健康人，采用ELISA法检测血清细胞迁移诱导透明质酸结合蛋白（CEMIP）水平，采用放射免疫法检测血清CA19-9和CA242水平。应用受试者工作特征曲线（ROC）下面积（AUC）评价各指标的诊断效能。采用Kaplan-Meier和Cox风险比例模型行生存分析。采用Logistic回归分析影响术后生存的因素。结果 胰腺癌患者血清CEMIP、CA19-9和CA242水平分别为0.7（0.4，1.0） ng/mL、180.1（89.1，230.3） U/mL和61.7（20.7，93.5）U/mL，均显著高于胰腺良性疾病患者和健康人，差异有统计学意义（P均<0.05）；应用血清CEMIP、CA19-9和CA242联合诊断胰腺癌的AUC为0.966，其诊断效能显著高于任一指标单独诊断；应用血清CEMIP、CA19-9和CA242水平预测胰腺癌患者根治术后1年生存的效能均较高；经Kaplan-Meier和Cox多因素分析，结果表明肿瘤分化程度、血管侵犯、术后化疗、血清CEMIP≥0.7 ng/mL、CA19-9≥90.3 U/mL和CA242≥32.8 U/mL均是影响胰腺癌患者根治术后生存的独立危险因素。结论 检测胰腺癌患者血清CEMIP、CA19-9和CA242水平可有助于对疾病的诊断和预后评估。     

Comparison of tumor marker CA 242 with CA 19-9 and carcinoembryonic antigen (CEA) in pancreatic cancer

BACKGROUND/AIMS: Although there are a variety of tumor markers used for diagnosis of pancreatic carcinoma, the sensitivity and specificity of those markers have not yet reached an ideal level. The aim of this study was to compare the diagnostic value of CA 242 with CA 19-9 and CEA in the patients with pancreatic cancer. METHODOLOGY: Serum CA 242, CA 19-9 and CEA levels were determined in 135 subjects in the following groups: Pancreatic cancer (n = 40), cholangiocellular carcinoma (n = 15), hepatocellular carcinoma (n = 10), cirrhosis (n = 7), chronic active hepatitis (n = 7), choledochal stone (n = 12), chronic pancreatitis (n = 9), acute pancreatitis (n = 6), and healthy controls (n = 29). RESULTS: An elevated serum CA 242 concentration (> 20 U/mL) was found in 30 out of 40 (70%) (mean; 2163 +/- 838 U/mL) patients with pancreas cancer, in 11 out of 15 patients with cholangiocellular carcinoma (93.3%) (mean 916 +/- 529 U/mL), in none of patients with hepatocellular carcinoma and healthy controls. Slightly elevated CA 242 concentration was found in 6 out of 41 patients with benign hepatobiliary and pancreatic disease (range 0.4-97.8 U/mL) (1 acute pancreatitis, 2 chronic pancreatitis, 1 cirrhosis, 2 choledochal stone). Mean serum CA 242, CA 19-9 and CEA levels of the pancreas cancer group were significantly higher than those of the other groups except the cholangiocellular carcinoma group. There was no significant difference between the stage of pancreas cancer regarding mean serum CA 242, CA 19-9 and CEA level. There was positive correlation between serum CA 242 and CA 19-9 level. In the pancreas cancer, the sensitivity of CA 242, CA 19-9 and CEA was 75%, 80%, 40%, respectively and the specificity of those markers was 85.5%, 67.5% and 73%, respectively. CONCLUSIONS: In conclusion, the advantage of CA 242 compared to CA 19-9 is that its specificity is higher than that of CA 19-9 in the diagnosis of pancreas cancer.     

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。     

A clinical evaluation of monoclonal (CA19-9, CA50, CA12-5) and polyclonal (CEA, TPA) antibody-defined antigens for the diagnosis of pancreatic cancer

We measured in 193 patients, admitted to our wards for symptoms and signs suggestive of pancreatic or digestive malignancy, the serum levels of five tumor-associated antigens (CA 19-9, CA 50, CA 125, TPA, CEA) and we evaluated their diagnostic accuracy both when used alone and in combination. For CA 19-9 and CA 50 a sensitivity for pancreatic cancer as high as 92 and 88%, respectively, and specificity of 91.8% were found. A lower sensitivity vs. pancreatic cancer was found for the other tumor markers, and vs. the other digestive and nondigestive malignancies for all tumor markers (apart for CA 19-9 and CA 50 vs. biliary carcinomas). As for the combined assays, the best figures were found vs. pancreatic cancer for CA 19-9 plus CA 50, CA 50 plus CEA, CA 50 plus CA 125; a sensitivity by far worse vs. the other gastrointestinal cancers was found for all the possible combinations. We conclude that in selected symptomatic patients some tumor-marker determinations can be useful in identifying those with a high probability of harboring a pancreatic cancer, to be further studied or operated upon. The clinical relevance of this in patients already symptomatic is at present unclear.     

多种肿瘤标志物在胰腺癌临床分期中的应用

目的探讨多种肿瘤标志物检测对胰腺癌的临床分期及术前评估的应用。方法45例胰腺癌,其中Ⅰ-Ⅱ期16例、Ⅲ期11例、Ⅳ期18例,检测其术前CA199、CA125、CEA等肿瘤指标,分析多种肿瘤标志物在胰腺癌临床分期及术前评估中的意义。结果不同分期胰腺癌之间CA199水平差异无显著性（P=0．381）,CA125、CEA的水平随着分期的递增而升高,但统计分析显示只有CA125组间差异有统计学意义（P〈0．05）。按照是否可切除分为两组,CA199水平在两组间差异无统计学意义（Z=1．045,P=0．296）,而CA125、CEA水平在两组间存在显著性差异（P=0．000、0．045）。多因素分析结果显示,胰腺癌的不同分期与有无黄疸、胆道疾病史、性别、体重减轻等之间存在显著统计学差异（P〈0．05）,而与术前胆红素水平、血糖、糖尿病史、年龄等之间无统计学差异。结论CA125和CEA可辅助用于胰腺癌患者临床分期及术前评估,具有无创性、病人依从性好等优点,具有较好的临床潜在应用价值。     

血清CA19—9、CEA、CA125联合检测诊断食管癌的价值

目的探讨多抗原联合检测诊断食管癌的价值。方法应用全自动化学免疫分析检测254例食管癌患者、40例食管炎患者和100例健康体检者血清CA19-9、CEA、CA125的表达。结果三项指标联合检测诊断食管癌的灵敏度和特异度均明显高于单独检测及任两项联合检测（P均〈0．01）。结论三项指标联合检测可提高诊断食管癌的灵敏度和特异度,有利于早期诊断食管癌。     

肺癌患者血清CEA、CA242、VEGF联合检测的临床意义

目的研究血清CEA、CA242、VEGF的检测在肺癌诊断中的临床意义。方法采用ELISA方法测定96例肺癌患者血清CEA、CA242、VEGF的水平。结果CEA、CA242和VEGF的联合检测的阳性率达到71.9%,明显高于各单项标记物的检测阳性率（分别为42.7%、46.9%、40.6%）,Ⅲ＋Ⅳ期患者CEA、CA242、VEGF阳性率明显高于Ⅰ＋Ⅱ期患者（分别为52.2%vs18.5%、53.6%vs29.6%、47.8%vs22.2%,P〈0.05）,其值大小明显高于Ⅰ＋Ⅱ期患者（分别为33.32±55.91vs5.52±4.96ng/ml、45.82±86.27vs14.6±39.78u/ml、293.15±135.75vs47.91±28.64pg/ml,P〈0.01）。结论CEA、CA242、VEGF可用于肺癌的诊断、预后判断,联合检测可提高诊断率。     

Serum level of TSGF, CA242 and CA19-9 in pancreatic cancer

AIM: To establish a method to detect the expression of the tumor specific growth factor TSGF, CA242 and CA19-9 in serum and evaluate their value in diagnosis of pancreatic cancer. METHODS: ELISA and Biochemical colorimetric assay were used to detect the serum content of TSGF, CA242 and CA19-9 in 200 normal cases, 52 pancreatitis patients and 96 pancreatic cancer patients. RESULTS: The positive likelihood ratios of TSGF, CA242 and CA19-9 were 5.4, 12.6 and 6.3, respectively, and their negative likelihood ratios were 0.10, 0.19 and 0.17, respectively. With single tumor marker diagnosed pancreatic cancer, the highest sensitivity and specificity of TSGF were 91.6% and 93.5%. In combined test with 3 markers, when all of them were positive, the sensitivity changed to 77.0% and the specificity and the positive predictive value were 100%. The levels of TSGF and CA242 were significantly higher in the patients with pancreatic cancer of head than those in the patients with pancreatic cancer of body, tail and whole pancreas, but the expression of CA19-9 had no correlation with the positions of the pancreatic cancer. The sensitivity of TSGF, CA242 and CA19-9 was increased with the progress in stages of pancreatic cancer. In stage I, the sensitivity of TSGF was markedly higher than CA242 and CA19-9. CONCLUSION: The combined use of TSGF, CA242 and CA19-9 expressions can elevate the specificity for pancreatic cancer diagnosis. And it shows that it plays an important role to differentiate positions and tissue typing. It is a forepart diagnosis for the pancreatic cancer by combination checking. There is very important correlation between the three markers and the pancreatic cancer.