糖类抗原和癌胚抗原联合检测对肺癌的诊断价值

目的探讨联合测定患者血清和胸水中糖类抗原(CA125、CA199、CA153)和癌胚抗原(CEA)对肺癌的诊断价值。方法采用化学发光免疫法测定68例肺癌患者和38例肺结核患者血清以及胸水中CA125、CA199、CA153和CEA的含量。结果肺癌组患者血清中CEA、CA199、CA153的含量均明显增高且明显高于肺结核组患者血清中CEA、CA199、CA153的含量,有显著性差异(P<0.01)。而肺癌组患者和肺结核组患者血清中CA125的含量均明显增高,无显著性差异(P>0.05)。肺癌组患者胸水中CEA、CA125、CA199、CA153的含量均明显增高且明显高于肺结核组患者胸水中CEA、CA125、CA199、CA153的含量,CEA有显著性差异(P<0.01),CA125、CA199、CA153有显著性差异(P<0.05)。结论 CEA、CA125、CA199、CA153的血清和胸水联合检测可以提高肺癌诊断水平。     

癌胚抗原、糖抗原199、C反应蛋白及白细胞介素-6对结直肠癌转移预测价值研究

目的探讨癌胚抗原(CEA)、糖抗原(CA)199、C反应蛋白(CRP)及白细胞介素(IL)-6对结直肠癌转移的预测价值。方法收集2015年1月至2017年2月本溪市中心医院收治的结直肠癌患者82例,其中,Ⅱ~Ⅲ期(非转移组)42例,Ⅳ期(转移组)40例。采用化学发光法检测CEA、CA199,酶联免疫吸附测定法检测IL-6,散射比浊法检测CRP,比较两组患者CEA、CA199、CRP、IL-6水平的差异。采用Logistic进行受试者工作特征曲线(ROC)分析,Kaplan-Meier法绘制总生存期(OS)生存曲线。结果转移组患者CEA、CA199、CRP、IL-6分别为(288.80±58.17)ng/ml、(250.90±56.04)U/ml、(29.57±5.54)mg/L、(19.54±2.56)pg/ml,明显高于非转移组的(5.48±1.15)ng/ml、(39.08±23.57)U/ml、(11.21±2.80)mg/L、(13.38±1.59)pg/ml,差异均有统计学意义(P<0.05)。CEA、CA199、CRP、IL-6的ROC曲线下面积(AUC)分别为0.835、0.799、0.709、0.643,CEA+CA199+CRP+IL-6的AUC为0.902。根据CEA、CA199、CRP、IL-6的最佳临界值,将接受完整随访的32例转移组患者分别纳入CEA、CA199、CRP、IL-6高水平组与低水平组,并绘制OS生存曲线,可见CEA、CA199、CRP、IL-6高水平组患者的存活时间均低于低水平组患者,差异有统计学意义(P<0.05)。结论 CEA、CA199、CRP、IL-6水平在结直肠癌转移患者中明显升高,其作为预测结直肠癌转移的分子标志物,具有重要的临床意义。     

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.     

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。     

血清糖类抗原19-9对胰腺癌的诊断价值

用免疫或生化方法检出一个显著增高的肿瘤标志物 ,有助于该肿瘤的诊断。本研究评价了糖类抗原 19 9(ＣＡ19 9)对胰腺癌的临床应用价值。1　材料与方法1 1　材料　胰腺癌 36例 ,其中男 2 7例 ,女 9例。年龄 37～ 6 9岁 ,平均年龄 6 1岁。全部经临床、影像、实验室和病理检查确诊。胰腺良性疾病患者 30例 (其中慢性胰腺炎2 3例 ,急性胰腺炎 3例 ,胰腺囊肿 4例 ) ,男 2 3例 ,女 7例 ,年龄 32～ 6 4岁 ,平均 5 8岁。1 2　方法　 (1)清晨抽取静脉血 ,及时分离血清 ,待测。(2 )试剂盒由罗氏 (Ｒｏｃｈｅ)公司提供。采用ＥＬＩＳＡ法 ,应用抗生蛋白…     

血清糖链抗原724、糖链抗原19-9与癌胚抗原联合检测对胃癌诊断价值研究

目的 探讨血清糖链抗原724(CA724)、糖链抗原19-9(CA19-9)与癌胚抗原(CEA)联合检测对胃癌的诊断价值.方法 选取秦皇岛市第一医院自2019年1月至2020年1月收治的199例疑似胃癌患者为研究对象.按照病理结果 将患者分为B组(良性胃病组,n=98)与C组(胃癌组,n=101),另选取100例同期健...     

CEACAM1和CA199测定对胰腺癌的诊断价值

目的探讨癌胚抗原相关细胞黏附分子1（CEACAM1）和糖蛋白抗原199（CA199）测定对胰腺癌的诊断价值。方法采用酶联免疫法（ELISA）和电化学发光免疫分析法分别检测胰腺癌患者及正常对照组的血清CEACAM1和CA199水平并分析其临床价值。结果胰腺癌组CEACAM1和CA199明显高于对照组,两者差异有统计学意义（P〈0．05）。CEACAM1＋CA199联合诊断阳性率明显高于单项检测CEACAM1或CA199的阳性率。结论联合检测提高了临床诊断胰腺癌的检出率。     

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。     

AFP、CEA和CA199联合检测在原发性肝癌诊断中的应用

目的：探讨多种血清肿瘤标志物联合检测对原发性肝癌的诊断价值。方法：采集110例原发性肝癌和152例良性肝病（肝硬化和慢性肝炎）患者血液,用化学发光法测定AFP、CEA和CA199水平。结果：原发性肝癌患者血清中AFP、CEA和CA199水平分别为（60.6±80.5）μg/L、（22.2±13.9）μg/L、（47.2±28.3）U/L,明显高于良性肝病患者血清水平;原发性肝癌患者中AFP、CEA和CA199阳性率分别为74.6%、49.1%和45.5%,显著高于良性肝病患者;三者联合检测将原发性肝癌检测敏感率提升至92.7%。结论：联合检测可提高原发性肝癌诊断的敏感率,在原发性肝癌的筛查中有一定的应用价值。     

联合检测肿瘤标志物在肺癌诊断中的临床价值

目的 探讨肿瘤标志物CEA、CA125、神经元特异性烯醇化酶(NSE)、细胞角蛋白19片段抗原(CYFRA21-1)联合检测在肺癌中的诊断价值.方法 研究对象为2010年10月至2012年3月的确诊肺癌住院患者138例(男82例,女56例,平均年龄58.6岁),肺良性病变住院患者96例(男56例,女40例,平均年龄51.3岁);健康体格检查者45名(对照组,男30名,女15名,平均年龄43.9岁).用电化学发光法检测血清CEA、CA125、NSE和CYFRA21-1水平,各指标的组间比较采用单因素方差分析及q检验.按病理类型分组,对鳞状细胞癌[简称鳞癌(66例)]、腺癌(52例)和小细胞肺癌(20例)的肿瘤标志物水平进行比较,计算单项及联合检测对各类型肺癌的诊断效能.结果 肺癌组血清CEA、CA125、NSE、CYFRA21-1水平均高于肺部良性病变组和健康对照组[CEA:(19.99±30.99)、(10.78± 19.77)、(3.25±3.42) μg/L,CA125:(79.70±95.98)、(44.96±44.97)、(20.66±7.13) μg/L,NSE:(35.23±40.22)、(15.31±8.42)、(13.30± 5.65) μg/L,CYFRA21-1:(18.07±43.71)、(8.30±8.83)、(3.13±1.60) μg/L;F=4.481、5.436、4.776和6.002,均P＜0.05].CEA在腺癌中水平较鳞癌和小细胞肺癌高(F=4.932,P＜0.05),NSE在小细胞肺癌中水平较高(F=5.119,P＜0.05),CYFRA21-1在鳞癌中水平较高(F=5.378,P＜0.05).单项肿瘤标志物在肺癌诊断中灵敏度:鳞癌中CYFRA21-1灵敏度最高(78.8％,52/66),腺癌中CEA灵敏度最高(57.7％,30/52),而在小细胞肺癌中NSE灵敏度最高(75.0％,15/20).在联合检测中CEA+CYFRA21-1+ NSE组合对鳞癌诊断灵敏度最高(89.4％,59/66),腺癌诊断中CEA+CA125+NSE组合灵敏度最高(78.8％,41/52),小细胞肺癌中CEA+CYFRA21-1+NSE组合灵敏度最高(80.0％,16/20).结论 CEA、CA125、NSE、CYFRA21-1联合检测对肺癌的诊断有一定的临床价值,不同病理类型肺癌4种肿瘤标志物表达有所不同.     

血清甲胎蛋白、癌胚抗原在肝癌诊断与鉴别诊断中的应用价值

目的探讨甲胎蛋白（alpha fetoprotein,AFP）、癌胚抗原(carcinoembryonic antigen ,CEA)在肝癌诊断中的应用价值。方法选择原发性肝癌（primary hepatic cancer,PHC）组71例,转移性肝癌（metastatic hepatic carcinoma,MHC）组27例,健康体检对照(normal control,NC)组54例,采用电化学发光免疫检测各组AFP、CEA,并对结果进行统计学分析。结果PHC组 AFP水平明显高于MHC组和NC组（P <0001）,AFP在PHC组中检出的敏感率为7887%;MHC组中CEA的表达为(24819±5416)ng/mL明显高于PHC组和NC组（P<0001）,CEA在MHC组中检出的敏感率为5555%;AFP、CEA诊断原发性肝癌ROC曲线下面积分别为0874、0583。结论检测AFP、CEA在肝癌的诊断与鉴别诊断中具有较高的临床价值。     

多模型体素不相干运动成像对直肠癌的诊断价值

目的：探讨体素不相干运动（IVIM）不同模型参数诊断直肠癌的可行性。方法：回顾性分析直肠癌组（32例）和直肠正常组（35例）的MRI-IVIM序列资料,测算并比较正常直肠组织和癌组织的单指数、双指数、拉伸指数模型参数值,利用ROC曲线评估不同参数诊断直肠癌的阈值和效能;评价同组间同类型参数彼此间的相关性,并分析原因。结果：直肠癌组的标准扩散系数（ADC-stand）、慢速扩散系数（ADC-slow）、拉伸因子（α）、分布扩散系数（DDC）值均低于直肠正常组（均P<0.05）,ROC曲线下面积依次为0.929、0.911、0.849、0.718,相关阈值分别是1.275×10^-3 mm²/s、0.838×10^-3 mm²/s、0.737和1.045×10^-3 mm²/s;在直肠正常组与直肠癌组中,ADC-stand、ADC-slow、DDC三者之间均呈一定程度的正相关（均P<0.05）。结论：IVIM不同模型参数具备区分正常直肠组织与直肠癌组织的潜力,且不同参数之间存在一定的相关性,其可作为一种新的直肠癌影像评估手段应用于临床。     

Diagnostic and prognostic value of serum prostate specific antigen in prostate carcinoma

The upper normal limit of serum prostate specific antigen (PSA) of 4 ng/ml is positively evaluated since it discriminates a large percentage of patients having prostate cancer. The PSA limit of 2.5 ng/ml may be used accordingly for patients younger than 50 years of age. The PSA range of 3.3-4 ng/ml may indicate a percentage of patients positive for prostate carcinoma. The PSA above 10 ng/ml indicates that patients have prostate carcinoma by more than 50 %, which is more than double as compared to patients having PSA limits between 4.1-10 ng/ml. It is important to repeat doubtful PSA tests after 3-4 months. If within a year an increase in PSA of more than 2 ng/ml is detected, a high risk of death from prostate cancer is expected. The time for doubling PSA values within a year is described as "velocity index". As for free PSA, this test is not often applied in many nuclear medicine centers. According to the Mayo Clinic, USA, instructions, when total PSA is 2-3.9 ng/ml and free PSA above 18% of these values, the possibility of prostate cancer is less than 10%. On the contrary, for the above total PSA values, if free PSA is less than 10% of these values, the possibility of prostate cancer increases to more than 30%. It is suggested that PSA values be expressed per g of prostate tissue in order to relate to prostate volume. However, one should have in mind that prostate carcinomas have less PSA per g than hyperthophic glands and their volume is usually larger. There are cases where treatment of prostate hypertrophy with finasteride or treatment of prostate cancer with anticancer drugs, may induce a false low PSA. More information about the practical importance of PSA values is expected after 2 or 3 years when a study by the National Cancer Institute of USA on 74,000 men will be completed.     

组织多肽特异性抗原对胰腺癌患者的诊断价值

Objective To compare the diagnostic value of tissue polypeptide specific antigen (TPS) in serum, with the carbohydrate antigens (CA) 19-9, CA50, CA125 and CA242 in pancreatic carci-noma. Methods Serum TPS was measured with enzyme linked immunosorbent assay (ELISA). CA19-9 and CA125 were measured with chemiluminescent immunoassay. CAS0 and CA242 were measured with im-munoradiometric assay in 33 patients with pancreatitis, 34 patients with pathologically proven pancreatic car-cinoma, and 35 patients with non-pancreatic malignancies. Statistic analysis was carried out with SPSS 9.0 software. Results Patients with pancreatic carcinoma had relatively higher levels of TPS [(386.5± 315. 1) U/L] and CA19-9 [(10 820.9 ± 389.7) kU/L] when compared with patients with pancreatitis [(86. 2 ± 28.1) U/L and (61.5 ± 24.7) kU/L, respectively; F = 936. 42, P < 0. 001 ; F = 2217. 09, P < 0. 001], with a sensitivity and a specificity of 70.6% (48/68) and 57.4% (39/68), respectively, for TPS, and 82.4% (28/34) and 77.9% (53/68), respectively, for CA19-9. Diagnostic performance was further improved when TPS was assayed in combination with CA19-9, CA50, CA12.5 and CA242. Conclusion Serum TPS has an incremental value in complementing CA19-9 in the diagnosis of pancreatic carcinoma.     

组织多肽特异性抗原对胰腺癌患者的诊断价值

Objective To compare the diagnostic value of tissue polypeptide specific antigen (TPS) in serum, with the carbohydrate antigens (CA) 19-9, CA50, CA125 and CA242 in pancreatic carci-noma. Methods Serum TPS was measured with enzyme linked immunosorbent assay (ELISA). CA19-9 and CA125 were measured with chemiluminescent immunoassay. CAS0 and CA242 were measured with im-munoradiometric assay in 33 patients with pancreatitis, 34 patients with pathologically proven pancreatic car-cinoma, and 35 patients with non-pancreatic malignancies. Statistic analysis was carried out with SPSS 9.0 software. Results Patients with pancreatic carcinoma had relatively higher levels of TPS [(386.5± 315. 1) U/L] and CA19-9 [(10 820.9 ± 389.7) kU/L] when compared with patients with pancreatitis [(86. 2 ± 28.1) U/L and (61.5 ± 24.7) kU/L, respectively; F = 936. 42, P < 0. 001 ; F = 2217. 09, P < 0. 001], with a sensitivity and a specificity of 70.6% (48/68) and 57.4% (39/68), respectively, for TPS, and 82.4% (28/34) and 77.9% (53/68), respectively, for CA19-9. Diagnostic performance was further improved when TPS was assayed in combination with CA19-9, CA50, CA12.5 and CA242. Conclusion Serum TPS has an incremental value in complementing CA19-9 in the diagnosis of pancreatic carcinoma.     

组织多肽特异性抗原对胰腺癌患者的诊断价值

Objective To compare the diagnostic value of tissue polypeptide specific antigen (TPS) in serum, with the carbohydrate antigens (CA) 19-9, CA50, CA125 and CA242 in pancreatic carci-noma. Methods Serum TPS was measured with enzyme linked immunosorbent assay (ELISA). CA19-9 and CA125 were measured with chemiluminescent immunoassay. CAS0 and CA242 were measured with im-munoradiometric assay in 33 patients with pancreatitis, 34 patients with pathologically proven pancreatic car-cinoma, and 35 patients with non-pancreatic malignancies. Statistic analysis was carried out with SPSS 9.0 software. Results Patients with pancreatic carcinoma had relatively higher levels of TPS [(386.5± 315. 1) U/L] and CA19-9 [(10 820.9 ± 389.7) kU/L] when compared with patients with pancreatitis [(86. 2 ± 28.1) U/L and (61.5 ± 24.7) kU/L, respectively; F = 936. 42, P < 0. 001 ; F = 2217. 09, P < 0. 001], with a sensitivity and a specificity of 70.6% (48/68) and 57.4% (39/68), respectively, for TPS, and 82.4% (28/34) and 77.9% (53/68), respectively, for CA19-9. Diagnostic performance was further improved when TPS was assayed in combination with CA19-9, CA50, CA12.5 and CA242. Conclusion Serum TPS has an incremental value in complementing CA19-9 in the diagnosis of pancreatic carcinoma.