动态检测乳腺癌患者血清TPS和CA153的临床意义

目的探讨乳腺癌患者血清组织多肽特异性抗原(TPS)和癌相关糖蛋白抗原(CA153)水平动态检测的临床意义.方法采用化学发光法检测乳腺癌患者血清TPS和CA153水平.结果晚期乳腺癌患者血清TPS和CA153水平显著高于乳腺癌根治术后患者血清TPS和CA153水平(P＜0.01),晚期乳腺癌患者治疗后病情缓解者血清TPS和CA153水平明显低于病情进展者(P＜0.01).结论血清TPS和CA153水平可作为乳腺癌病情观察的参考指标,对病情监测及治疗疗效观察有较好的临床意义.     

乳腺癌肿瘤标志物CEA、CA15-3表达水平的临床意义

目的: 探讨血清CEA、CA15-3与乳腺癌临床诊断方面的关系。 方法: 应用微粒子免疫萤光技术对210例乳腺癌患者、75例乳腺良性疾病患者及50例正常对照者血清CEACA15-3表达水平进行检测比较。 结果: CEA、CA15-3在乳腺癌Ⅲ、Ⅳ期中表达明显增高(P<0.005),在Ⅰ、Ⅱ期中表达与正常组及良性疾病组比较无显著性差异(P>0.05)。两种标志物与肿瘤分期、淋巴结受累程度有关,腋淋巴结转移≥4枚或远处脏器转移时CEA、CA15-3浓度明显增高(P<0.005)。两种标志物与肿瘤病理学分型的关系不明显(P>0.05)。乳腺癌术后动态监测CEA、CA15-3对肿瘤远处转移呈高表达(P<0.005),对局部复发CEA无显著性(P>0.05),而CA15-3有指导意义(P<0.005)。 结论: CEA、CA15-3并非乳腺癌早期诊断的理想标志物,但其与肿瘤临床分期、淋巴结转移程度、远处转移关系密切,是乳腺癌术前预测转移及监测术后复发转移与评估乳癌预后的有效指标。     

乳腺癌诊治中肿瘤标志物CA15-3的临床价值

目的：探讨CA15-3在乳腺癌诊治中的临床价值.方法：采用酶联免疫吸附法检测.结果：CA15-3在诊断乳腺良性疾病与乳腺癌时,差异无显著性（P＞0.05）;对62例乳腺癌进行观察,CA15-3在骨、肺转移及乳腺癌出现转移或复发时,阳性检测率较高,分别为85.71%、50%、100%,并且标志物浓度与转移、复发部位及病灶数目多少、浸润面积大小密切相关.结论：乳腺癌CA15-3浓度较高时,提示转移肿瘤存在且预后较差.     

乳腺肿瘤组织Ha-ras基因蛋白表达与血清CA15-3水平的相关性及其临床价值

用免疫组化ＡＢＣ法和ＩＲＭＡ法分别检测了４２例乳腺癌和３０例良性乳腺病变患者组织中Ｈａ－ｒａｓ基因蛋白（ｒａｓＰ２１）的表达状况及血清ＣＡ１５－３值，结果恶性病变组织中ｒａｓＰ２１呈过度表达，ｒａｓＰ２１的表达与细胞的分化状态密切相关。不同淋巴结转移状况的乳腺癌患者，其血清ＣＡ１５－３差异呈显著性。ＣＡ１５－３水平的变化与ｒａｓＰ２１表达状况显著相关。提示血清ＣＡ１５－３水平为监测乳腺癌病情变化的良好指标，Ｈａ－ｒａｓ癌基因点突变的结果可能导致乳腺癌相关抗原的异常分泌。     

血清TPS、CEA、Pro-GRP和CYFRA21-1水平在肺癌患者中的临床意义

背景与目的血清肿瘤标志物在肺癌的诊断、疗效、预后判断中起着重要作用。本研究探讨血清组织多肽特异性抗原(tissue polypeptide specific antigen,TPS)与癌胚抗原(carcinoembryonic antigen,CEA)、胃泌素释放肽前体(precursor of gastrin-releasing peptide,Pro-GRP)和细胞角蛋白19片段(cytokeratin-19-fragments,CYFRA21-1)的水平及其在肺癌患者中的临床意义。方法应用ELISA检测82例肺癌患者化疗前及部分患者化疗后4种标志物水平。结果肺癌患者TPS、CEA、Pro-GRP阳性率及水平显著高于肺部良性疾病组和健康对照组。广泛期小细胞肺癌患者TPS阳性率显著高于局限期患者。患者化疗后TPS、CEA、Pro-GRP阳性率及水平均显著下降。非小细胞肺癌患者TPS水平是预后的独立因素。结论TPS在肺癌患者的辅助诊断、疗效观察有较好的临床意义,对非小细胞肺癌的预后判断方面可能有一定价值。     

CA15—3在乳腺癌诊断和监测中的应用

我们使用CA15-3放免分析试剂盒测定了正常人、乳腺良性疾病及乳腺癌病人血清CA15-3水平，探讨CA15-3对乳腺癌诊断及监测的实用价值。1材料和方法1．1临床资料所有病人为1994年1月～1995年8月就诊患者，均为女性。其中乳腺癌76例（初诊65例、复发转移性乳腺癌11例），乳腺良性病变48例，均经病理证实。乳腺癌病人62例行根治术、1例行姑息术加术后化疗、13例行化疗。治疗前检测血清CA15七，治疗后4周复测CA15-3，并对部分乳腺癌病人CA15-3水平进行了动态观察，对16例转移性或疑有转移的乳腺癌病人联合检测CEA。选择4O例健康女性血清CA…     

CEA与CA15-3联合检测在乳腺癌诊断中的临床意义

目的：探讨癌胚抗原（carcinoembryo antigen,CEA）与肿瘤相关糖类抗原15-3（carbohydrate antigen15-3,CA15-3）联合检测在乳腺癌诊断中的应用价值。方法：采用电化学发光方法检测116例乳腺癌患者与94例乳腺良性肿瘤患者血清中CEA与CA15-3水平并进行统计学分析。结果：乳腺癌患者血清中CEA与CA15-3水平明显高于乳腺良性肿瘤对照组（P〈0.01）;二者联合检测诊断敏感性显著提高（P〈0.05）;治疗后CEA与CA15-3含量与治疗前相比显著无明显变化（P〉0.05）。结论：CEA与CA15-3联合检测可提高乳腺癌诊断敏感性,对临床诊断与疗效评价有一定的应用价值。     

CEA与CA15-3联合检测在乳腺癌诊断中的临床意义

目的:探讨癌胚抗原(carcinoembryo antigen,CEA)与肿瘤相关糖类抗原15-3(carbohydrate antigen15-3,CA15-3)联合检测在乳腺癌诊断中的应用价值。方法:采用电化学发光方法检测116例乳腺癌患者与94例乳腺良性肿瘤患者血清中CEA与CA15-3水平并进行统计学分析。结果:乳腺癌患者血清中CEA与CA15-3水平明显高于乳腺良性肿瘤对照组(P<0.01);二者联合检测诊断敏感性显著提高(P<0.05);治疗后CEA与CA15-3含量与治疗前相比显著无明显变化(P>0.05)。结论:CEA与CA15-3联合检测可提高乳腺癌诊断敏感性,对临床诊断与疗效评价有一定的应用价值。     

血清TRACP5b、CA15-3水平预测乳腺癌术后骨转移的临床意义

研究表明,乳腺癌骨转移中10%为成骨型,10%为混合型,80%均为以破骨细胞活动为主的溶骨性转移,而血清抗酒石酸盐酸性磷酸酶Sb( Serum tar-trate resistant acid phosphatase, TRACPSb)主要来源于破骨细胞,是一个反映破骨细胞功能的指标^[1],故在众多乳腺癌骨转移标志物中显示出很高的特异性。     

骨显像和血清CA15-3测定联合诊断乳腺癌骨转移

目的：评价骨显像和血清ＣＡ１５－３ＲＩＡ诊断乳腺癌骨转移的临床价值。方法：骨显像在静脉注射＾９９ｍＴｃ－ＭＤＰ３－４小时后进行,ＣＡ１５－３测定参考药盒说明书,对６１例乳腺癌术后全身骨显像及血清ＣＡ１５－３放射免疫测定结果进行分析。结果：９例临床及Ｘ线检查诊断为骨转移者,骨显像及ＣＡ１５－３测定均为阳性,其中骨显像示多发病灶７例,单发病灶２例。１５例骨显像及ＣＡ１５－３测定均阳性,而Ｘ线平片检查阴     

组织多肽特异性抗原检测在卵巢癌诊断和治疗中的应用价值

目的　探讨组织多肽特异性抗原 (TPS)在卵巢癌诊断和治疗中的应用价值。方法　对 96例卵巢癌患者 (初诊未治组 3 6例 ,治疗有效组 3 5例 ,复发转移组 2 5例 )和 3 3例妇科良性疾病患者 ,采用ELISA法和EIA法分别检测血清TPS及CA12 5水平。结果　TPS对卵巢癌初诊的特异性、阳性预测值 (PV )及准确性与CA 12 5无显著性差异 (P >0 .0 5 ) ,而灵敏度、阴性预测值 (PV-)显著低于CA 12 5 (P <0 .0 5 ) ,两者联合检测可显著提高卵巢癌诊断准确性 (P <0 .0 5 )。Ⅲ Ⅳ期卵巢癌患者血清TPS和CA12 5平均水平及阳性率均显著高于Ⅰ Ⅱ期 (P <0 .0 5 )。治疗有效组TPS和CA12 5水平显著低于初诊未治组 ,而复发转移组TPS水平 10 0 .0 %升高。结论　TPS的检测有助于卵巢癌复发、转移的诊断 ,可用于其疗效观察、病情追踪、监测复发及预后判断 ,与CA12 5联合检测 ,可提高卵巢癌的诊断准确性     

血清CA15-3对乳腺癌、肺癌转移的诊断价值分析

[目的]探讨血清CA15—3对预测乳腺癌、肺癌转移的临床应用价值。[方法]应用化学发光免疫分析技术检测了3995例乳腺癌、1269例肺癌患者血清CA15-3水平。[结果]3995例乳腺癌患者中,未转移患者CA15-3中位数为10．1U／ml;转移患者CA15-3中位数为32．4U／ml。1269例肺癌患者中,未转移患者CA15-3中位数为12．9U／ml;转移患者CA15-3中位数为19．7U／ml。两组肿瘤患者中,转移患者血清CA15—3显著高于未转移的肿瘤患者。[结论]血清CA15—3检测对乳腺癌、肺癌转移的预测有重要参考价值。     

Serum tissue polypeptide specific antigen (TPS): a complementary tumor marker to CA 15-3 in the management of breast cancer

The efficacy of CEA and CA15-3 tumor markers in monitoring breast cancer was evaluated in 1365 patients with either benign (n=534) or malignant (n=831) breast diseases. Thirty-nine breast cancer patients were monitored before and after neoadjuvant chemotherapy. Three hundred forty-nine patients were monitored during post-surgical follow-up for either a minimum of 5 years or until time of recurrence. Twenty-one patients with metastases were also monitored during chemotherapy. Elevated CA 15-3 and TPS levels were found in 28.6% and 30.0% of patients. CA 15-3 and TPS sensitivities rose to 71.9% and 66.3% in metastatic patients, respectively. The addition of TPS to CA 15-3 increased the sensitivity up to 44.4% in the overall population, and to 87.6% in patients with metastases. During post-surgical follow-up CA 15-3 was elevated in 65.7% and TPS in 61.3% of patients with recurrence. The combination of TPS and CA 15-3 increased the overall sensitivity by 12.7%. Longitudinal monitoring of metastatic patients undergoing chemotherapy demonstrated that, when positive, both CA 15-3 and TPS paralleled response to treatment. TPS monitoring may provide additional value when used in combination with CA15-3 during post-surgical follow-up of breast cancer patients.     

265例乳腺癌手术前后血清CA15-3和CEA检测分析

[目的]探讨乳腺癌手术前后血清糖类抗原15．3（CA15—3）和癌胚抗原（CEA）测定的临床意义。[方法]取265例乳腺癌病例外周静脉血，采用电化学发光免疫分析fECLIA）检测术前及术后CA15—3、CEA水平。[结果]术前已发生转移者23例，CA15—3增高18例，CEA增高10例，阳性率分别为78-3％、43．5％；术后无复发转移组201例，CA15—3增高2例（0．99％）、复发转移组41例，CA15-3增高33例，CEA增高27例，阳性率分别为80．5％和65．9％。[结论]血清CA15-3和CEA的动态检测可作为乳腺癌术后随访的监测指标，CA15-3水平的变化有助于预测肿瘤转移及其治疗效果的判定。     

CA15-3, CASA,MSA, and TPS as diagnostic serum markers in breast cancer

Summary This is the first comparison of the three mucin based tests CA15-3, CASA, and MSA, and the cytokeratin-related TPS assay in breast cancer. The mucin markers were superior to TPS in receiver-operator analysis, though no marker was of use in the diagnosis of malignancy due to low sensitivity. Using cutpoints that gave 95% specificity in benign disease (n = 83), corresponding sensitivities in pre-treatment breast cancer (n = 123: 13in situ, 54 stage I, 45 stage II, 4 stage III, 7 stage IV) were 17% (CA15-3), 16% (CASA), 13% (MSA), and 8% (TPS), with a strong relationship between marker levels and disease stage. These assays did not always detect the same patients, and the use of CA15-3 combined with CASA gave the highest sensitivity (23%), though this was not significantly better than the use of CA15-3 alone. Despite detecting similar antigens, these assays can show markedly different responses in some patients, indicating that one mucin-based test cannot be sub-stituted for another.     

Clinical evaluation of potential usefulness of CEA, CA 15-3, and MCA in follow-up of breast cancer patients

The potential usefulness of MCA, CA 15-3 and CEA in monitoring of breast cancer patients was evaluated in 135 female patients with histologically confirmed breast cancer. The patients were classified into two groups as follows: group of patients with no evidence of disease, NED; and group of patients with progressive disease, PD. In total, 2106 measurements of CEA, CA 15-3, and MCA were performed using an enzyme immunoassay. Serum levels of all three markers in the NED group differed significantly from those of patients with PD. The observed differences in the sensitivity and specificity of CEA, CA 15-3, and MCA tests were not significant. The serum concentrations of a particular marker correlated well with the concentrations of the other two markers, except when CEA was correlated with MCA or CA 15-3 in NED group patients. The elevation of tumor markers preceded by some 7 months the clinical evidence of dissemination, and marker levels reflected at a high percentage the response to therapy in PD patients. Therefore, this clinical study confirmed that MCA, CA 15-3 and also CEA are suited to discriminate between disease and disease-free periods, and also validated the usefulness of markers for treatment response monitoring.     

肿瘤标志物CA15-3的免疫放射分析及其临床应用

目的发展一项新的肿瘤标志物免疫放射分析,并初步评价其临床应用价值。方法从瑞典引进单克隆抗体Ｍａ５５２与Ｍａ６９５,以前者为扑捉抗体,后者为标记抗体,建立一种夹心式的免疫放射分析。将Ｍａ５５２包被于聚苯乙烯小珠上,并以１２５－Ｉ标记Ｍａ６９５单抗。测定为室温下的一步反应。结果标准曲线的Ｂｍａｘ／Ｂ０为８２。本测定的灵敏度为０．３Ｕ／ｍｌ;批内与批间ＣＶ分别为８％与１０％。５０名正常女性血清ＣＡ１５－３值为１１．３±３．９Ｕ／ｍｌ,若以３０Ｕ／ｍｌ为判别的界值,则假阳性率为０％。良性乳腺病４０例,ＣＡ１５－３值９．６±５．８Ｕ／ｍｌ,假阳性率０％。６５例不同病程阶段的乳腺癌患者,疗前血清ＣＡ１５－３水平为８８．４±１５９．６Ｕ／ｍｌ,总阳性率５０．８％。肝转移,特别是骨转移引起显著的血清ＣＡ１５－３升高,阳性率可达１００％（ｎ＝９）。乳腺癌复发的患者ＣＡ１５－３阳性率为８０％（ｎ＝５）。结论新建成的免疫放射分析在乳腺癌的诊断,鉴别诊断,监视转移和复发中有高度的临床应用价值,比ＣＥＡ更好。     

乳腺癌患者血清CA15—3检测的临床意义

采用放射免疫法检测１８０例乳腺疾病患者血清ＣＡ１５－３水平，其中乳腺良性疾病４２例，乳腺癌术前５１例，乳腺癌术后无复发转移者７３例，乳腺癌术后有复发或转移者１４例。ＣＡ１５－３阳性率分别为９．５％、２７．５％、５．５％、８５．７％。结果显示，乳腺癌术后有复发或转移者的阳性率明显高于无复发转移者（Ｐ＜０．０１）。血清ＣＡ１５－３检测对乳腺癌术前诊断意义不大，而对乳腺癌术后复发和转移的监测有重要价值。     

原发性乳腺癌患者术前血清中糖类抗原153癌胚抗原和组织多肽特异性抗原水平与临床病理特征和预后的关系

目的 探讨原发性乳腺癌患者术前血清中糖类抗原153( CA153)、癌胚抗原(CEA)和组织多肽特异性抗原(TPS)水平与患者临床病理特征和预后的关系.方法 对386例Ⅰ～Ⅳ期原发性乳腺癌患者的临床资料进行严格随访,回顾性分析患者术前血清中CA153、CEA和TPS水平与乳腺癌临床病理特征和预后的关系.结果 分别有383、382和324例患者进行了术前CA153、CEA和TPS的检测,平均表达水平分别为(21.46±34.88)U/ml、(1.53±7.95)μg/L和(224.87±436.19) AU/ml,CA153、CEA和TPS的阳性表达率分别为10.7％ (41/383)、7.6％ (29/382)和63.9％ (207/324).原发性乳腺癌患者术前血清CA153的表达水平与患者的年龄和肿瘤大小显著相关(均P＜0.05),CEA的表达水平与肿瘤大小显著相关(P＜0.05),TPS的表达水平与肿瘤大小和淋巴结转移状况显著相关(均P＜0.05).术前血清CA153、CEA和TPS阳性表达患者的总生存率显著低于阴性患者(均P＜0.05).Cox多因素分析表明,ER的表达水平以及术前CA153的表达水平是影响乳腺癌患者预后的独立因素(均P＜0.05),其中术前CA153水平增高是危险因素,而ER阳性表达则是保护因素.结论 术前血清CA153、CEA和TPS的表达水平与乳腺癌患者的临床病理特征和预后有关,CA153是影响乳腺癌患者预后的独立因素,CA153表达水平增高者的预后较差.     

血清TPS 与肝细胞肝癌临床病理特征的相关性探讨

 目的 探讨血清组织多肽特异性抗原(TPS)与肝细胞肝癌(HCC)临床病理特征的相关性。方法 采用酶联免疫吸附法，分别测定74例HCC患者、35例肝硬化患者、22例慢性肝炎患者和42例健康人体血清TPS和AFP水平。分析TPS与HCC临床病理特征的相关性，并与AFP比较。结果 HCC组TPS血清水平仅高于正常对照组(P<0．05)．与肝硬化及肝炎组比较无显著性差异(P>0．05)；TPS与DB、IB、ALT、AST、γ-GT、LDH以及肿瘤大小之间存在显著相关性(P<0．05)，但与肿瘤数目、门脉癌栓、肝外转移、临床分期及肿瘤分化程度均无显著相关性(P>0．05)；AFP与肿瘤大小、门脉癌栓及肿瘤分化程度之间存在显著相关性(P<0．05)。结论 血清TPS与HCC肿瘤侵袭性之间无显著相关性，但与肝功能受损程度相关性显著，因此必须谨慎对待肝病患者血清TPS的升高。