胃液和唾液CEA临床意义的探讨

本文用酶联免疫吸附夹心法检测94例胃良、恶性疾患的胃液及27例唾液CEA含量。其中,22例胃癌胃液CEA含量(152.2±85.6ng/ml)明显高于26例浅表性胃炎(26.4±34.6ng/ml)、17例萎缩性胃炎(33.5±35.0ng/ml)、16例肠上皮化生(38.9±49.1ng/ml)及13例异型增生(68.8±46.6ng/ml),异型增生组又明显高于浅表性胃炎和萎缩性胃炎组。27例唾液CEA(18.7±23.2ng/ml)与胃液CEA无相关性。免疫组化结果表明组织CEA染色与胃液CEA含量无恒定关系。并讨论了胃液和唾液内CEA测定的临床意义。     

同时检测血和胃液中癌胚性抗原的临床意义

本文分析111例良恶性胃病的血和胃液CEA测定结果(其中88例同时检测血和胃液CEA),与胃镜检查和活检病理特点相比较。胃液CEA值高于血CEA(约高1.5～15倍),45例恶性胃病中,胃液CEA阳性41例,仅1例单独血CEA阳性。胃液CEA对恶性胃病的诊断具有一定的特异性,癌和HR(高危险人)组的阳性率分别为88.57％(31/35例)和82.35％(14/18例),与良性胃病相比有显著差异(P<0.01)。胃液CEA测定是一个简便、安全、具有一定特异性和敏感性筛诊胃癌的方法。作者建议可以用于健康人或RH人群的一项普查方法,对CEA增高患者,进一步深入检查。     

胃病患者胃液癌胚抗原的测定及临床意义

本文对胃癌病人胃液与血清CEA、肿瘤组织学类型的关系进行研究,并与胃良性疾病相比较。结果表明:1.胃癌病人胃液CEA值明显高于非癌胃疾患(P<0.001)。本文以102ng/ml为阳性标准,胃癌组阳性率为80％。2.胃癌的组织学类型与胃液CEA间无明显相关,但低分化腺癌假阴性率较高(40％)。3.萎缩性胃炎伴肠上皮化生者胃液CEA值升高,介于胃癌和浅表性胃炎、溃疡病组之间。胃液CEA与血清CEA联合测定,在胃癌的辅助诊断方面有一定意义。     

化疗对晚期胃癌TAM、CEA、CA72-4的影响及意义

目的 探索化疗对晚期胃癌TAM、CEA、CA72-4的影响及临床意义.方法 应用电化学免疫发光法对49例胃癌患者化疗前后血清中CEA、CA72-4进行检测；应用生化法对其血清TAM进行检测,并均与健康对照组进行比较.结果 晚期胃癌患者化疗后血清中TAM、CEA、CA72-4分别为(99.00±17.00) u/ml、(24.17±7.54)ng/ml、(48.44±17.36) u/ml；健康对照组分别为(70.00±12.00)u/ml、(4.24±1.28)ng/ml、(5.49±1.89)u/ml,两组差异具有统计学意义(P＜0.01)；亚组分析显示化疗有效的病例(PR+ SD)化疗前后TAM分别为(123.00±21.00) u/ml、(97.00±16.00)u/ml; CEA、CA72-4化疗前分别为(25.80±2.57) ng/ml、(47.69±13.19) u/ml,化疗后分别为(21.56±7.87) ng/ml、(38.47±14.23)u/ml,差异有统计学意义(P＜0.01,P＜0.05).临床进展的病例(PD)化疗前TAM、CEA分别为(1 1 7.00±18.00) u/ml和(21.34±5.68) ng/ml,化疗后分别为(14000±17.00) u/ml和(30.94±8.79) ng/ml,差异有统计学意义(P＜0.01);CA72-4化疗前后分别为(41.78±11.99) u/ml和(50.34±17.06) u/ml,差异有统计学意义(P＜0.05).结论 TAM、CEA、CA72 4的联合检测可作为一种评价化疗效果的早期预测指标.     

癌胚抗原糖链抗原CA199和CA724联合检测在胃癌诊断中的价值

目的分析血清癌胚抗原(CEA)、糖链抗原CA199和CA724联合检测在胃癌诊断中的价值。方法选取2011年2月到2013年2月间收治的、经临床检查确诊为胃癌的84例患者,胃良性病变者80例,另选取80例健康人作为对照组。采用电化学发光法检测患者血清中CEA、CA199和CA724含量,分析CEA+CA199、CEA+CA724、CA199+CA724及CEA+CA199+CA724等不同组合联合方式的胃癌诊断价值。结果胃癌组患者血清中CEA、CA199和CA724含量分别为(48.1±21.2)ng/ml、(98.4±12.2)U/ml和(39.8±19.6)U/ml,均明显高于胃良性病变组和对照组,差异有统计学意义(P<0.05)。3项指标联合检测诊断胃癌的准确率为86.2%,特异度为88.9%,敏感度为84.1%,准确率和敏感度明显高于两种肿瘤标志物联合检测,差异有统计学意义(P<0.05)。3项指标不同组合方式联合检测的特异度无明显差异(P>0.05)。结论 CEA、CA199和CA724联合检测对胃癌诊断具有优越性,而对胃良性病变仅有一定的指导意义。     

肺癌患者血液中Hsp90α的表达

目的:探讨血清热休克蛋白Hsp90α 在肺癌患者血液中的表达情况.方法:统计分析94例肺癌患者和20例正常查体人群的血液Hsp90α 测量值,自身对比分析与血清CEA、NSE和CY211的一致性.结果:94例肺癌患者,Hsp90α、CEA、NSE和CY211阳性率分别为42.6%、29.8%、21.3%和38.3%;CEA、NSE和CY211联合诊断阳性率46.8%;Hsp90α、CEA、NSE和CY211联合诊断阳性率68.1%;Hsp90α、CEA、NSE和CY211血清含量分别为(110±116) ng/ml(14~551 ng/ml,中位数64 ng/ml)、(19±23) ng/ml(1.3~81 ng/ml,中位数13 ng/ml)、(17±30) ng/ml(1.6~159 ng/ml,中位数6.9 ng/ml)和(12±19) ng/ml(1.1~102 ng/ml,中位数4.2 ng/ml).采用Kappa方法比较Hsp90α 和CEA、NSE及CY211的一致性,Kappa值分别为0.5、0.58和0.6,按照0.75标准,一致性不满意.结论:热休克蛋白Hsp90α 在肺癌患者血清中有较高的表达,阳性率高于CEA、NSE和CY211,和其无明确相关性,联合诊断可进一步提高灵敏度,值得深入研究.     

肺癌患者血清中癌胚抗原和细胞角蛋白片段19的检测与临床价值

目的 探讨血清癌胚抗原(CEA)和细胞角蛋白片段19( CYFRA21-1)检测对肺癌的诊断价值.方法 采用电化学发光法对102例肺癌患者、78例肺部良性病患者和104例健康人血清进行分析,检测CEA和CYFRA21-1水平.结果 肺癌组患者血清中CEA水平及阳性率[(25.77±15.34) ng/ml,47.1％]均明显高于肺良性病组[(4.67±2.21)ml,7.7％]和健康组[(3.98±3.00)ng/ml,3.8％],差异有统计学意义(P＜0.05).肺癌组患者血清中CYFRA21-1水平及阳性率[(14.08±8.34)ng/ml,62.7％]也同样高于肺良性病组[(3.27±2.87)ml,7.7％]和健康组[(2.69±2.02)ng/ml,3.8％],差异有统计学意义(P＜0.05),而良性病组和健康组间差异无统计学意义(P＞0.05).肺癌组患者经TNM分期后,随着肿瘤分期级别的升高,CEA水平[Ⅱ～Ⅳ期分别为(17.78±8.71)ng/ml、(25.84±7.34)ng/ml和(34.85±6.99) ng/ml]和CYFRA21-1水平[Ⅱ～Ⅳ期分别为(10.05±6.76)ng/ml、(15.93±6.66) ng/ml和(22.78±4.12)ng/ml]也升高.CEA和CYFRA21-1联合检测后,灵敏度增高,特异度降低,准确率基本不变.结论 CEA和CYFRA21-1对肺癌有一定的辅助诊断价值,并且对肺癌的分期有一定诊断价值,联合检测可提高对肺癌的阳性诊断.     

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.     

老年胃癌患者胃液中肿瘤标志物联合检测的临床意义

目的探讨老年患者胃液中TNFα、CA199和CA724联合检测对胃癌的诊断意义。方法采用放射免疫技术测定42例胃癌、30例浅表性胃炎和31例胃癌前病变的老年患者胃液中TNFα、CA199和CA724浓度。结果胃癌组胃液中TNFα、CA199和CA724的浓度分别显著高于浅表性胃炎组、胃癌前病变组(8.96±2.10)ng/mlvs(5.66±1.65)ng/ml,(4.92±1.24)ng/ml;(59.47±10.58)U/mlvs(38.73±9.23)U/ml,(36.89±11.23)U/ml;(37.08±7.06)U/mlvs(25.42±7.26)U/ml,(23.87±6.31)U/ml;P均<0.001);胃癌组联合检测胃液中TNFα、CA199和CA724,其敏感度、特异度分别为86.9%,83.3%,均分别高于3项标志物的敏感度和特异度(TNFα69.1%,75.4%;CA19965.7%,67.2%;CA72466.7%,70.5%)。结论联合检测胃液中TNFα、CA199和CA724等肿瘤标志物能有助于提高老年患者胃癌的诊断准确率。     

胃液CEA和CA50检测在胃癌诊断及术后复发预测中的价值

探讨胃液癌胚抗原(CEA)、糖链多肽抗原50(CA50)在胃癌诊断和术后复发筛查中的价值。应用免疫放射法检测了62例胃癌患者手术前后胃液中CEA、CA50的变化并进行了随访观察。手术后32例肿瘤复发组2项标志物分别为CEA(65.81±18.6)ng/mL,CA50(90.13±21.43)U/mL,明显高于30例未复发组,两组比较,差异有统计学意义,P=0.001。联合检测可将敏感性提高至81.25%,并可在胃癌术后亚临床期检出复发。初步研究结果提示,胃液CEA、CA50联合检测对胃癌诊断和术后复发筛查有重要意义。     

胃癌与胃溃疡病人血液及胃液中癌胚抗原（CEA）的定量研究

应用放免的方法对２１７例肠型胃癌，２５例胃溃疡病人分别于手术前，后测定胃液及血液中的ＣＥＡ含量。结果表明：（１）手术前，后胃液中的ＣＥＡ均高于血液中的ＣＥＡ含量（Ｐ＜０．０１）。（２）胃癌组手术前血液及胃液中ＣＥＡ含量分别高于胃溃疡组手术前血液及胃液中ＣＥＡ含量（Ｐ＜０．０１）。（３）在胃癌组中手术前血液ＣＥＡ阳性率为３３．３３％，而胃液ＣＥＡ阳性率为６３．６３％（Ｐ＜０．０１）。因此，对胃癌病人     

Changing patterns of Serum CEA and CA199 for Evaluating the Response to First-line Chemotherapy in Patients with Advanced Gastric Adenocarcinoma

Background: This study was designed to investigate the value of CEA and CA199 in predicting the treatmentresponse to palliative chemotherapy for advanced gastric cancer. Materials and Methods: We studied 189 patientswith advanced gastric cancer who received first-line chemotherapy, measured the serum CEA and CA199 levels,used RECIST1.1 as the gold standard and analyzed the value of CEA and CA199 levels changes in predictingthe treatment efficacy of chemotherapy. Results: Among the 189 patients, 80 and 94 cases had increases ofbaseline CEA (≥5 ng/ml) and CA199 levels (≥ 27U/ml), respectively. After two cycles of chemotherapy, 42.9%patients showed partial remission, 33.3% stable disease, and 23.8% progressive disease. The area under theROC curve (AUC) for CEA and CA199 reduction in predicting effective chemotherapy were 0.828 (95%CI0.740-0.916) and 0.897 (95%CI 0.832-0.961). The AUCs for CEA and CA199 increase in predicting progressionafter chemotherapy were 0.923 (95%CI 0.865-0.980) and 0.896 (95%CI 0.834-0.959), respectively. Patients whoexhibited a CEA decline ≥24% and a CA199 decline ≥29% had significantly longer PFS (log rank p=0.001,p<0.001). With the exception of patients who presented with abnormal levels after chemotherapy, changes of CEAand CA199 levels had limited value for evaluating the chemotherapy efficacy in patients with normal baselinetumor markers. Conclusions: Changes in serum CEA and CA199 levels can accurately predict the efficacy offirst-line chemotherapy in advanced gastric cancer. Patients with levels decreasing beyond the optimal criticalvalues after chemotherapy have longer PFS.     

Evaluation of serum CEA and CA19-9 levels as prognostic factors in patients with gastric cancer

Background. This clinicopathological study evaluated the utility of serum carcinoembryonic antigen (CEA) and carbohydrate antigen (CA) 19-9 as predictors of locoregional recurrence and long-term disease-free survival in patients with gastric cancer. Methods. During the period January 1989 to December 1994, 485 patients with primary gastric cancer were evaluated. Gastrectomies were performed in 434 patients. Prognostic factors were analyzed by the Kaplan-Meier method and multivariate analysis, using Cox regression. Results. Elevated serum CEA and CA19-9 levels were observed in 92 of the 485 patients (19.0%), and in 95 of the 435 patients (21.8%), respectively, and both markers were elevated in 29 of these 435 patients (6.7%). Elevated serum CEA and CA19-9 levels correlated well with lymph node metastasis, lymphatic invasion, vessel invasion, stage grouping, depth of invasion, and curability. Patients with elevated serum CEA levels were at significantly higher risk of having all recurrence factors than were those with normal serum CEA levels. Patients with elevated serum CA19-9 levels were at significantly higher risk of having peritoneal metastases and distant metastases than were those with normal serum CA19-9 levels. A significant difference in the cumulative survival curves of patients was demonstrated between those with elevated and those with normal serum CEA or CA19-9 levels, even for patients at the same disease stage (stage III). Patients with elevated levels of both markers had a significantly worse prognosis than patients in whom the levels of both markers were normal. In patients who underwent gastrectomy, elevated serum CEA levels either preoperatively or within 3 weeks after gastrectomy were associated with significantly worse prognosis than were normal levels. When the cutoff level of serum CEA was increased to 10 ng/ml, serum CEA, age, lymph node metastasis, and surgical stage grouping were selected as independent prognostic factors by multivariate analysis of 14 prognostic factors, using Cox regression. Conclusion. Serum CEA and CA19-9 levels provide additional prognostic information in patients with primary gastric cancer. In particular, an elevated serum CEA level provides additional prognostic information and is a useful indicator of curability in patients who undergo gastrectomy. Serum CEA level is an independent prognostic factor in patients with primary gastric cancer. Received: June 20, 2000 / Accepted: November 14, 2000     

Carcinoembryonic antigen and immunoglobin in gastric juice in the diagnosis of gastric cancer

Levels of carcinoembryonic antigen (CEA) and immunoglobin (Ig) in gastric juice of 93 patients with benign and malignant gastric diseases were assayed. The CEA level in gastric cancer patients (55.73 +/- 38.26 ng/ml) was obviously higher than that in peptic ulcer (15.51 +/- 12.09 ng/ml) and superficial gastritis (26.96 +/- 20.17 ng/ml). But no significant difference was found between the CEA levels of gastric cancer and chronic atrophic gastritis (48.66 +/- 31.87 ng/ml). Also, elevated CEA was closely correlated to intestinal metaplasia. The positive rate of Ig was significantly higher in gastric cancer (IgG greater than or equal to 185 ug/ml, IgA greater than or equal to 100 ug/ml) than in benign gastric diseases. Although no correlation is present in the CEA and Ig in gastric juice, the combination of these two methods could improve the diagnostic accuracy. We believe that the two assays are worthy for screening gastric cancer from patients with high risk, and for identifying precancerous lesions.     

癌胚抗原及铁蛋白联合测定在胃癌诊断中的价值

本文用放射免疫法测定58例胃癌、43例胃起性疾病、24例食管癌患者及158例健康成人血清与胃液中的CEA及Ft。结果表明,胃癌患者血清CEA水平高于正常对照组,P<0.01,但与胃良性疾病及食管癌纽问的差异不明显;胃癌患者血清Ft水平低于各对照组,P<0.01;胃癌患者的胃液CEA及Ft水平均高于各对照组,P<0.01。54例胃癌患者联合测定了血清CEA、胃液CEA及胃液Ft,胃癌胃液中的CEA、Ft双项阳性28例,敏感性为51.85％、特异性为99.04％、阳性诊断价值为96.55％。由此提示,胃液CEA及Ft联合测定有助于胃癌的诊断。     

The prognostic significance of gastric juice CA 19-9 and CEA levels in gastric carcinoma patients

AIM: The usefulness of gastric juice CA 19-9 and carcinoembryonic antigen (CEA) levels in the diagnosis of gastric carcinoma is controversial. There is only one study related with their prognostic value. In this study the clinical significance of gastric juice CA 19-9 and CEA levels in patients with gastric carcinoma was investigated. METHODS: Preoperative serum and gastric juice CA 19-9 and CEA concentrations were measured in 139 patients with gastric carcinoma, 54 patients with benign gastroduodenal disease and as the 'healthy' control group 46 patients with inguinal hernia and with no other pathology. RESULTS: In all groups the mean gastric juice levels of CA 19-9 and CEA were significantly higher than the serum levels. The gastric juice CA 19-9 levels were not different between groups. Gastric juice CEA levels of the gastric carcinoma group were significantly higher than those of the benign gastroduodenal disease group (P=0.007) and had a tendency to increase when compared to those of the control group (P=0.064) whereas there was no significant difference between the benign gastroduodenal disease and the control group. The cut-off values of gastric juice CA 19-9 and CEA were 440U/ml and 320ng/ml and the positivity ratios of these markers in gastric carcinoma patients were 16.5 and 27.3%, respectively. There was no significant relationship between the histopathological features and the gastric juice CA 19-9 or CEA positivities. Neither univariate analysis nor the multivariate Cox proportional hazards model analysis showed prognostic value for gastric juice CA 19-9 and CEA positivities. CONCLUSIONS: The gastric juice CA 19-9 and CEA levels have no diagnostic and prognostic significance in gastric carcinoma patients.     

细胞角蛋白18片段检测在胃癌诊断中的临床意义

目的评估细胞角蛋白18片段(CK18-3A9）在胃癌诊断中的临床意义。方法采用化学发光法检测236例胃癌(胃腺癌186例、胃印戒细胞癌50例）、慢性胃炎、胃溃疡患者150例和165名健康对照者血清CK18-3A9水平,并用电化学发光免疫分析法测定上述患者血清中CEA、CA199、CA72-4标志物水平。将CK18-3A9与传统的胃癌标志物进行比较分析。结果单项CK18-3A9检测胃癌的敏感度为36.02%、特异性为97.5%,(CEA+CA199+CA72-4）检测胃癌的敏感度为33.47%、特异性为97.5%;CK18-3A9联合(CEA+CA199+CA72-4）检测胃癌的敏感度可提高至55.08%,特异性可保持在97.5%。联合CK18-3A9与(CEA+ CA199+CA72-4）检测胃癌的敏感度高于单项CK18-3A9以及(CEA+CA199+CA72-4）检测,差异均有统计学意义(P<0.05);但特异性没有明显差异。结论 CK18-3A9片段可作为一种新的胃癌标志物。CK18-3A9检测联合传统的标志物CEA、CA199、CA724可显著提高诊断的敏感度,并保持较高的特异性。     

Alpha-fetoprotein (AFP) Elevation Gastric Adenocarcinoma and Importance of AFP Change in Tumor Response Evaluation

Background: Elevated serum alpha-fetoprotein (AFP) levels in adults are considered abnormal. This parameteris used mostly in the diagnosis and follow-up of hepatocellular carcinomas and yolk sac tumors. Among the otherrare tumors accompanied with elevated serum AFP levels, gastric cancer is the most common. In this study, weevaluated the follow-up and comparison of the treatment and marker response of patients with metastatic gastriccancer who had elevated serum AFP levels. Materials and Methods: We performed a retrospective study, includingall consecutive patients with advanced gastric cancer, who received systemic chemotherapy with elevated AFPlevel. Results: Seventeen metastatic gastric cancer patients with elevated AFP levels at the time of diagnosis wereevaluated. Fourteen (82.4%) were males and three (17.6%) were females. The primary tumor localization wasthe gastric body in 8 (76.4%), cardia in 7 (41.2%), and antrum in 2 (11.8%). Hepatic metastasis was observed in13 (76.4%) at the time of diagnosis. When the relationship of AFP levels and carcinoembryonic antigen (CEA)response of the patients with their radiologic responses was evaluated, it was found that the radiologic responsewas compatible with AFP response in 16 (94.1%) patients and with CEA response in 12 (70.6%); however, in 5(29.4%) patients no accordance was observed between radiological and CEA responses. Conclusions: Followupof AFP levels in metastatic gastric cancer patients with elevated AFP levels may allow prediction of earlytreatment response and could be more useful than the CEA marker for follow-up in response evaluation.     

胃癌患者血清可溶性E-选择素检测的临床意义

目的:探讨血清可溶性E-选择素（sE-selectin ）检测在胃癌诊治中的临床意义。方法:采用ELISA 法检测200 例胃癌患者、45例胃良性疾病患者和40例健康体检者血清中的可溶性E-选择素水平,比较其中140 例胃癌患者手术前后血清可溶性E-选择素水平的变化,并对胃癌患者血清可溶性E-选择素、CEA 、CA199 和CA724 的阳性率进行比较。结果:胃癌组血清可溶性E-选择素表达水平为69.12± 18.19ng/mL,与正常对照组（15.85± 5.27ng/mL）及良性疾病组（19.47±7.88ng/mL）比较,差异性具有统计学意义（P<0.01）。 血清可溶性E-选择素阳性表达与肿瘤部位及组织学分型无明显相关（P>0.05）,但与病理分期及肝转移呈正相关（P<0.05,P<0.01）。胃癌患者手术后血清可溶性E-选择素水平明显下降。胃癌患者血清可溶性E-选择素阳性率远远高于其他消化道肿瘤标物（CEA 、CA199、CA724）,P<0.01。结论:可溶性E-选择素有可能成为胃癌早期辅助诊断、预测复发转移及评估预后有价值的肿瘤标记物。      

CA125和CEA在胃癌中的表达及与临床病理特征的相关性

目的探讨糖链抗原125(CA125)、癌胚抗原(CEA)在胃癌中的表达及与临床病理特征的相关性。方法2018年1月到2020年6月选择在平煤神马医疗集团总医院诊治的胃癌患者288例作为胃癌组,同期选择体检的健康人群288例作为正常组,检测2组入选者血清CA125与CEA含量,判断阳性率并对相关性、危险因素进行分析。结果胃癌组的血清CA125、CEA水平都高于正常组,对比差异有统计学意义(P<0.05)。胃癌组的CA125、CEA阳性率分别为34.7%、38.9%,正常组为4.2%和6.9%,胃癌组都显著高于正常组(P<0.05)。在胃癌组中,Pearson相关分析显示临床分期、肿瘤最大直径、组织学分化、淋巴结转移与血清CA125、CEA表达水平存在相关性(P<0.05)。多因素Cox比例风险模型结果分析显示CA125和CEA都是导致胃癌发生的主要独立危险因素(P<0.05)。结论CA125和CEA在胃癌中呈现高表达状况,与患者的临床病理特征显著相关,也是导致胃癌发生的主要危险因素。