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。     

血清肿瘤标志物联合检测对消化系恶性肿瘤的诊断价值

目的探讨多项肿瘤标志物联合检测对诊断消化系恶性肿瘤的实用价值．方法选择经临床确诊的消化系恶性肿瘤１１９例，其中原发性肝癌２５例，胰腺癌２１例，胃癌２９例，大肠癌２７例，其他消化系恶性肿瘤１７例，以及同期良性消化系疾病５６例，应用ＲＩＡ或ＥＬＩＳＡ法检测血清ＣＥＡ，ＡＦＰ，ＳＦ，β２ＭＧ，ＣＡ１９９及ＣＡ５０水平．由实验室参考药盒厂家提供的正常值及实验室所做的正常人群均值，确立各项检测正常上限值，样品超过界值为阳性，反之为阴性．结果肝癌组以ＡＦＰ敏感度最高（６８０％），联合ＳＦ和ＣＡ１９９可提高至９２０％．胰腺癌组ＣＡ１９９最敏感（７６２％）．应用ＣＡ１９９，ＳＦ和ＣＡ５０联合检测，敏感度可达８５７％和９５２％．对胃癌和大肠癌，即使６项联合也不足８０％．结论联合检测对肝癌和胰腺癌可明显提高阳性率，但对胃癌及大肠癌仅起部分辅助作用．联合检测既提高灵敏度，也降低特异度．     

消化系统肿瘤患者血清CA50和CA19-9免疫放射分析的比较

目的：比较消化系统肿瘤患者血清ＣＡ５０和ＣＡ１９－９免疫放射分析（ＩＲＭＡ）的诊断价值,探讨ＣＡ５０和ＣＡ１９－９联合检测模式的合理性。方法：ＩＲＭＡ方法检测１４９例消化系统肿瘤患者与对照组血清ＣＡ５０和ＣＡ１９－９,比较分析２项检测结果张临床诊断价值指标。结果：带瘤生存组血清ＣＡ５０和ＣＡ１９－９单独和联合检测的阳 生率显著高主后无 和良性疾病组,其中肝物胰腺肿瘤患者的阳性率最高。ＣＡ５０和ＣＡ     

血型抗原H与消化道肿瘤

血型抗原Ｈ与消化道肿瘤全欣罗和生湖北医科大学附属第一医院消化内科湖北省武汉市４３００６０ＳｕｂｊｅｃｔｈｅａｄｉｎｇｓＤｉｇｅｓｔｉｖｅｓｙｓｔｅｍｎｅｏｐｌａｓｍｓ／ｉｍｍｕｎｏｌｏｇｙＡｎｔｉｇｅｎｓ，ｂａｃｔｅｒｉａｌ／ａｎａｌｙｓｉｓ主题...     

CA19-9、CA242、CEA联合检测诊断消化道肿瘤的价值

近两年来 ,我们采用酶联免疫方法对 1 1 2例消化道肿瘤患者于术前行 CA19-9、CA2 42 和癌胚抗原( CEA)测定 ,旨在探讨各种标志物单独及联合检测对消化道肿瘤的诊断价值。1　资料与方法1 .1　一般资料　本文 1 1 2例消化道肿瘤患者 ,均经病理检查确诊。其中大肠癌 42例 ,胰腺癌 30例 ,胃癌40例。患者年龄 31～ 68岁。均于术前取肘静脉血2 ml,离心取血清 ,- 2 0℃冻存备用。采用酶联免疫方法检测 CA19-9(试剂盒为意大利 SORINBIOMEDICA 公司生产 )、CA2 42 (试剂盒为瑞典Can Ag公司生产 )及 CEA(试剂盒为北京中山生物技术有限公司…     

结直肠癌患者血清CEA、CA19-9的检测价值

目的 探讨癌胚抗原（ＣＥＡ）、糖链抗原（ＣＡ１９－９）在结直肠癌的诊断、观察预后、监测复发转移中的应用价值。方法 ＣＥＡ采用ＥＬＩＳＡ法、ＣＡ１９－９采用放免法,对１９例结肠癌、２６例直肠癌、３０例正常人进行了分析,并在术后定期检查。ＣＥＡ、ＣＡ１９－９水平下降,可恢复至正常：术后复发ＣＥＡ、ＣＡ１９－９重又异常升高,伴广泛转移者升高更加显著,并且ＣＥＲＡ、ＣＡ１９－９的升高出现在临床症状和Ｘ线异     

血清癌胚抗原、糖链抗原及血清铁蛋白检测对大肠癌的诊断价值

用放射免疫法检测41例大肠癌患者和20树结肠炎患者血清CEA、CA19-9、SF含量。结果显示：大肠癌三项标记物测定值均明显高于对照组（P＜0．01）。三项指标中除CEA在A_2期较高外，基本符合病理进展程度越深，肿瘤标记物检出率越高的特点。组织学分类中CEA阳性率粘液腺癌＞乳头状腺癌，CA19-9粘液腺癌＞管状腺癌＞乳头状腺癌，SF则管状腺癌明显＞乳头状腺癌（P＜0．05）。三项标记物联合检测时其敏感性、特异性、准确性为90．2％、75．0％、85．2％。     

肝功能生化指标对常用肿瘤标志物检测的影响

目的:探讨肝脏代谢对常用肿瘤标志物检测结果的影响.方法:回顾我院2004-01/2005-03收治入院诊断明确且具有完整肿瘤标志物(AFP、CEA和CA19-9)和肝功能各生化指标患者845例,分为普通疾病组、良性肝胆胰疾病组和恶性肿瘤组,对不同组别的肿瘤标志物与肝功能生化指标进行分析.结果:恶性肿瘤和普通疾病组中肝功能异常者的AFP高于肝功能正常者(z=-3.917,2.252;P＜0.01或0.05).在普通疾病组中AFP与TBIL、DBIL、γ-GT存在正相关(r=0.082,0.133,0.190;P＜0.01或0.05).在三组不同疾病组中肝功能正常与异常者的CEA未发现有差异.普通疾病组中CEA与γ-GT、ALP存在正相关性(r=0.171,0.139;均P＜0.01).恶性肿瘤组中肝功能异常者的CA19-9高于正常者(z=-1.973,P＜0.05).三组不同疾病中CA19-9与多种肝功能指标存在正相关.结论:胆道梗阻对CA19-9测定值有明显影响;低水平AFP与γ-GT有一定关系;而CEA则与肝功能无明确关系.     

胃癌患者血清CA19-9水平测定及临床意义

胃癌患者血清ＣＡ１９９水平测定及临床意义王国品吴根生蒋娥南化（集团）医院消化科江苏省南京市２１００４８Ｓｕｂｊｅｃｔｈｅａｄｉｎｇｓｓｔｏｍａｃｈｎｅｏｐｌａｓｍｓ／ｉｍｍｕｎｏｌｏｇｙ；ＣＡ１９９ａｎｔｉｇｅｎ／ａｎａｌｙｓｉｓ主题词胃肿瘤...     

胃癌细胞DNA含量肿瘤相关抗原及其异质性

目的探讨胃癌异质性标志物之间的关系．方法应用显微分光光度计和抗ＳＳＥＡ１，抗胃癌单抗ＭＧ７的免疫组织化学染色对３５例胃癌和１０例正常胃粘膜进行了ＤＮＡ含量和ＳＳＥＡ１，ＭＧ７抗原表达的研究．结果正常胃粘膜细胞和管状腺癌，低分化腺癌，粘液腺癌，印戒细胞癌及未分化癌的ＤＮＡ相对含量分别为１１６０±０２０７，２１７６±０７０３，２２１４±０６６３，２２０６±０６０２，１１９６±０２７９和１６６５±０４９１，其中正常胃粘膜９５８％细胞为２Ｃ细胞，而胃癌常见＞８Ｃ，＞１２Ｃ细胞，在直方图上分布弥散；同一类型的不同病例间，同一病例切片的不同部位呈明显的异质性，但印戒细胞癌的ＤＮＡ含量接近正常．大部分胃癌标本中可检出ＳＳＥＡ１和ＭＧ７Ａｇ，但分布及染色程度呈明显的不均质性．ＳＳＥＡ１，ＭＧ７Ａｇ的表达与ＤＮＡ含量无明显关系．结论ＤＮＡ含量和ＳＳＥＡ１，ＭＧ７的表达是互相独立的，均与肿瘤的行为有关．     

抗结直肠癌单克隆抗体测定胃、肠癌患者血清中癌相关抗原

目的 应用结直肠癌单克隆抗体对胃肠癌患者进行血清学诊断。 方法 采用ELISA法对胃癌、结直肠癌、胃良性疾病和健康供血者血清中结直肠癌抗原(CCA)进行了测定,同时测定了胃癌、结直肠癌患者血清中CEA含量。 结果 正常人血清CCA阳性仅1.5％。胃癌血清阳性率52.8％,CEA阳性率24.5％,CEA阳性病例中CCA阳性率为30.0％。结直肠癌患者CCA阳性率为52.9％,CEA阳性率为20.6％,CEA阴性病例中CCA阳性率为48.2％。胃良性疾病组CCA阳性率为10％。 结论 CCA单抗与CEA无交叉反应,临床上测定CCA可作为CEA的补充,为临床诊断及普查提供了新的诊断指标。     

非小细胞肺癌患者癌胚抗原、C反应蛋白表达水平与预后的关系

目的探讨晚期非小细胞肺癌(NSCLC)患者血清癌胚抗原(CEA)及C反应蛋白(CRP)的表达水平及与预后的关系。方法回顾分析82例晚期NSCLC患者的临床病理特征和生存资料,采用放射免疫分析法及速率散射比浊法检测患者血清基线CRP、CEA的含量,并对检测结果进行统计分析。结果血清基础CEA水平与病理类型、性别(P=0.000,0.025)相关,与年龄、分期、淋巴结转移、远处转移等均无明显相关性(P0.05)。血清CRP水平与分化程度相关(P=0.038),与病理类型、性别、年龄、分期、淋巴结转移、远处转移均无明显相关性(P0.05)。Kaplan-Meier生存分析和Cox模型多因素分析,血清基础CEA、CRP水平与患者预后明显相关(P=0.027,0.015),且两者均是影响晚期NSCLC患者预后的独立危险因素。结论对于晚期NSCLC患者血清CEA、CRP基础水平可以作为判断NSCLC预后的参考指标。     

Carcinoembryonic antigen fraction in digestive cancer

A clinical study in a group of patients with digestive cancers was done with a radioimmunoassay technique employing a carcinoembryonic antigen (CEA) fraction. Among 45 patients with colorectal carcinomas, 51% showed CEA levels in the pathologic range before therapy, those with metastatic disease from well differentiated adenocarcinomas showed the higher values. Measurement of the circulating levels of this CEA fraction proved to be more useful in the monitoring of the course of disease during and after antineoplastic treatment. Sensitivity of the radioimmunoassay technique for the remaining digestive cancers was over 50%, but pathologic CEA values are not exclusive for malignant digestive disease, since 22% of patients with benign diseases also showed raised serum levels of CEA.     

Carcinoembryonic antigen assay in cancer of the colon and pancreas and other digestive tract disorders

In a study of 279 persons, carcinoembryonic antigen (CEA) was detected in the sera of 32 of 35 patients with carcinoma of the colon, 13 of 13 patients with carcinoma of the pancreas, and 6 of 14 patients with other gastrointestinal cancers, confirming previous work which associated circulating CEA with GI tract malignancies. Six of 8 patients with bronchogenic carcinomas also gave positive assays. Seventy-nine assays on 40 young normal controls were negative. Twenty-four of 46 selected patients with severe alcoholic liver disease and 7 of 13 selected patients with uremia also gave positive results, thus requiring careful interpretation of the assay as presently performed on such patients pending further studies.Supported by grants from the National Cancer Institute (CA-04486 and CA-02090), the National Institute of Arthritis and Metabolic Diseases (TI AM-05320), National Institutes of Health; and the American Cancer Society (C1–19).     

Hypercalcemia of cancer in the digestive tract

We made a retrospective review of the patients with cancer of the digestive organs who died between January 1, 1975 and December 31, 1985, at Shinshu University Hospital. Of 183 patients with such cancers 15 (8.2%) had hypercalcemia. Hypercalcemia was defined as serum calcium level greater than 11.0 mg/dl on at least two determinations. The incidence of hypercalcemia by site was 5 of 74 (6.8%) liver, 1 of 16 (6.3%) biliary tract, 4 of 33 (12.1%) pancreas, 3 of 15 (20.0%) esophagus, 0 of 37 stomach, 0 of 2 duodenum, 2 of 5 colon, and 0 of 1 rectum carcinomas. There was no sexual or age predisposition to hypercalcemia. Bone scans and/or x-ray results were positive in three of eight, negative in five of eight, and were not evaluated in the remaining seven patients. Of five patients tested, four had low to normal serum parathyroid hormone (PTH) levels, and one had a serum PTH level high by C-terminal assay but normal by N-terminal assay. Serum chloride levels at the late stage of hypercalcemia were less than 102 mEq/L in all patients. Therefore, hyperproduction of PTH was unlikely to be a causative factor for hypercalcemia. Indomethacin was given to four patients with hypercalcemia with no effect on serum calcium levels in any cases. Survival from the diagnosis of hypercalcemia ranged from 2 to 96 days (mean 33 days). We conclude that hypercalcemia is a complication not infrequent at the late stages of cancers of the digestive organs, with the exception of gastric cancer, and a portent of a poor prognosis.     

用抗人结肠癌单克隆抗体检测血清和粪便中大肠癌相关抗原的研究

目的 研究抗人结肠癌MAb检测血清及粪液中癌相关抗原的价值。 方法 采用抗人结肠癌单抗SC_(3A)和SC_6检测47例结直肠癌、33例结直肠腺瘤、15例增生性息肉、14例炎性息肉及60例正常人群的血清和粪便中癌相关抗原。经ELISA双抗体夹心法检测。 结果 血清和粪便阳性率在结直肠癌组分别为66.0％和72.3％;腺瘤组为63.6％和60.6％;增生性息肉组为35.7％和57.1％;炎性息肉组为40.0％和33.3％;而正常对照组仅为11.7％和13.3％。45例大肠癌Dukes分期进行检测,早期癌粪便检测的阳性率为72.2％,而血清为50.0％。 结论 ELISA法检测不仅对大肠癌及癌前病变具有较好的敏感性,而且对早期癌及癌前期病变检测较血清学检测意义更大。此外,随腺瘤不典型增生程度加重而检测阳性率增高。粪便中检测大肠癌相关抗原,方法简便,取材容易,具较好敏感性,对大规模人群普查大肠癌具有一定的应用价值。