免疫法粪便隐血试验和血癌胚抗原检测对大肠癌早期诊断的意义

目的探讨以免疫法粪便隐血试验与血癌胚抗原(CEA)检测为主要方法提高早期大肠癌的诊断率。方法应用问卷调查,按易感因素将研究对象分组,进行免疫法粪便隐血试验(iFOBT)、CEA、肠镜及病理检查。结果依据问卷调查将6997例研究对象分为大肠癌低度危险组(n=4551)、可疑组(n=2085)、高度危险组(n=361)。3组iFOBT阳性率依次升高,差异具有统计学意义(P<0.05,P<0.01)。共检出早期大肠癌6例,其中高度危险组5例,可疑组1例。根据结肠镜检查结果分为结肠癌、结肠息肉、结肠炎、正常组,结肠癌组iFOBT、CEA结果明显高于其他组,差异有统计学意义(P<0.05)。结论 iFOBT可以作为早期大肠癌筛查的主要方法,iFOBT和CEA联合检测可以提高早期结肠癌的检出率。     

肿瘤标记物CEA、CA724对大肠癌的诊断价值

目的探讨肿瘤标记物癌胚抗原(CEA)、糖类抗原(CA724)对大肠癌的诊断价值。方法使用电化学发光仪、采用电化学发光法检测19例大肠癌患者(大肠癌组)及81例行电子肠镜检查未见异常的患者(正常对照组)血清CEA、CA724水平。结果大肠癌组患者血清CA724水平与正常对照组比较差异无统计学意义(P>0.05),大肠癌组患者血清CEA水平显著高于正常对照组(P<0.05)。大肠癌组患者血清CEA水平与正常对照组血清CEA水平呈正相关(r=0.784,P<0.05),大肠癌组患者血清CA724水平与正常对照组血清CA724水平无关(r=0.018,P>0.05)。结论 CEA对大肠癌的诊断具有重要的诊断价值,而CA724作为大肠癌临床诊断及肿瘤筛查指标的价值仍有待进一步的研究。     

C反应蛋白在大肠癌早期诊断中的价值

目的 探讨C反应蛋白(CRP)与大肠癌发病的关系.方法 回顾性分析180例大肠癌,84例大肠腺瘤、36例肠镜正常者CRP和肿瘤标志物表达结果.结果 血清CRP和癌胚抗原(CEA)、糖类抗原12-5(CA12-5)、糖类抗原19-9(CA19-9)在大肠癌组表达强度和阳性率明显高于大肠腺瘤组和肠镜正常组(P<0.01或<0.05).大肠癌组内上述指标的表达强度为Ⅲ、Ⅳ期>Ⅰ、Ⅱ期(P<0.01或<0.05),阳性率为Ⅲ、Ⅳ期>Ⅰ、Ⅱ期(P<0.05),而Ⅲ、Ⅳ期之间阳性率差异无统计学意义(P>0.05).大肠癌Ⅰ、Ⅱ期CRP阳性率高于CEA、CA12-5、CA19-9的阳性率,Ⅰ期40.0% vs 5.0%、10.0%、5.0%(P<0.05),Ⅱ期66.1% vs 27.4%、37.1%、35.5%(P<0.01),而在大肠癌Ⅲ、Ⅳ期中上述比较差异无统计学意义(P>0.05).结论 CRP对大肠癌早期诊断具有临床价值,临床医生不应忽略CRP持续升高患者在排除其他升高原因后有潜在肿瘤的可能性,应尽早作进一步检查.     

血清CA125联合CA19-9及CEA检测应用于大肠癌诊断的临床价值

目的研究血清CA125联合CA19-9及CEA检测对大肠癌诊断的临床意义。方法我院2009年1月至2011年8月期间收治并手术确诊的大肠癌患者78例为研究对象,选取同期正常体检者100例正常人为对照组,用酶联免疫吸附测定两组血清CA125、CA19-9和CEA水平,并进行比较分析。对各指标均数比较采用组间t检验,计数资料采用组间χ2检验,检验水平P=0.05。结果大肠癌组血清CA125、CA19-9和CEA阳性率分别为33.3%(26/78)、37.2%(29/78)和34.6%(27/78),对照组分别为4%(4/100)、5%(5/100)和7%(7/100),两组患者三种指标阳性率分别比较差异具有统计学意义,P<0.05。大肠癌组Dukes A+B期、Dukes C+D期三种肿瘤指标阳性率相比较差异均有统计学意义,P<0.05。不同组织学类型大肠癌血清CA125、CA19-9阳性率差异无统计学意义,P>0.05;但是不同组织学类型大肠癌CEA阳性率差异具有统计学意义,P<0.05。结论大肠癌血清CA125、CA19-9和CEA检测能够帮助评估肿瘤进展及病情分期,值得临床进一步推广应用。     

联合检测血清Dermokine-β和癌胚抗原在结肠癌诊断中的价值

目的 探讨联合检测血清Dermokine-β (DK-β)和癌胚抗原(carcinoembryonic antigen,CEA)、糖类抗原199(carbohydrate antigen 199,CA199)对结肠癌的诊断价值.方法 检测214例结肠癌患者(结肠癌组)及20例结肠炎患者(炎性肠病组)和30例体检健康者(对照组)血清DK-β、CEA、CA199水平,比较不同Dukes临床分期结肠癌患者血清CEA,CA199,DK-β水平,及DK-β,CEA,CA199单独及联合检测诊断结肠癌的敏感性和特异性.结果 结肠癌组血清CEA,CA199,DK-β水平均较炎性肠病组、对照组明显升高(P＜0.01);血清CEA,CA199,DK-β联合检测诊断结肠癌的敏感性最高,CEA单独检测诊断结肠癌的特异性最高,血清DK-β诊断结肠癌Dukes分期A、B期的敏感性最高(P＜0.01),血清CEA诊断Dukes分期C,D期结肠癌的敏感性最高(P＜0.01);同一组合在不同Dukes分期结肠癌诊断中的敏感性比较差异无统计学意义(P＞0.05).结论 DK-β,CEA,CA199单独或联合检测对不同Dukes分期结肠癌的敏感性较高,可提高结肠癌诊断率.     

M-CSF、CA153、HPV联合检测在宫颈癌早期筛查中的临床意义

目的研究巨噬细胞集落刺激因子(M-CSF)、糖类抗原153(CA153)、人乳头瘤病毒(HPV)联合检测在宫颈癌早期筛查中的临床意义。方法以该院2016年3月至2018年10月收治的120例宫颈癌患者作为宫颈癌组,另选取同期于该院体检合格者120例作为健康组以及不典型增生患者120例作为CIN组。比较3组研究对象M-CSF、CA153、HPV水平差异,分析宫颈癌患者的M-CSF、CA153、HPV水平相关性以及单独检测和联合检测的效能差异。结果宫颈癌组患者的M-CSF、CA153、HPV水平均显著高于CIN组和健康组(P<0.05);宫颈癌组患者的M-CSF、CA153、HPV水平与宫颈癌呈正相关,均为宫颈癌的独立危险因素,通过ROC曲线分析,宫颈癌组患者的M-CSF、CA153、HPV联合检测的诊断灵敏度高于单独检测,宫颈癌患者的M-CSF、CA153的诊断界值分别为485.12pg/mL和317.62U/mL。结论M-CSF、CA153、HPV联合检测对宫颈癌早期筛查具有重要意义,在一定程度上可对患者的宫颈癌病变进行早期预测。     

社区大肠癌筛查结果及危险因素分析

目的了解本地区社区大肠癌筛查疾病情况,并探讨其危险因素。方法采用问卷调查、初步潜血试验筛查和肠镜镜检的方式,在社区中开展大肠癌筛查,并进行统计学分析。结果本次筛查有效筛查者3 212人,阳性率27.37%。其中100例患者接受了进一步肠镜筛查,肠镜结果:大肠癌4例(4%),大肠炎性病变14例(14%),大肠息肉性病变44例(44%),其他15例(15%),无异常者23例(23%);性别、吸烟、上腹不适、精神刺激史等因素与粪便潜血阳性呈正相关(P0.05);年龄与性别是大肠癌致病的危险因素(P0.01)。结论本地区社区居民粪便潜血阳性率较高,性别和年龄是大肠癌发生的重要危险因素。     

结直肠病变患者的肠镜活检及联合检测血清CEA、CA19-9、CA72-4

摘要：目的：探讨用肠镜活检技术分析结直肠病变患者的病理参数及与血清CEA、CA19-9、CA72-4表达水平的关系。 方法：收集经肠镜活检及病理切片诊断的结直肠病变患者122例,同时检测其血清CEA、CA19-9、CA72-4的表达水平,并进行统计学分析。 结果：经肠镜活检诊断为高级别上皮内瘤变（HGIN）组、无蒂组、最大径＞30 mm组及浸润性癌组血清CEA、CA19-9和CA72-4的表达水平分别高于低级别上皮内瘤变(LGIN)组、有蒂组、最大径≤30 mm组和腺瘤伴上皮内瘤变组（P均＜0.05）;血清CEA、CA19-9、CA72-4联合检测诊断浸润性癌的阳性率高于单项检测（P均＜0.05）。 结论：肠镜活检技术结合血清CEA、CA19-9、CA72-4联合检测,有助于浸润性癌的术前判断。     

血清肿瘤标志物检测在结肠癌辅助诊断中的价值

目的探讨血清肿瘤标志物癌胚抗原(CEA)、血清糖类抗原199(CA199)、糖类抗原724(CA724)检测在结肠癌辅助诊断中的应用价值。方法选取结肠癌患者600例为结肠癌组,另选取结肠癌良性病变患者110例为良性病变组,健康体检人群100例为健康组。比较3组血清CEA、CA724、CA199的水平。结果结肠癌组CEA、CA199、CA724水平均显著高于良性病变组和健康组(P 0. 05)。CEA、CA199、CA724联合检测结肠癌的阳性率显著高于单独检测(P 0. 05)。采用CEA、CA199、CA724联合检测结肠癌的敏感性显著高于单独检测,而特异性显著低于单独检测(P 0. 05)。结论血清CEA、CA724、CA199联合检测对结肠癌的辅助诊断具有指导价值。     

血清TuM2-PK、CEA、CA19-9和CA72-4对结肠癌的筛查价值

目的探讨血清肿瘤M2型丙酮酸激酶(TuM2-PK)、癌胚抗原(CEA)、糖类抗原CA19-9和CA72-4对结肠癌的筛查价值。方法采用酶联免疫吸附试验(ELISA)检测80例结肠癌、75例结肠良性疾病和90例健康人血清TuM2-PK,电化学发光法检测血清CEA、CA19-9和CA72-4并进行统计分析。结果结肠癌组血清TuM2-PK、CEA、CA19-9和CA72-4水平明显高于良性疾病组和健康对照组(P0.05)。受试者工作特征曲线下面积(AUC)显示,TuM2-PK对结肠癌的诊断效能最高(0.83,95%CI:0.76~0.89),其血清水平为25.9U/mL时,灵敏度和特异性分别为73.8%和86.1%。联合检测两项标志物,最优的组合为CEA+TuM2-PK,其灵敏度、特异性和准确度分别为78.8%、84.8%和82.9%。联合检测3种标志物,最优的组合为CEA+CA19-9+TuM2-PK,其灵敏度、特异性和准确度分别为90.0%、84.8%和86.5%。联合检测血清CEA+CA19-9+TuM2-PK+CA72-4的灵敏度、特异性和准确度分别为87.5%、83.0%和84.5%。结论联合检测血清肿瘤标志物CEA、CA19-9和TuM2-PK更有助于结肠癌的筛查。     

Hematopoietic growth factors in colorectal cancer patients.

Hematopoietic growth factors (HGFs) are involved in the regulation of growth and spread of cancer. Therefore, in the present study, we have investigated in colorectal cancer patients the serum levels of selected HGFs, such as stem cell factor (SCF), interleukin 3 (IL-3), granulocyte-macrophage-colony stimulating factor (GM-CSF), and M-CSF in relation to controls and to the classical tumor markers, such as carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA 19-9) in colorectal cancer. Additionally, we have compared the serum levels of cytokines with tumor site and stage and other clinical characteristics such as age and sex. We also defined the receiver-operating characteristics (ROC) curve for HGFs and classical tumor markers. The tested cytokines were measured in 70 patients with colorectal cancer and in 40 healthy subjects. HGFs were determined using enzyme-linked immunosorbent assay (ELISA). CEA and CA 19-9 were measured by microparticle enzyme immunoassay. There were significant differences in the levels of circulating SCF, IL-3, M-CSF, GM-CSF, and CEA and CA 19-9 in the colorectal cancer patients compared to the control group. The levels of M-CSF and CEA were significantly higher in patients with a more advanced tumor stage. The significant positive correlation was observed between the CEA and CA 19-9 concentrations. The M-CSF serum levels correlated positively with the tested tumor markers. The M-CSF area under the ROC curve was the largest. These results suggest that M-CSF is, among the tested HGFs, the best candidate for a colorectal cancer tumor marker.     

Granulocyte-colony stimulating factor (G-CSF) and macrophagecolony stimulating factor (M-CSF) in colorectal cancer patients.

We have investigated the serum level of granulocytecolony stimulating factor (G-CSF) and macrophagecolony stimulating factor (M-CSF) and the commonly accepted tumor markers, such as carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA 19-9) in colorectal cancer. Additionally, we have defined the diagnostic sensitivity, specificity, positive predictive value, negative predictive value and receiver-operating characteristics (ROC) curve for G-CSF and M-CSF. The serum levels of cytokines were measured in 49 patients with colorectal cancer and in 40 healthy subjects. G-CSF and M-CSF were determined using enzyme-linked immunosorbent assay (ELISA). CEA and CA 19-9 were measured by microparticle enzyme immunoassay. There were significant increases in the level of circulating G-CSF and M-CSF in the colorectal cancer patients compared to the control group. Moreover, the diagnostic sensitivity of M-CSF was higher (65%) than the sensitivity of CEA (31%) and CA 19-9 (20%). The diagnostic specificities of M-CSF and G-CSF were 95%, and the M-CSF predictive value was higher compared with the predictive value of G-CSF. These results suggest a potential role for M-CSF as a tumor marker for colorectal cancer.     

结直肠癌患者凝血功能指标和肿瘤标志物与临床病理特征的关系

目的 探讨结直肠癌患者的凝血功能指标和肿瘤标志物与临床病理特征的关系,为临床结直肠癌的早期诊断提供一定的参考价值.方法 收集2019年10月至2020年10月在该院行住院治疗的200例结直肠癌患者(结直肠癌组)的血浆标本,行常规凝血功能指标和肿瘤标志物检测,并以100例结直肠良性病变患者(结直肠良性病变组)和100例体...     

CEA、CA19-9、CA125和CA72-4不同组合在结直肠癌诊断中的临床意义研究

目的:探讨CEA、CA19-9、CA125和CA72-4不同组合在结直肠癌诊断中的临床意义。方法:回顾性分析分析我院2010年1月-2011年12月确诊的结直肠癌患者373例的临床资料。结果:373例结直肠癌患者中,单一检测CEA、CA19-9、CA125和CA72-4阳性率为24.4%-48.3%,其中CEA阳性率为48.3%,阳性率最高;同时检测两个指标,任一个指标大于正常值的阳性率为38%-55.3%,其中CEA+CA19-9阳性率为55.3%,阳性率最高,与CEA+CA125(阳性率为55%)比较,无统计学意义(P0.05),与其他组合及单一检测CEA比较有统计学意义;检测三个指标,任一个指标大于正常值的阳性率为46.3%-60.6%,其中CEA+CA19-9+CA125阳性率为60.6%,阳性率最高,与CEA+CA19-9两个指标比较,有统计学意义;同时检测四个指标,任一个指标大于正常值的阳性率为61.2%,虽然比CEA+CA19-9+CA125阳性率高,但无统计学意义。结论:联合检测CEA、CA19-9、CA125和CA72-4可以提高结直肠癌诊断的阳性率,其中联合检测CEA+CA19-9+CA125三个指标是最优组合。     

胰腺癌患者血清细胞质胸腺激酶1及肿瘤标志物水平变化及其临床意义

目的探讨胰腺癌患者血清细胞质胸腺激酶1(TK1)、癌胚抗原(CEA)、糖链抗原19-9(CA19-9)、糖链抗原72-4(CA72-4)水平变化及其临床意义。方法我院诊治的胰腺癌患者75例(胰腺癌组)和40例良性胰腺疾病患者(良性组),同期体检健康志愿者35例(对照组)。检测各组血清TK1、CEA、CA19-9、CA72-4水平,根据血清TK1、CEA、CA19-9、CA72-4检测(串联)结果分为联合检测阳性组(n=49)和联合检测阴性组(n=26),依据患者预后情况分为预后良好组(n=24)、预后不良组(n=51)。比较各组血清TK1、CEA、CA19-9、CA72-4水平,ROC曲线分析四项指标联合检测对胰腺癌患者预后的预测价值。结果与对照组比较,胰腺癌组、良性组血清TK1、CEA、CA19-9、CA72-4水平明显增高,且胰腺癌组高于良性组(P<0.05)。联合检测阳性组临床分期为Ⅳ期、分化程度为低分化的占比高于联合检测阴性组(P<0.05)。预后不良组血清TK1、CEA、CA19-9、CA72-4水平高于预后良好组(P<0.05)。TK1、CEA、CA19-9、CA72-4水平联合检测诊断胰腺癌患者预后的ROC曲线下面积、灵敏度均较四项指标单独检测的高。结论胰腺癌患者血清TK1、CEA、CA19-9、CA72-4水平呈明显升高趋势,且四项指标联合检测对胰腺癌患者预后的预测价值较高,有望为胰腺癌患者预后的改善提供理论参考。     

Delayed sample arrival at the laboratory does not lead to more false negatives in the Danish population screening for colorectal cancer

In Denmark, biennial population screening for colorectal cancer was introduced in 2014 for all aged 50–74 years. Five laboratories representative for the regional division of Denmark perform the immunochemical testing of faecal occult blood in the screening samples (iFOBT, OC-Sensor (Eiken Chemical, cut-off 100 µg/L)). In July 2016, a new agreement on the public post-delivery entailed an increased lag time (five days) from the screening participant drops the screening sample into a mail-box until sample arrival at the laboratories. Previous work had reported that a lag time above five days led to more false negative iFOBT tests. We investigated if this was true also under Danish conditions. We performed two stability tests; one with sample storage at 30?°C for 14 days (N?=?60), and another with sample storage at room temperature for 13 days (N?=?10). We extracted data from our laboratory information system (LABKA) on all iFOBT tests performed in the entire Central Denmark Region (N?=?104,328 patients) during the last six months for each calendar year 2014–16. For each year, we computed the distribution of iFOBT tests below and above cut-off. Our stability tests showed no positive samples switching to false negative after storage; however, some negative samples turned false positive, especially at 30?°C. The data showed no change in the distribution of iFOBT tests below and above cut-off after July 2016. We found no evidence that an enhanced lag time increased the number of false negative iFOBT tests in the Danish screening program for colorectal cancer.     

A retrospective study of immunochemical fecal occult blood testing for colorectal cancer detection

BackgroundColonoscopic examination is the common pathway for positive screening tests detecting colorectal lesions. We evaluated a specific, quantitative high-throughput automatic immunochemical fecal occult blood test (Auto iFOBT) method for colorectal cancer (CRC) screening and to determine its concordance with physician assessments informed by complete colonoscopy, the gold-standard technique for evaluation of the colonic mucosa.Methods1200 CRC symptomatic patients were recruited for a retrospective investigation. Colorectal neoplasia were localized by colonoscopy and cancer outcomes were enumerated according to severity. In addition, stool samples were collected and analyzed by Auto iFOBT to derive sensitivity, specificity, and positive predictive value. Qualitative colonoscopy and Auto iFOBT results were correlated, as were cancer severities and quantitative hemoglobin concentrations.ResultsNinety-one patients were found positive for CRC; 50 mucosal, 20 submucosal, and 21 advanced. At standard cutoff, sensitivity was 60%, 90%, and 95%, respectively. Specificity and positive predictive value for all neoplasia and cancers were 89.6% and 86.4%, and 60.9% and 33.7%, respectively. Cancer severities could be approximated roughly according to hemoglobin concentrations.ConclusionsSpecific qualitative 2-day Auto iFOBT is an accurate tool for the detection of colorectal cancer and therefore provides the basis for a large-scale screening program.     

Hematopoietic cytokines in the sera of patients with pancreatic cancer.

Hematopoietic cytokines (HCs) can affect the growth and spread of cancer. Therefore, in the present study, we investigated in pancreatic cancer patients the serum levels of selected HCs, such as stem cell factor (SCF), interleukin 3 (IL-3), granulocyte-macrophage-colony stimulating factor (GM-CSF), granulocyte-colony stimulating factor (G-CSF) and macrophage-colony stimulating factor (M-CSF) in relation to a control group and to a group of patients with chronic pancreatitis. Classical tumor markers such as carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA 19-9) were also tested. We compared the serum level of cytokines with the tumor stage. The diagnostic sensitivity, specificity, positive and negative predictive values and receiver-operating characteristics (ROC) curve for cytokines and classical tumor markers were defined. The cytokines were measured in 48 patients with pancreatic cancer, in 23 patients with chronic pancreatitis and in 40 healthy subjects. HCs were determined using ELISA. CEA and CA 19-9 were measured by microparticle enzyme immunoassay. There were significant differences in the levels of circulating SCF, IL-3, GM-CSF, M-CSF, CEA and CA 19-9 in the pancreatic cancer patients compared to the control group. The serum levels of M-CSF and tumor markers were significantly higher in pancreatic cancer patients compared to the pancreatitis group. The levels of SCF, M-CSF and tumor markers were higher in patients with a more advanced tumor stage. The M-CSF serum levels in the pancreatitis group correlated positively with the tumor markers tested--CEA and CA 19-9. The diagnostic sensitivity of SCF and specificity of M-CSF and tumor markers were the highest. The SCF and M-CSF areas under the ROC curve were greater than the areas for other cytokines. These results suggest the potential usefulness of HCs in pancreatic cancer detection; however, further investigations of early-stage pancreatic cancer patients and confirmation by a prospective study are necessary.