胃癌组织雌激素受体定位及其生物学意义

采用免疫组化ＡＢＣ法对８９例胃癌、１０例癌旁和１１例胃溃疡旁粘膜组织进行雌激素受体（ＥＲ）检测。结果发现：１．癌旁和溃疡旁粘膜上皮均为ＥＲ阴性，胃癌组织ＥＲ阳性率达３３．７％，其ＥＲ颗粒在细胞内分布呈核型、浆型和核浆型；２．胃癌ＢｏｒｒｍａｎｎＩＶ型、低分化癌和伴淋巴结转移的胃癌，其ＥＲ阳性率明显高于其它类型（Ｐ＜０．０５，或Ｐ＜０．０１）。研究表明，ＥＲ阳性表达的胃癌与其恶性生物学行为有正相关性。     

胃癌组织雌激素受体定位及其生物学意义

采用免疫组化ＡＢＣ法对８９例胃癌、１０例癌旁和１１例胃溃疡旁粘膜组织进行雌激素素受体（ＥＲ）检测。结果发现：１．癌裤和溃疡粘膜上皮均为ＥＲ阴性，胃癌组织ＥＲ阳性率达３３．７％，其ＥＲ颗粒在细胞内分布呈核型。浆型和核浆型；２．胃癌ＢｏｒｒｍａｎｎＩＶ型、低分化癌和伴淋巴结转移的胃癌，其ＥＲ阳性率明显高于其它类型（Ｐ〈０．０５，或Ｐ〈０．０１）。研究表明，ＥＲ阳性表达的胃癌与其恶笥生物学行为有正相关性     

联合检测血清CyFRA21—1和CEA对非小细胞肺癌临床价值探讨

目的探讨血清ＣｙＦＲＡ２１１和癌胚抗原（ＣＥＡ）对非小细胞肺癌（ＮＳＣＬＣ）的临床价值。方法采用免疫放射分析方法对３０例经临床和病理证实的ＮＳＣＬＣ患者和２０例正常人进行血清ＣｙＦＲＡ２１１和ＣＥＡ联合测定。结果血清ＣｙＦＲＡ２１１值在ＮＳＣＬＣ组的阳性率为４８％，鳞癌组阳性率为６２５％，分别明显高于正常组和腺癌组（Ｐ＜００１）；且与分期有关，Ⅱ期阳性率为３３３％，Ⅲ期为６６７％，Ⅳ期为７２％。血清ＣＥＡ值在ＮＳＣＬＣ组阳性率为４０％，腺癌中阳性率为５０％，分别明显高于正常组和其他类型（Ｐ＜００１）。联合检测ＣｙＦＲＡ２１１和ＣＥＡ可将整个ＮＳＣＬＣ组阳性率提高到６３２％。结论两者联合检测对ＮＳＣＬＣ的诊断、分型、分期和预后判断有一定的临床意义。     

监测血清酸溶性蛋白和癌胚抗原对消化道恶性肿瘤的临床价值研究

本文用考马斯亮蓝法和ＥＬＩＳＡ双抗体夹心法，检测了３０例正常健康人和６９例消化道恶性肿瘤治疗前后血清ＡＳＰ和ＣＥＡ值的动态变化。治疗前明显高于正常对照（Ｐ＜０．０１）。３４例癌症手术切除后，ＡＳＰ和ＣＥＡ值降低，复发、转移时，再次升高。但在应激状态（手术、炎症、创伤、等）时，血清ＡＳＰ值暂时升高，二周后下降接近正常；治疗前ＡＳＰ和ＣＥＡ值升高，治疗后无变化或继续升高的有效率不如前两者（Ｐ＜０．０１）；ＡＳＰ和ＣＥＡ阳性者治疗效果较阴性者差。病变有复发、伴远处转移者较无复发、无远处转移者阳性率高；ＡＳＰ和ＣＥＡ阴性有效率为９２．８６％和９６．５５％；阳性者仅有５３．８５％和６０．０％，两者相比有显著性差异（Ｐ＜０．０１）。结果显示动态观察血清ＡＳＰ和ＣＥＡ值，对判断消化道恶性肿瘤疗效、复发、病程转归和预后有重要价值。     

血清AFP,CEA,SF检测对肝癌的诊断意义

作者检测４９例转移性肝癌、１０７例原发性肝癌和４６例健康人血清的ＡＦＰ、ＣＥＡ、ＳＦ。结果：转移性肝癌和原发性肝癌的ＡＦＰ阳性率为２．０％和４８．６％（Ｐ＜０．０１）、ＣＥＡ阳性率为８３．７％和２６．２％（Ｐ＜０．０１）、ＳＦ阳性率为７１．４％和７３．８％（Ｐ＞０．０５），原发癌为腺癌和非腺癌的转移性肝癌，其ＣＥＡ阳性率分别为９６．９％和５８．８％（Ｐ＜０．０１）。提示ＡＦＰ和ＣＥＡ对转移性肝癌有诊断意义，尤其对原发癌为腺癌的转移性肝癌，ＡＦＰ和ＳＦ有助于原发性肝癌的诊断。     

CD3AK对晚期肝癌疗效初步观察

目的观察晚期肝细胞癌（ＨＣＣ）患者采用抗ＣＤ３抗体激活的杀伤细胞（ＣＤ３ＡＫ）治疗的效果。方法５８例晚期ＨＣＣ患者分为三组，Ａ组［ＣＤ３ＡＫ＋肝动脉化学栓塞（ＴＡＣＥ）］２２例，Ｂ组（ＣＤ３ＡＫ）１５例，Ｃ组（ＴＡＣＥ）２１例。结果部分缓解率（ＰＲ）Ａ，Ｂ，Ｃ组分别为４５．５％、１３．３％（Ｐ＜０．０５）和１４．３％（Ｐ＜０．０５），中位生存期分别为１１．３月、４．９月（Ｐ＜０．０１）和４．１月（Ｐ＜０．０１），半年和１年生存率分别依次为６８．２％，３３．３％（Ｐ＜０．０５）和２３．８％以及４０．９％、６．６％（Ｐ＜０．０５）和９．５％（Ｐ＜０．０５）。结论本组结果表明ＣＤ３ＡＫ＋ＴＡＣＥ治疗晚期ＨＣＣ疗效最佳     

表皮生长因子及其受体在胃癌患者中的表达

采用放射免疫法测定２６例胃癌病人血清、尿液ＥＧＦ水平，同时采用免疫组化ＳＡＢＣ法检测胃粘膜组织切片中ＥＧＦＲ染色的阳性率，并与正常对照进行比较分析。结果表明：胃癌患者血清和尿ＥＧＦ水平均显著高于正常对照（３．７２±１．８３μｇ／Ｌ与１．７７±０．６０μｇ／Ｌ，Ｐ＜０．０１；１８．４４±１７．８８ｎｇ／ｍｇ与５．１９±６．３７ｎｇ／ｍｇ，Ｐ＜０．０１），胃粘膜组织切片ＥＧＦＲ染色阳性率也明显高于正常对照（７３％与１１％，Ｐ＜０．０１）。胃癌病人中，ＥＧＦＲ染色阳性者血清ＥＧＦ水平显著高于ＥＧＦＲ阴性者（Ｐ＜０．０５），但两者尿ＥＧＦ水平无显著性差异。胃癌患者血清、尿ＥＧＦ水平与胃癌大小、分化程度及淋巴结转移无显著性相关。     

血清糖链抗原50对胃癌的诊断价值

观察５４例正常人，６２例胃癌及３２例胃良性疾病病人血清糖链抗原５０（ＣＡ５０）含量。结果表明：胃癌病人血清ＣＡ５０含量显著高于正常人和胃良性疾病病人（Ｐ均＜０．００１）；且胃癌早期即有明显增高，晚期增高更为显著。行根治术后其血清含量较术前显著降低而接近正常（Ｐ＜０．０１）；术后复发者又再增高，行姑息术或化疗后较治疗前略降低。若以血清ＣＡ５０９ｋＵ／Ｌ为阳性诊断界值，对胃癌诊断的敏感性为８２．３％，特异性为９３．８％，阳性预计值为９２．７％，胃良性疾病的假阳性率为６．３％，正常人假阳性率为３．７％。癌性腹水病人血清和腹水ＣＡ５０含量均显著高于良性腹水病人（Ｐ均＜０．００１）。提示血清和腹水ＣＡ５０含量检测在胃癌和癌性腹水的诊断，尤其是胃癌的早期诊断和治疗后监测中有一定临床实用价值。     

妊娠性滋养细胞肿瘤P185和雌孕激素受体的表达及意义

以ＡＢＣ法检测了４０例妊娠性滋养细胞肿瘤石蜡标本Ｐ１８５及ＥＲ、ＰＲ的表达。其中绒毛膜癌２４例。侵蚀性葡萄胎１６例，Ｐ１８５阳性率为４０％，ＥＲ、ＰＲ阳性率分别为４５％，７５％，Ｐ１８５在侵蚀性葡萄胎中的阳性率均明显高于绒瘤（Ｐ＜０．０１）。病程小于１年者，Ｐ１８５的阳性率高于病程大于１年者（Ｐ＜０．０５），ＥＲ、ＰＲ阳性者，Ｐ１８５的阳性率分别高于其阴性者（Ｐ＜０．０５、Ｐ＜０．０１），Ｐ１８５阳性与阴性的患者，分别有８１．３％、５０％的患者于３疗程内血ｈＣＧ转阴（Ｐ＜０．０５）。资料提示：Ｐ１８５倾向于在滋养细胞肿瘤恶性转化的早期表达，Ｐ１８Ｓ阳性者对化疗较为敏感。     

测定胃癌术后患者血清CEA,CA50及Cu／Zn比值的临床意义

作者测定了３０例胃癌术后无瘤患者及３４例胃癌术后复发或转移患者血清中的ＣＥＡ、ＣＡ_（５０）及Ｃｕ／Ｚｎ比值，并对２０例术后无癌残留患者进行随访观察。结果：术后复发转移组的ＣＥＡＣＡ_（５０）及Ｃｕ／Ｚｎ比值均显著高于术后无瘤组（Ｐ＜０．０１）；术后复发转移组中ＣＡ_（５０）、ＣＥＡ及ＣＵ／Ｚｎ比值阳性率分别为５８．８％、４７．０％、４７．０％；术后随访组中，三种指标对胃癌术后转移总的阳性预测率为７５．０％（６／８）。揭示ＣＡ_（５０）、ＣＥＡ及Ｃｕ／Ｚｎ比值可用于胃癌术后患者复发及转移的监测。三者比较，ＣＡ_（５０）敏感性最高，而ＣＥＡ特异性最好。联合检测可提高阳性率。     

胃液癌胚抗原含量对胃癌的诊断意义

用放射免疫法测定145例胃病患者的胃液和血清癌胚抗原(CEA)。61例良性胃病的胃液和血清CEA含量,均数分别为47.81ng/ml和13.39ng/ml;84例胃癌的胃液和血清CEA含量,均数分别为1,291.62ng/ml和39.32ng/m1。84例中76例(91.7％)胃癌的胃液CEA显著增高,血清CEA水平在84例胃癌病人中仅有32例(38％)升高。结果表明,胃液中cEA测定的明显增值是胃癌辅助诊断的标准之一。     

Early and advanced gastric cancer during follow-up of apparently benign gastric ulcer: significance of the presence of epithelial dysplasia

One hundred and forty-four patients with apparently benign gastric ulcer were endoscopically followed up in order to evaluate the outcome of the lesion. Particular attention was given to: (a) detect possible delay in diagnosing gastric cancer; (b) ascertain the frequency of association with epithelial dysplasia; (c) establish the role of markers, such as serum pepsinogen group I (PGI), and gastric juice CEA in predicting gastric ulcer evolution. Endoscopic and bioptic check-ups were carried out during the first year at 3, 6 and 12 months after endoscopic healing of the ulcer, and then at every symptomatic recurrence. Ten patients (6.9%) were found to present histological evidence of malignancy (within 3 months in six cases, between 6 and 12 months in three cases, and after 41 months in the rest). Four cases were early gastric cancers, and six had shown dysplastic changes of the mucosa at the edge or scar of the ulcer. Serum PGI levels were not significantly different in gastric cancer patients, while gastric juice CEA levels were sharply increased compared to those of gastric ulcer patients: nine out of ten patients had values above normal range. These data suggest that: (a) there may be some delay in diagnosing gastric carcinoma, and gastric ulcer patients should be controlled routinely more than once; (b) the presence of dysplasia indicates the need for prolonged follow-up, because of the high risk of association with or evolution into gastric cancer, and because of the higher number of early gastric cancer detections that this protocol allows; (c) further support in monitoring patients "at risk" may be afforded by gastric juice CEA determination.     

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.     

胃癌患者血卟啉变化及其临床意义

采用光致发光荧光光谱技术,检测39例胃癌血与胃液中卟啉类含量,并与76例溃疡病,慢性胃炎等相对照.胃癌组血中锌卟啉与原卟啉较非癌组明显升高,特别是原卟啉达3倍以上,差别有极显著意义(P<0.01).其敏感度为64.1%,特异度为89.4%,准确性为88.5%.以原卟啉作为胃癌的血液标志物,用于溃疡良恶性鉴别,人群普查筛选早期发现胃癌或随访观察疗效,是一种简便可靠的方法,有重要参考价值.     

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。     

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 preoperative and postoperative carcinoembryonic antigen test in the diagnosis, staging, and prognosis of gastric cancer. Tumor Marker Committee, Japanese Foundation for Multidisciplinary Treatment of Cancer

Preoperative and postoperative carcinoembryonic antigen (CEA) levels were studied in 3,532 patients with Surgically treated gastric cancer in 52 institutions from 1980 to 1981. These patients had disease resectable with curative intent and were followed for a minimum of 5 years or until death. Among 2,749 Stage I cases, 33 had recurrence and proved to be histologically stage I. A pair matching case control study between these 33 cases and matched 33 stage I controls without recurrence proved that the preoperative CEA level was relatively higher in cases with recurrence (p = 0.079). In Stage II and III cases, an analysis of variance using a cut off level as a block factor was performed. Among 315 Stage II cases, preoperative CEA levels were significantly higher in cases with recurrence than in cases without recurrence. In 468 Stage III cases, no correlations between preoperative CEA levels and high risks of cancer recurrence were detected. In Stage I and Stage II cases, CEA levels significantly increased at the time of recurrence. In conclusion, preoperative high serum CEA levels might be considered one of the risk factors for recurrence of Stage I and II gastric cancers, and monitoring the postoperative CEA levels might be useful in early detection of recurrence.     

Clinical study on tissue polypeptide antigen (TPA) in gastric cancer

We evaluated whether assay of tissue polypeptide antigen (TPA) in the serum ia valuable for the determination of cancer stages compared to other tumor markers such as CEA, AFP, and ferritin. The study population consisted of 79 gastric cancer patients and 212 patients with benign gastroenteric disease. The percentage of positive cases for TPA (higher than 200u/l) was 41% in gastric cancer and 20% in active peptic ulcer. Serum TPA levels in well differentiated carcinoma and signet ring cell carcinoma were higher than that in other histological types. Serum TPA levels correlated well with the stage of the gastric cancer.     

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。     

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.