胆汁中CEA浓度测定在大肠癌肝转移诊断中的意义

背景与目的:外周血癌胚抗原(CEA)测定目前主要用于大肠癌术后随访.近年来有研究提示胆汁CEA检测对诊断大肠癌隐匿性肝转移有一定的价值.本研究通过检测大肠癌患者外周血及胆汁中CEA的浓度,并分析胆汁CEA浓度变化情况与肝转移之间的关系,以探讨胆汁中CEA浓度在大肠癌肝转移患者诊断中的意义.方法:2007年3月-2008年2月间收集原发性大肠癌患者27例(原发组),大肠癌肝转移患者14例(肝转移组),分别测量外周血及胆汁中CEA浓度;检测20例良性胆囊疾病患者胆汁CEA浓度作为对照组.结果:对照组、原发组和肝转移组胆汁CEA浓度分别为1.73、13.7和314.27 ng/ml,差异有显著性(P<0.05),以肝转移组最高.肝转移组胆汁中CEA显著高于外周血(314.27 ng/ml比43.51 ng/ml).肝转移组中胆汁CEA浓度与肝转移灶数目及大小有一定的关系. 结论:已确诊的大肠癌肝转移患者胆汁中CEA浓度显著升高, 胆汁CEA浓度测定可能对隐匿性大肠癌肝转移有诊断价值.     

大肠癌肝转移患者胆汁中癌胚抗原含量测定的临床价值

我们对12例肝转移大肠癌患者的外周血、门静脉血、胆汁中癌胚抗原(CEA)的含量进行测定:12例肝转移者,外周血、门静脉血、胆汁中CEA含量分别为16.3ng/ml、24.1ug/ml和302.2ng/ml.对照组8例非肝转移大肠癌,其外周血、门静脉血、胆汁中CEA含量分别为10.9ng/ml、15.2ng/ml和14.8ng/ml.肝转移病人胆汁中CEA含量与肝转移灶的体积大小有密切关系:每1cm~3体积的肝转移灶CEA值为45.8ng/ml.肝转移病人的胆囊胆汁中CEA水平明显高于外周血及门分脉血水平.我们认为通过术前经皮抽取胆囊胆汁标本可以确诊较小的转移灶.同时胆汁CEA测定也可证实CT可疑的肝转移灶.     

肝癌患者血清TGF-α和IGF-Ⅱ检测的临床意义

目的　探讨转化生长因子 (TGF α)和胰岛素样生长因子 Ⅱ (IGF Ⅱ )在肝癌患者血清中的水平及临床意义。方法　采用放射免疫分析法 ,分组检测患者血清TGF α和IGF Ⅱ的水平 ,其中肝癌组 3 5例 ,肝转移癌组 3 2例及肝硬化组 3 0例。结果　肝癌及肝转移癌组血清TGF α水平分别为 ( 2 2 .0 2± 4.10 ) pg/ml和 ( 3 1.0 5± 3 8.2 4) pg/ml ,明显高于肝硬化组 ( 8.61± 2 .0 2 )pg/ml和对照组 ( 6.0 1± 1.5 8) pg/ml(P <0 .0 5和P <0 .0 1) ,肝硬化组血清TGF α水平 ( 8.61± 2 .0 2 )pg/ml与对照组 ( 6.0 1± 1.5 8)pg/ml比较无显著性差异 (P <0 .0 5 )。肝癌组IGF Ⅱ水平 ( 1.3 2± 0 .2 4)ng/ml明显高于肝硬化组 ( 0 .3 8± 0 .16)ng/ml和对照组( 0 .48± 0 .12 )ng/ml(P <0 .0 5 ) ,肝硬化组及肝转移癌组IGF Ⅱ水平分别为 ( 0 .3 8± 0 .16)ng/ml和 ( 0 .40± 0 .13 )ng/ml ,与对照组 ( 0 .48± 0 .12 )ng/ml比较无显著性差异 (P >0 .0 5 )。 结论　检测血清TGF α和IGF Ⅱ的水平有助于肝癌的诊断     

血清癌胚抗原(CEA)值增高与大肠癌的诊断、预后和复发的关系

本文对196例大肠癌患者进行了血清CEA值测定,采用放免法中的非提取法。正常对照组共测50例,测得的CEA均值为11.026,均值±两个标准差,其正常范围值为11.026±3.994,正常值定为15ng/ml以下。结果表明肿瘤越大CEA均值越高;随着Dukes分期的增加而明显增高;有肝转移者及有淋巴结转移者CEA均值明显升高,肝转移病人的CEA均值升高甚于淋巴结转移的病     

癌胚抗原与血清铁蛋白检测在肺癌患者中的比较

目的探讨癌胚抗原(CEA)与血清铁蛋白(SF)检测在肺癌中的比较.方法回顾分析48例肺癌伴转移患者组及46例肺癌患者的癌胚抗原及血清铁蛋白水平.结果 CEA在肺癌伴转移组值为(69.31±46.94) ng/ml;肺癌组值为(56.55±24.13) ng/ml,两组CEA值均高于正常值,但两组差异无显著性意义(P＞0.05).SF在肺癌伴转移组值为(1026.06±473.94) ng/ml;在肺癌组值为(378.62±257.38) ng/ml,肺癌伴转移组SF值明显高于肺癌组(P＜0.001),差异具有显著性.结论肺癌患者SF的检测较CEA检测对明确有无转移病灶有更好的辅助意义.     

大肠癌患者可溶性E-选择素及细胞内黏附分子-1血清水平的临床意义

目的:探讨大肠癌患者可溶性E-选择素(sE-selectin)及细胞内黏附分子-1(ICAM-1)血清浓度的临床意义。方法:采用酶联免疫吸附试验(ELISA法)检测98例大肠癌患者E-selectin和ICAM-1的血清浓度,并以16例健康志愿者作为对照。结果:血清ICAM-1浓度在正常、大肠癌未转移(DukesA、B期)、大肠癌转移组中(DukesC、D期)依次升高,分别为:15.9±3.6ng/ml、37.9±5.6ng/ml、57.8±4.3ng/ml;各组间差异显著(P均<0.01)。血清sE-selectin浓度在正常、大肠癌未转移(DukesA、B期)、大肠癌转移组中(DukesC、D期)依次升高,分别为:211.2±22.5ng/ml、304.1±19.7ng/ml、391.3±36.2ng/ml;各组间差异显著(P均<0.01)。血清E-selectin和ICAM-1水平与性别、年龄、肿瘤部位及组织学分级无明显相关(P>0.05)。结论:血清E-selectin和ICAM-1表达水平可在一定程度上反映大肠癌的病理进展及转移情况。     

C60-氮芥对胃癌生长和转移抑制作用的实验研究

目的研究C60-氮芥对胃癌生长和转移的抑制作用。方法建立人胃癌裸鼠原位种植模型。40只荷瘤裸鼠随机分为4组,分别腹腔内注入生理盐水、C60、氮芥及C60-氮芥。观察原位种植肿瘤生长及转移情况,检测血清CEA值。结果生理盐水组、C60组、氮芥组和C60-氮芥组的抑瘤率分别为0%、4.6%、36.2%和41.4%;淋巴结转移率分别为90%、90%、70%和20%;肝转移率分别为80%、80%、60%和30%;血清CEA值分别为(32.6±4.5)ng/ml、(30.5±4.8)ng/ml、(17.9±4.1)ng/ml和(16.3±3.3)ng/ml。C60-氮芥组或氮芥组与生理盐水组比,对胃癌的生长的抑制作用差异有统计学意义,而C60-氮芥组与氮芥组比,对胃癌生长抑制作用差异不显著(P>0.05)。C60-氮芥组或氮芥组与生理盐水组比,对胃癌淋巴结转移生长后抑制作用差异均有统计学意义(P<0.05),且C60-氮芥组与氮芥组比,对胃癌的淋巴结转移生长的抑制作用差异有统计学意义(P<0.05)。结论C60-氮芥可抑制人胃癌裸鼠原位种植瘤的生长和转移,对淋巴结转移的抑制作用尤其明显。     

早期鼻咽癌患者血清中TGF-β1的检测

目的探讨早期鼻咽癌(T1-2N0-1M0)患者放疗前、后血清TGF-β1水平的变化,分析其与临床分期和近期疗效的关系。方法 2010年2月10日至2011年7月3日共入组早期鼻咽癌初治患者57例,根据入组患者放疗前的血清TGF-β1含量,将入组患者分为两组:A组29例:血清TGF-β1值低于或等于标准值的患者;B组28例:血清TGF-β1值高于标准值的患者。观察患者放疗前、放疗至40 Gy、放疗后的血清TGF-β1含量。应用酶联免疫吸附测定(ELISA)法检测血清TGF-β1含量。选取32例健康志愿者的平均血清TGF-β1水平(50.2±3.2 ng/ml)作为本试验患者的标准值。结果 57例患者放疗前血清TGF-β1水平为(46.9±1.8)ng/ml,与健康志愿者比较差异无统计学意义(P>0.05)。而57例患者放疗中、放疗后的血清TGF-β1水平为分别为(23.2±1.0)ng/ml和(19.4±0.7)ng/ml,与健康志愿者及放疗前比较,差异有统计学意义(P<0.05)。A、B两组放疗前血清TGF-β1水平比较差异有统计学意义\[(35.4±1.4)ng/ml vs(58.8±1.0)ng/ml,P<0.05];而两组放疗中、放疗后的血清TGF-β1水平比较差异无统计学意义(P>0.05)。两组患者的鼻咽病灶及颈部淋巴结的缓解率比较差异无统计学意义(P>0.05)。T1和T2分期患者放疗前、放疗中、放疗后的血清TGF-β1水平比较差异无统计学意义P>0.05);N0、N1a和N1b分期患者放疗前、放疗中、放疗后的的血清TGF-β1水平比较差异无统计学意义()P>0.05)。结论放疗能明显降低早期鼻咽癌患者的血清TGF-β1水平。患者放疗前、放疗中、放疗后的血清TGF-β1水平与T、N分期无关,也不能有效监测肿瘤客观反应率。     

血清癌胚抗原(CEA)值增高与大肠癌的诊断、预后和复发的关系

本文对196例大肠癌患者进行了血清CEA值测定,采用放免法中的非提取法。正常对照组共测50例,测得的CEA均值为11.026,均值±两个标准差,其正常范围值为11.026±3.994,正常值定为15ng/ml以下。     

肿瘤相关物质联合检测试验对肿瘤的筛查及监控意义

目的　探讨肿瘤相关物质 (TumorSuppliedGroupofFactors ;TSGF)检测在肿瘤诊断及疗效观察中的意义。方法　用化学法测定163例恶性肿瘤患者 (A组 ) ,12 0例健康体检者 (B组 )及 2 2例良性肿瘤患者 (C组 )血清中的TSGF含量 ,并分析各观察组中TSGF的关系。结果　血清TSGF含量A组为 ( 67 4± 18 6)U/mL ;B组为 ( 5 1 7± 6 3 )U/mL ;C组为 ( 5 4 6± 7 5 )U/mL ,A组TSGF含量明显高于B组及C组 (P <0 0 1)。TSGF肿瘤诊断的总阳性率为 84 7% ,特异性为 96 3 % ;其中肺癌和大肠癌的阳性率分别为 90 7%、89 6% ;手术和化疗后随访的 2 3例大肠癌患者中 ,一年后有 1例TSGF持续阳性 ,后经确诊其为复发患者。结论　TSGF是一种广谱、灵敏 ,简便的肿瘤筛查指标 ,对肿瘤诊断、疗效评估、肿瘤复发判断等有重要的临床意义。     

Detection of occult liver metastases in colorectal cancer by measurement of biliary carcinoembryonic antigen concentration: a prospective study

BACKGROUND: It has been suggested that bile CEA levels could be a sensitive index for the detection of occult liver metastases (LM) in colorectal cancer (CRC) patients. The aim of this study was to determine the potential value of biliary CEA assay in the early detection of occult LM from CRC. METHODS: From 1995 to 1999 biliary and blood CEA levels were determined in three groups of patients undergoing surgery; Group 1 (n = 35) patients with LM from CRC; Group 2 (n = 154) patients with CRC without LM; Group 3 (n = 23) was the control group. RESULTS: Biliary and serum CEA levels were significantly lower in group 3 than in group 2 (P = 0.008 and P = 0.002) and in group 2 than in group 1 (P = 0.001 and P = 0.005). With a follow-up of 36 months (group 2), 22 patients (14%) developed LM. For 59 patients, the bile CEA level during laparotomy was less than 5 ng/ml and for 95 patients this level was more than 5 ng/ml, 4 and 18 patients respectively developed metachronous LM; we found a difference (P = 0.03) between these two subgroups. When this analysis was performed with regard to the stage of the tumor, we found no difference for the node negative cancer (n = 79) subgroup (P = 0.6), but we found a significant difference for the node positive cancer (n = 75) subgroup (P = 0.01). CONCLUSIONS: Our data suggest that biliary CEA concentrations at the time of resection of the primary tumor cannot be used to identify patients with occult LM in the node-negative CCR subgroup. However, patients with node-positive CCR and bile CEA level under 5 ng/ml developed LM in only 3% of cases; it might be therefore, possible to use that as a discriminant in situations where the risk of LM is small.     

Biliary carcinoembryonic antigen in the diagnosis of occult hepatic metastases from colorectal cancer

BACKGROUND AND OBJECTIVES: Twenty five percent of patients who undergo radical surgical treatment for colorectal cancer have occult hepatic metastases that become evident during the follow-up period. We evaluated whether biliary carcinoembryonic antigen (CEA) measurements could be used in these patients to diagnose occult hepatic metastases. METHODS: Three groups of patients were enrolled in the study. The first group consisted of patients treated for lithiasis of the common bile duct, the second group was affected by colorectal cancer and evident hepatic metastases, and the third group of patients underwent radical surgical treatment for colorectal cancer but had no evident hepatic metastases. RESULTS: In the first study group, mean biliary CEA level was 0.52 ng/mL (normal value: 0-5 ng/mL) (diagnostic accuracy: 100%), 83.3 ng/mL in the second group (diagnostic accuracy: 91%) and 3.9 ng/mL in the third group. We registered only one false-positive result in the third group, whereas biliary CEA level was above normal values in the three patients in whom hepatic metastases developed (diagnostic accuracy: 89.5%). CONCLUSIONS: This study suggests that biliary CEA determination could represent an important method to select patients affected by occult hepatic metastases for inclusion in appropriate treatment protocols.     

Macrocreatine kinase type 2 in the serum of patients with tumors and with nonmalignant colonic diseases

The macrocreatine kinase type 2 isoenzyme (MCK-2) was investigated as a marker for colonic cancer. It was sought in 252 serum samples from 231 patients: 69 with active colonic cancer, 49 in whom colonic cancer had been successfully resected, 58 with nonmalignant diseases of the colon, and 76 patients immediately following colonic surgery. MCK-2 was detected in the serum of 39 of the patients with cancer (57%) and in one patient with diverticulitis. MCK-2 and carcinoembryonic antigen (CEA) were both measured in 47 colonic cancer patients. Both markers were detected in 19 cases, MCK-2 alone in eight and CEA alone in eight. We conclude that MCK-2 is a promising tumor marker for carcinoma of the colon and that its value might be complementary to that of CEA.     

血清胆汁CA19-9、CEA、CA242联合检测诊断胆道良恶性肿瘤的可行性分析

目的:探讨血清、胆汁CA19-9、CEA、CA242联合诊断胆道良恶性肿瘤的临床价值。方法:对象为2013年10月-2015年2月来我院诊治的疑似恶性胆道肿瘤的患者202例,均行手术探查。所有患者均通过穿刺的方式取胆汁进行CA19-9、CEA、CA242检测,比较不同疾病类型患者血清、胆汁中的CA19-9、CEA、CA242检测水平,分析血清胆汁联合检测在胆道良恶性肿瘤中的诊断价值。结果:202例手术探查患者中,98例经病理证实为恶性胆道肿瘤患者、22例为良性胆道肿瘤患者,82例为其他胆道疾病。恶性胆道肿瘤与良性胆道肿瘤患者胆汁中CA242、CA19-9和CEA的表达水平要显著性的高于在血清中的表达水平（P＜0.05）;恶性肿瘤组患者的胆汁中CA242、CA19-9和CEA检测水平均显著性高于良性肿瘤患者（P＜0.05);胆汁CA242、CA19-9和CEA联合诊断胆道恶性肿瘤的敏感率为33.66%,准确率为88.98%,特异性为91.16%,阳性率为35.24%。结论:利用胆汁中肿瘤标记物对胆道肿瘤的检测水平要高于血清中的水平,采用CA19-9、CEA、CA242的联合检测是诊断胆道肿瘤比较理想的组合。上述肿瘤标志物的组合能够提高胆道肿瘤良恶性的预判准确度,对于早期胆道良恶性肿瘤的发现、治疗具有十分重要的意义。     

Tumor markers--a diagnostic and prognostic test

Blood levels of carcinoembryonic antigen (CEA), alpha-fetoprotein, ferritin, ACTH. triiodothyronine and thyroxin were measured by radioimmunoassay in 217 cases of lung, hepatopancreatoduodenal and colonic cancer, 61 patients with nontumor pathology of those sites and in 37 healthy controls. CEA proved the most reliable marker of lung and colonic cancer and tumor-related mechanical jaundice, its lowest concentration in 65-100% of cancer patients exceeding the highest levels observed in controls. In the colorectal group, CEA level returned to normal after radical surgery and rose again at recurrence or distant metastases. Ferritin, cortisol and ACTH appeared less efficient.     

肿瘤标志物在胃癌早期诊断中的应用价值

目的 探讨血清中常见肿瘤标志物在胃癌早期诊断中的应用价值.方法 选择64例胃癌患者(A组),45例胃良性囊肿患者(B组),42例胃黏膜正常的人(C组)作为研究对象.对3组患者血清中CA242、CA724、CA19-9和CEA水平进行比较、癌症各期患者血清中各肿瘤标志物表达水平的检测以及各种肿瘤标志物单测及联合检测对胃癌诊断有效率进行比较.结果 恶性肿瘤组(A组)患者血清中CA242、CA724、CA19-9和CEA水平均显著性高于良性(B组)、对照组(C组)患者,差异有统计学意义(P<0.05);B组患者血清中肿瘤标志物水平显著性的高于C组患者,差异有统计学意义(P<0.05).随着肿瘤分期的不断延长,胃癌患者血清中CA242、CA724、CA19-9和CEA的表达水平均显著增加;各标志物中CA724的灵敏度最高,CEA标志物的特异性最高,CA724标志物的有效诊断率最高,4项标志物联合检测的灵敏度、特异性以及有效诊断率要显著高于单测肿瘤标志物,差异具有统计学意义(P<0.05).结论 采用CA242、CA724、CA19-9和CEA联合检测是诊断胃癌的理想组合,联合检测能够有效提高诊断的特异性、灵敏度以及有效率,对于胃癌早期的诊断、治疗具有十分重要的意义.     

Indication for hepatic resection after hepatic arterial infusion chemotherapy for multiple liver metastases of colorectal cancer

The indications for hepatic resection after hepatic arterial infusion chemotherapy (HAI) for unresectable metastatic liver tumor of colorectal cancer were analyzed from the surgical outcome of hepatic resections in 23 cases of hepatic resection after HAI. The mean duration of HAI until hepatic resection was 7.4 months (5-14 months). The total dose of 5-FU was 25.7 +/- 8.0 g for a CR + PR group and 14.0 +/- 3.5 g for a NC + PD group. There was a significant difference between two groups (p < 0.01). The group in which serum CEA level normalized after HAI (the normal CEA group) included 7 patients, and the group in which serum CEA level did not normalize (the high CEA level group) had 9 patients. The total dose of 5-FU was 30.0 +/- 7.6 g in the normal CEA level group and 19.1 +/- 6.9 g in the high CEA level group. There was a significant difference between the two groups. The 3-year survival rate was 40.0% in the group with the duration of HAI for longer than 8 months (n = 10) and 0% in the group with the duration of HAI for shorter than 8 months (n = 7). The 3-year survival rate was 66.7% in the normal CEA level group (n = 3) and 0% in the high CEA level group (n = 8). The surgical outcome was better in the HAI for longer than 8 month and normal CEA groups.     

检测十二指肠胆汁癌胚抗原对诊断大肠癌肝转移的价值

目的 探讨十二指肠胆汁癌胚抗原（ＣＥＡ）水平对诊断大肠癌肝转移的意义。方法 Ａ组３０例,为非肿瘤患者,Ｂ组３０例,为大肠癌患者;Ｃ组１５例,为大肠癌合并肝转移患者,所有患者空腹抽取前壁静脉血,同时经鼻十二指肠引流管取十二指肠胆汁,用宝林曼公司提供的试剂盒测定ＣＥＡ值。     

肿瘤标志物联合检测对原发性肝癌的诊断价值

目的:探讨肿瘤标志物（testing multi-tumor,TM）联合检测对原发性肝癌的诊断价值。方法:应用电化学发光法定量测定46例原发性肝癌患者、32例良性肝病患者、40例健康体检者血清中糖类抗原199（CA-199）、神经特异性烯醇酶（NSE）、癌胚抗原（CEA）、糖类抗原242（CA-242）、血清铁蛋白（FERR）、人绒毛膜促性腺激素（HCG）、甲胎蛋白（AFP）、游离前列腺特异性抗原（FPSA）、前列腺特异抗原（TPSA）、糖类抗原125（CA-125）、生长激素（HGH）、糖类抗原153（CA-153）12种TM的浓度。结果:肝癌组CA-199、CEA、CA-242、Ferritin、AFP、CA-153阳性率相对于良性肝病组及健康对照组显著增高（P<0.01）;肝癌组CA-199、CEA、CA-242、Ferritin、AFP、CA-153联合检测相对于健康对照组阳性率及敏感性显著增高（P<0.01）。结论:CA-199、CEA、CA-242、Ferritin、AFP、CA-153联合检测有助于提高原发性肝癌阳性检出率。     

血清CEA、SF、AFP联合检测对肝转移癌的诊断价值

目的　探讨肝转移癌患者血清中CEA、SF、AFP检测及临床意义。方法　检测 134例肝转移癌和183例原发性肝癌血清的CEA、SF、AFP。结果　原发性肝癌的CEA、SF和AFP阳性率分别为 2 0 2 2 % ,81 4 2 %和 6 1 75 % ,肝转移癌的CEA、SF和AFP阳性率分别为 87 31% (P <0 0 1) ,72 39% (P >0 0 5 )和5 2 2 % (P <0 0 1)。肝转移癌化疗前后的血清CEA有显著性差异 (P <0 0 1)。结论　检测CEA对肝转移的诊断、治疗及预后有明显的指导意义。