联合检测CEA、CA19-9在结直肠癌诊断中的应用

目的:探讨用化学发光法检测CEA和CA19-9在结直肠癌诊断中应用价值.方法:用化学发光法测定29例结直肠癌患者46例良性疾病患者和20例健康人群血清CFA和CA19-9含量.结果:癌变组CEA和CA19-9含量明显高于良性对照组和健康对照组,差异具有显著性(P＜0.05),其中敏感性、特异性、有效性分别为65.5%、92.4%、84.2%和51.7%、95.4%和82.1%,联合检测的敏感性、特异性、有效性分别为82.8%、90.9%、88.4%.结论:联合检测CEA和CA19-9有利于结直肠癌临床诊断,可提高其敏感性和有效性.     

糖类抗原19-9及癌胚抗原对恶性腹水鉴别价值

目的：探讨糖类抗原19—9（CA19-9）和癌胚抗原。（CEA）检测在恶性腹水中的意义。方法：对80例腹水病人分为结核性、非结核良性及恶性腹水3组。采用放射免疫分析同步检测腹水CA199、CEA。结果：恶性腹水CA19—9和CEA明显高于结核性及非结核良性腹水（P〈0．01）。CA19—9诊断恶性腹水的敏感性和特异性分别为77．8％和93％，CEA的敏感性和特异性分别为52．8％和93％，二者联合检测敏感性为89．7％、特异性为86．6％。结论：CA19—9和CEA对良恶性腹水有鉴别价值，CA19—9诊断恶性腹水的敏感性优于CEA，联合检测可使诊断恶性腹水的敏感性明显增高。     

TSGF与CEA、CA19-9联合检测在大肠癌诊断中的应用评价

目的评价联合检测恶性肿瘤特异生长因子(TSGF)、癌胚抗原(CEA)和CA19-9在诊断大肠癌中的应用价值。方法取健康体检者259例、大肠癌285例(直肠癌182例、结肠癌103例)、大肠良性疾病167例(增生性息肉79例、炎性息肉57例、管状腺瘤31例)血清,同时检测血清中TSGF(分光光度法)、CEA和CA19-9水平(化学发光法)。结果 TSGF、CEA和CA19-9诊断大肠癌的敏感率分别为87.4%、53.3%和51.2%,TSGF敏感率明显高于CEA和CA19-9(P<0.05),三者联合检测敏感性可提高至91.9%。结论 TSGF诊断大肠癌的敏感度高于CEA、CA19-9,但特异性低于CEA、CA19-9。三者联合检测可提高大肠癌诊断的特异性和灵敏度。     

多项肿瘤标志物联合检测对恶性胸腔积液诊断价值的探讨

目的：探讨胸腔积液糖链抗原50（CA50），糖链抗原125（CA125）及癌胚抗原（CEA）3项指标联合检测对恶性胸腔积液的诊断价值。方法：CA50采用免疫放射技术测定，CA125与CEA应用全自动化学发光免疫分析技术检测。结果：恶性胸腔积液中CA50、CA125与CEA水平明显高于良性胸腔积液组，差异均有显著性（P〈0．01）。3项指标联合检测诊断恶性胸腔积液的敏感性71．8％，特异性90．0％，准确性80．6％。结论：胸腔积液CA50、CA125及CEA单项检测在恶性胸腔积液诊断中特异性较高，而敏感性均偏低，且三者联合检测可提高恶性胸腔积液的敏感性及特异性，临床诊断价值更大。     

血清糖类抗原与癌抗原对胰腺癌诊断价值

目的探讨联合监测与胰腺癌相关的血清糖类抗原19-9(CA19-9)、糖抗原125(CA125)、糖抗原242(CA242)和癌胚抗原(CEA)在胰腺癌诊断中的价值。方法选取2012年1月至2014年4月武警辽宁省总队医院收治的胰腺癌患者110例设为观察组,同期100例健康体检者设为对照组。观察两组患者中血清CA19-9、CA125、CA242及CEA之间的差异,并分析单项检测和4项肿瘤标记物联合检测诊断胰腺癌的敏感性和特异性的差异。结果观察组患者血清CA19-9、CA125、CA242及CEA水平均高于正常对照组,组间比较,差异有统计学意义(P<0.05)。单独检测血清CA19-9、CA125、CA242和CEA时,4项指标的敏感性分别为75.5%、71.8%、70.9%、50.9%,特异性分别为78.0%、88.0%、89.0%、80.0%,联合测定时敏感性和特异性分别为95.4%、86.0%。结论胰腺癌患者血清CA19-9、CA125、CA242及CEA水平升高,联合4种肿瘤标记物的检测具有较高的敏感性和特异性,对胰腺癌具有较高的诊断价值。     

血清AFP、CA19—9、CA125、CEA、GGT联合检测对原发性肝癌的诊断价值

目的：探讨血清甲胎蛋白（AFP）、糖类抗原CA19—9、糖类抗原CA125、癌胚抗原（CEA）、γ-谷氨酰转肽酶（GGT）对原发性肝癌的诊断价值。方法：对39例原发性肝癌45例良性肝病及36名正常体检者血清AFP、CAD-9、CA125、CEA、GGT水平同步测定并进行对照。结果：AFP、CA19—9、CA125、CEA、GGT对原发性肝癌诊断的灵敏度依次为78．4％、70．3％、67．6％、48．6％和64．9％．E0i联合检测对原发性肝癌诊断的灵敏度可提高为94．6％。结论：多种肿瘤标志物联合检测对原发性肝癌的诊断具有重要价值。     

肿瘤标记物联合检测乳腺癌的优越性

目的探讨血清抗原CA153,CA125,CEA,三项肿瘤标记物对乳腺恶性肿瘤的检测的优越性。方法用化学发光免疫分析仪检测40例女性乳腺癌患者,30例女性乳房良性肿瘤患者,30例正常健康女性的血清CA153,CA125,CEA,三项指标。进行联合检测和单项检测敏感度和特异性的比较。结果血清CA153,CA125,CEA三项指标在乳腺癌患者组中显著升高,与良性肿瘤组和正常组比较P〈0．01,有显著的差异性。另外,单项检测其对乳腺癌的敏感度分别为CA153为51．9％,CA125为32．2％,CEA为31．7％。特异性分别为CAl53为65．3％,CA125为38．2％,CEA无明显特异性。而在三者联合检测中发现,其对乳腺癌的敏感性为83．3％,特异性达到91．2％。结论血清CA153,CA125,CEA,的联合检测对乳腺癌的诊断,治疗及预后观察都具有很重要的临床意义。     

肿瘤标志物联合检测对胸腔积液的诊断价值

目的:评价多项肿瘤标志物联合检测对胸腔积液的诊断价值。方法:采用化学发光免疫分析法测定胸腔积液112例CA125、CA19-9、CA15-3及CEA水平,对结果进行综合分析。结果:恶性组CA15-3、CA19-9及CEA均明显高于结核组及良性组(P<0.01);恶性组与结核组CA125均明显高于良性组(P<0.01);4项肿瘤标志物联检对恶性胸腔积液的敏感性为81.6%、特异性为95.2%、诊断准确性为89.3%。结论:肿瘤标志物联合检测对胸腔积液具有一定诊断价值。     

肿瘤标志物CEA、CA19-9、CA242联检在结直肠癌患者诊断中的应用

目的 探讨云南省大理州结直肠癌患者血清中肿瘤标志物癌胚抗原(CEA)、糖链蛋白抗原19-9(CA19-9)、糖链蛋白抗原242(CA242)单项或多项联检对结直肠癌的临床诊断价值.方法 应用电化学发光法和放免法检测89例结直肠癌患者和50例正常体检者的CEA、CA19-9和CA242水平.结果 三种肿瘤标志物在结直肠癌患者血清中含量均明显高于健康对照组(t分别为2.97、3.55和7.44,P均＜0.01);三种肿瘤标志物联检对结直肠癌的临床诊断效果明显优于各单项(CEA、CA19-9、CA242)和两项联检(CA242+CA19-9和CEA+CA19-9),差异有统计学意义(X2分别为30.552、32.076、18.365、7.130和8.862,P均＜0.01);三项联检可提高结直肠癌诊断的灵敏度(85.39%)和准确率(90.60%),但特异度下降(88.00%).结论 CEA、CA19-9和CA242可用于该地区结直肠痛的早期诊断和病情判断,三者联检可提高诊断效率.     

联合检测胸水ADA、CEA、CA125、CA153在结核性与恶性胸水中的鉴别诊断价值

目的探讨联合检测胸水ADA、CEA、CA125、CA153对结核性与恶性胸水的鉴别诊断价值。方法收集114例已确诊胸腔积液患者的胸水,其中恶性组胸水64例,结核性胸水50例,检测两组患者胸水ADA、CEA、CA125、CA153水平。结果恶性组ADA明显低于结核组,而CEA、CA125、CA153水平明显高于结核组,两者差异显著。具有统计学意义。CEA、CA125、CA153对恶性胸水诊断的敏感性分别为73-4％、81．2％、43．8％,特异性分别为84．0％、46．0％、88．0％．准确性分别为79．8％、63．2％、66．7％,三项联合检测可显著提高诊断敏感性（93．4％）。ADA对结核性胸水的敏感性、特异性、准确性分别为83．4％、91．5％、87．6％。结论联合检测胸水ADA、CEA、CA125、CA153有助于结核性与恶性胸水的鉴别诊断。     

结直肠癌患者术前血清癌胚抗原及糖类抗原19-9阳性与临床病理学特征的关系

目的 探究结直肠癌(coloretal cancer,CRC)患者术前血清肿瘤标志物癌胚抗原(carcinoembryonic antigen,CEA)及糖类抗原19-9(carbohydrate antigen 19-9,CA19-9)检测结果与CRC临床病理学特征的关系.方法 收集武警总医院肛肠病研究所2010-01至2016-04行CRC根治性手术治疗的475例的病历资料,将术前CEA及CA19-9检测结果与术后临床病理分期结果及临床资料进行统计分析,并研究其相关性.结果 475例中,术前血清CEA阳性198例(41.68％),CA19-9阳性109例(22.95％).CEA和CA19-9阳性率与CRC患者性别、年龄、吸烟史、梗阻、肿瘤位置、肿瘤大小、肿瘤类型均无相关性.CEA和CA19-9阳性率与CRC TNM分期、临床分期、肿瘤分化程度、癌结节、脉管浸润有相关性(P＜0.05),且CRC患者中CEA和CA19-9阳性率均与肿瘤TNM分期和肿瘤临床分期呈正相关(P＜0.05).结论 术前CEA和CA19-9的血清学检测在一定程度上具有预判CRC临床及病理分期的作用,从而为临床上CRC患者后续治疗和预后判断提供一定帮助.     

Clinical Usefulness of Serum CYFRA 21–1 in Patients with Colorectal Cancer

Purpose

Among diverse tumor markers, pretreatment evaluation and follow-up detection of recurrence in colorectal cancer are generally evaluated by serum carcinoembryonic antigen (CEA) levels. However, there have been some reports about the low accuracy and high false-positive results of CEA in colorectal cancer. We investigated the clinical utilities of CYFRA 21–1 by comparing CEA and cancer antigen 19–9 (CA 19–9) in pretreatment and recurrent colorectal cancer.

Methods

Using a solid-phase immunoradiometric assay, serum levels of CYFRA 21–1, CEA and CA 19–9 were analyzed in 132 patients with primary colorectal cancer, 124 healthy controls, 104 patients with benign colorectal disease and 19 patients with recurrent colorectal cancer. We determined three different cutoff values to evaluate the sensitivity of diagnostic performance in pretreatment and recurrent colorectal cancer.

Results

CYFRA 21–1 (≥ 1.13 ng/ml) had a sensitivity of 47 %, compared with 37 % for CEA (≥ 3.05 ng/ml) and 32.6 % for CA 19–9 (≥ 23.1 ng/ml) in the initial staging of primary colorectal cancer. Using different cutoff values, CYFRA 21–1 showed higher sensitivity for pretreatment colorectal cancer than CEA and CA 19–9 in adenocarcinoma and adenosquamous carcinoma of this study. A mildly significant correlative relationship was noted between Dukes’ stages and three tumor markers (p < 0.01). The areas under the receiver operating characteristic curves of CYFRA 21–1, CEA and CA 19–9 were 0.81 ± 0.03, 0.74 ± 0.03 and 0.62 ± 0.04, respectively, for discriminating colorectal cancer patients from patients with benign colorectal disease. In addition, CYFRA 21–1 was determined as the most sensitive tumor marker for evaluating recurrent colorectal cancer for all cutoff values.

Conclusion

This study showed that CYFRA 21–1 could be a useful and dependable tumor marker for pretreatment and recurrent colorectal cancer. Further prospective studies on its usefulness with respect to the prognosis and utility of combined tumor markers are needed.     

肿瘤标志物联合检测对肝外胆道梗阻的诊断价值

目的评价CA19-9、CA125与CEA联合检测对肝外胆道梗阻的鉴别诊断价值。方法采用化学发光免疫分析法测定97例肝外胆道梗阻患者血清CA19-9、CA125及CEA水平,进行统计分析。结果 CA19-9在恶性梗阻时的阳性率明显高于CEA和CA125（P〈0.01）,三项联检,诊断准确率可提高至89.1%。结论血清CA19-9、CA125与CEA联合检测对肝外胆道梗阻的鉴别诊断具有一定价值,CEA和CA125还可以为恶性梗阻的腹腔转移提供可靠信息。     

CA242高灵敏时间分辨荧光免疫分析及其初步应用

目的采用时间分辨荧光免疫分析技术（TRFIA）建立高灵敏的恶性肿瘤相关糖类抗原（CA）242的快速全自动检测方法并进行初步应用。方法以抗CA242单克隆抗体601#包被96孔微孔板,以Eu^3＋-N^2-[p-异氰酸苄基]-二乙烯三胺四乙酸标记抗CA242单克隆抗体242#,发光增强系统为以β-二酮体为主的增强液。采用平衡饱和法建立CA242 TRFIA,采用Auto DELFIA1235系统考核CA242 TRFIA,并进行健康人和胃癌患者血清样本的检测。结果该方法的批内和批间CV分别为2．92％和5．36％,平均回收率为98．75％,灵敏度为0．2kU／L,可测范围为0．2～200kU／L,最高浓度点计数的20％、50％、80％对应的效应点值（ED20、ED50、ED80）分别为25．2kU／L、53．3kU／L和112．5kU／L。CA50、CA19-9对CA242分别有15％和32％的交叉反应,癌胚抗原（CEA）、甲胎蛋白（AFP）、CA125对CA242 TRFIA均无交叉反应。Eu^3＋标记242#抗体于-20℃下保存6个月免疫反应性基本无损,同批试剂连续6个月应用分析结果稳定,检测健康体格检查人员的血清,样品的平均值为（6．52±5．15）kU／L,建议阳性阈值为17kU／L,临床结果与酶联免疫吸附测定（ELISA）的结果相符,r为0．916。116例胃癌患者血清CA242的阳性率为26．7％。结论CA242 TRFIA的灵敏度高、稳定性好,可用于血清CA242含量的免疫测定。     

Radioimmunodetection of lung cancer with IMACIS-1, I-131 labeled monoclonal antibodies to CEA and CA19-9

IMACIS-1 is a radiopharmaceutical containing a mixture of Iodine-131 labeled monoclonal antibodies to CEA and CA19-9. IMACIS-1 immunoscintigraphy was evaluated for tumor detection in 7 primary lung cancer and 2 metastatic lung cancer patients who received radiotherapy. No adverse side effects due to IMACIS-1 were observed in this study. Positive detection was achieved in 5 of 9 patients (55.6%). It was less, but nearly the same as the detection rate obtained with Gallium-67 citrate (⁶⁷Ga-citrate) in these patients. There was no clear correlation between IMACIS-1 accumulation and the CEA or CA19-9 serum levels. The IMACIS-1 positive detection rate decreased in many of the irradiated lesions. We considered that the decreased number of tumor cells and changes in blood perfusion are some of the factors controlling accumulation in tumors.