p27和Skp2在大肠癌中表达及临床病理关系研究

目的：研究大肠癌组织p27和Skp2蛋白表达，以及p27和Skp2表达与临床病理关系．探讨两者之间相关性。方法：采用免疫组织化学SP法检测30例大肠癌标本组织和18例正常大肠粘膜组织p27和Skp2蛋白表达。结果：p27在正常大肠粘膜组织中平均阳性率为55。2％，显著高于大肠癌组织（27。5％，P〈0．05）。p27表达与大肠癌分化程度，Dukes’分期及淋巴结转移呈显著性负相关（P〈0．05）。Skp2在大肠癌组织中平均阳性率为9．5％．显著高于正常大肠粘膜组织（1．8％，P〈0．05）。Skp2表达与大肠癌分化程度呈显著性负相关（P〈0．05），与患者年龄．性别．Dukes’分期及淋巴结转移无明显相关（P〉0．05）。大肠癌中p27与Skp2表达呈负相关（r=-0．806，P〈0．01）．结论：大肠癌中Skp2与p27降解有关，Skp2是大肠癌致癌基因，参与了大肠癌发生，可能成为大肠癌治疗新靶点.     

KAI1基因在186例大肠癌中的表达及意义

[目的]探讨大肠癌中KAI1基因蛋白表达与病理组织学特征及预后的关系。[方法]对186例存档大肠癌石蜡组织标本进行重新切片，KAI1免疫组化染色（S—P法）。将不同大肠癌组织学分型、分化程度、浸润深度及临床分期（Dukes＇）下染色结果进行比较。[结果]大肠癌不同组织学分型和分化程度下KAI1表达无显著性差异（P〉0．05）；而在肿瘤伴淋巴结转移组，KAI1阳性表达率低于无淋巴结转移组（20．6％vs．64．3％）；KAI1阳性率随Dukes＇分期依次减低，分别Dukes＇A阳性表达率为86.4％．Dukes＇B阳性表达率为54．8％，Dukes＇C阳性表达率为21．6％，有显著性差异（P〈0．05）。[结论]KAI1的阳性表达与大肠癌的进展及转移有关，对判断大肠癌预后有益。     

CEA,p53、Ki-67、GST-π在大肠癌组织表达及其相关性研究

[目的]探讨大肠癌中CEA、p53、Ki-67、GST-π的表达与临床病理分期之间的关系。[方法]回顾性分析2004年1月-2007年6月收治的63例大肠癌患者的临床、病理资料，对肿瘤石蜡标本采用免疫组化SP染色法检测CEA、p53、Ki-67、GST-π，分析其免疫组化特点及其与临床病理之间的关系。[结果]CEA、p53、Ki-67、GST-π在大肠癌切片中的阳性率依次为95.2％、55．6％、52．4％、82．5％。p53、Ki-67与肿瘤的Dukes’分期和淋巴结转移有关，在Dukes’C、D期的阳性表达率明显高于Dukes’A、B期患者。p53、Ki-67表达之间呈现明显的正相关：GST-π和p53两者的表达呈正相关。[结论]大肠癌CEA、p53、Ki-67、GST-π表达与其发生发展和浸润转移密切相关，联合检测对了解大肠癌的生物学行为和判断患者预后有一定的实用价值。     

大肠癌中NF—kB p65、VEGF表达的相关性研究

目的 检测细胞核因子kB(NF-kB)、VEGF在大肠癌组织中的表达并探讨其与大肠癌肿瘤血管生成关系。方法 应用免疫组织化学方法检测NF－kB p65及VEGF在52例大肠腺癌组织、21例大肠腺瘤及10例正常大肠组织中的表达情况，同时观察肿瘤内微血管密度（MVD）。结果 52例大肠腺癌中34例NF－kB p65阳性，阳性产物主要定位于肿瘤细胞胞浆、21例大肠腺瘤中10例NF－kB p65阳性。10例正常大肠组织中NF－kB p65无1例阳性表达，NF－kB p65表达与患者的性别、年龄、大肠癌组织学分型，淋巴结转移、Dukes‘分期无关；VEGF阳性表达率为61．5％；MVD在NF－kB p65阳性大肠癌中明显高于阴性者；NF－kB p65表达与VEGF、MVD表达呈显著正相关。结论 NF－kB p65是一个大肠癌相关的癌蛋白、NF－kB p65对VEGF可能有正向调节作用，并影响大肠癌血管生成。     

散发性结直肠癌、腺瘤组织中hMLH1和突变型p53表达

[目的]探讨hMLH1和p53基因在散发性结直肠癌发生机制中所起的作用。[方法]采用PV-6000二步法免疫组化检测技术对60例散发性结直肠癌，45例大肠腺瘤和26例正常大肠黏膜石蜡切片进行hMLH1和p53表达的检测。[结果]（1）60例散发性结直肠癌hMLH1蛋白阴性表达和p53蛋白阳性表达分别为11例（18．3％）和32例（53.3％），hMLH1蛋白阴性表达和p53蛋白阳性表达与患者年龄、肿瘤部位、组织学类型和分化程度密切相关（P〈0．05或P〈0．01），而与患者性别、肿瘤大体类型、肿块大小、浸润深度、淋巴结及远处转移与否和患者的Duke’s分期均无显著相关性（P〉0．05）。（2）大肠腺瘤患者p53蛋白阳性表达与患者腺瘤部位、组织学类型和不典型增生程度密切相关（P〈0．05），而与患者性别、年龄无显著相关性（P〉0．05）。（3）散发性结直肠癌中hMLH1蛋白阴性表达组p53蛋白阳性表达率（18.2％，2/11）低于阳性表达组（61．2％，30／49）（P〈O．05）。[结论]（1）大部分散发性结直肠癌是沿染色体不稳定途径发生，其中抑癌基因p53的突变起重要作用。同时，一定比例的散发性结直肠癌中存在错配修复基因的缺陷，并具有相对特殊的临床病理特征。（2）大肠腺瘤组织中有一定比例的hMLH1蛋白阴性表达和p53蛋白阳性表达，提示hMLH1和p53基因的突变可能是散发性结直肠癌发生的早期事件之一。     

大肠癌细胞体外培养药敏试验与临床特征关系探讨

目的探讨大肠癌细胞体外培养药敏试验与临床特征的关系。方法采用MTT法体外检测54例大肠癌患者癌细胞对9种常用化疗药物的敏感性,采用免疫组织化学方法检测大肠癌组织中PCNA的表达,统计分析大肠癌药物敏感性与患者性别、年龄、Dukes分期及PCNA的表达之间的关系。结果5-Fu的敏感率最高,达85.2%,其后依次为DDP(70.4%)、VP16(55.6%)、MTX(55.6%)、MTZ(48.1%)、VCR(48.1%)、MMC(44.4%)、EPI(33.3%)、ADM(22.2%);Dukes分期与药物的敏感性无关;60岁以下者对5-Fu的敏感率(100.0%)显著高于60岁以上者(73.3%),P<0.05;PCNA低表达者对EPI的敏感率(50.0%)显著高于PCNA高表达者(15.4%),P<0.05;而PCNA低表达者对MTZ的敏感率(21.4%)显著低于PCNA高表达者(76.9%,)P<0.01;男性患者对VP16和VCR的敏感率(分别为78.6%和64.3%)都显著高于女性(均30.8%),P<0.05;其它药物与临床特征无关。结论5-Fu可作为大肠癌化疗的临床首选的药物,一些临床特征也可作为某些药物选择的参考依据。     

大肠小扁平腺瘤内镜和组织学特征及p53、p21表达研究

[目的]探讨大肠小扁平腺瘤的形态学特征及p53、p21表达的生物学意义。[方法]①用电子结肠镜及光学显微镜观察50例大肠小扁平腺瘤形态学特征。②用免疫组化二步法检测50例小扁平腺瘤及对照组26例大肠癌、15例正常人大肠黏膜中p53、p21表达率。[结果]①小扁平腺瘤发生于大肠任何部位．其发病率依次以横结肠、乙状结肠、直肠为多见；肠镜下见病灶呈圆形或椭圆形，扁平状，基底宽，体积〈1cm。②光镜下小扁平腺瘤呈管状腺瘤样图像，上皮具有不同程度的异型增生。⑧小扁平腺瘤中p53、p21的表达率分别为58％（29／50）、56％（28／50）。随着小扁平腺瘤异型增生程度的增高．p53、p21的表达率也逐渐升高（P〈0．05）。p53、p21在正常肠黏膜、小扁平腺瘤及大肠癌组中阳性表达率均逐渐升高，三组问差异有显著性（P〈0．05）。[结论]大肠小扁平腺瘤有其独特的形态学特征，p53、p21的表达与大肠小扁平腺瘤的癌变发生发展有密切关系。     

MGMT在结直肠癌中表达的临床病理意义

目的：探讨大肠癌MGMT表达的临床病理意义。方法：采用免疫组织化学法检测139例大肠癌组织及48例正常大肠组织巾的MGMT表达，分析其与临床病理参数的相关性。结果：MGMT在大肠癌组织中的阳性表达率为75．5％（105／139），明显高于正常大肠组织的12．5％（6／48）（P=0．000）；大肠癌组织中，MGMT的阳性表达率在浸润达浆膜组为82．0％（82／100），明显高于未达浆膜组的58．9％（23／39）（P=0．005）；在低分化组为33．3％（9／27），明显低于高分化组和中分化组的78．1％（32／41）和90．0％（64／71）（P=0．000）；但与患者性别、年龄、肿瘤发生部位、淋巴转移及Dukes分期均无明显相关性（P均〉0．05）。结论：监控MGMT表达可有助于大肠癌的诊断和预后判断。     

大肠癌PKC-α、CyclinD1和Cdk4的表达与临床病理学特征的关系

目的：探讨大肠癌PKC-α，CyclinD1和Cdk4的表达与临床病理学特征的关系。方法：应用免疫组织化学sP法对PKC-α，CyclinD1和Cdk4的表达进行检测。结果：PKC-α在大肠癌组织中阳性表达率31／47（66．0％）与大肠正常组织3／15（20．0％）及腺瘤10／21（47．6％）对比有显著性差异（P〈0．05），与大肠癌分化程度，Dukes分期，淋巴结转移及CEA水平明显相关（P〈0．05）。CyclinD1和Cdk4在大肠癌中阳性表达率分别为26／47（55．5％），28／47（59．6％），与正常组织中表达2／15（13．3％），1／15（6．70％）及腺瘤组织中表达8／21（38．1％），9／21（42．9％）相比呈递增趋势（P〈0．05）。大肠癌中CyclinD1阳性表达与肿瘤分化程度，Dukes分期，淋巴结转移呈正相关关系（P〈0．05），而与CEA水平关系不大（P〉0．05）；Cdk4阳性表达则与分化程度，Dukes分期有关（P〈0．05），与淋巴结转移及CEA水平关系不密切（P〉0．05）。结论：PKC-α，Cy-clinD1和Cdk4的高表达与大肠癌分化程度，Dukes分期呈明显相关，对判断大肠肿瘤恶性程度具有一定的临床意义。     

抑癌基因p53在大肠癌中的表达及其意义

用免疫组织化学方法检测55例大肠癌中抑癌基因p53蛋白的过度表达，以探讨大肠癌的发生与组织学的类型及分化程度的关系。结果显示：p53蛋白的过度表达在大肠癌中为53．8％，而在正常及良性肿瘤中为阴性。按Turbull氏分期，不同分期大肠癌中p53蛋白过度表达阳性率不同，早期癌（Ⅰ－Ⅱ）中为32．1％（9／28）；晚期癌（Ⅲ－Ⅳ）中为48．1％（13／27），差异明显（P＜0．015），p53蛋白过度表达在不同组织类型中阳性率不同，粘液腺癌中阳性率（41．6％）明显低于管状腺癌（66．6％）和乳头状腺癌（53．3％）的阳性率。其粘液腺癌与管状腺癌的差别较显著（P＜0．05）。p53蛋白的过度表达在不同分化程度的大肠癌中阳性率不同，高分化癌中为37．5％，而低分化癌中为75．4％，差异显著（P＜0．05）。提示：p53蛋白过度表达可能发生于大肠癌病理过程的较晚阶段，作为大肠癌的预后指标可能有参考价值。     

Implications of CEA and p53 overexpression in the poor prognosis of colorectal cancer

Colorectal cancer (CRC) is one of the most frequent and aggressive types of cancer. Several clinicopathologic features have been studied to identify the prognostic factors that can provide information concerning the favorable or the poor outcome of colorectal cancer. In the present study, the relationship between serum CEA, p53 expression, and DNA index to the different clinicopathological characteristics of colorectal cancer patients was sought. Fifty patients with CRC were included in this study. p53 protein was detected immunohistochemically using specific monoclonal antibodies. Samples were investigated for DNA index using flow cytometry. In addition, the serum CEA was determined using ELISA. The results showed that 27/50 (54%) were positive for p53. Concerning CEA reactivity, it was found that 35/50 (70%) were reactive for CEA. These results indicate that CEA is more sensitive than p53 to detect colorectal cancer. There was a statistically significant difference between the recurrent and nonrecurrent groups in the CRC Duke's stages, survival time, serum CEA (p = 0.001, 0.016, < 0.001, respectively). Kaplan-Meier method and log-rank test showed that the mean survival time for cases positive for both p53 and CEA is significantly different from cases positive for CEA only, positive for p53 only, and negative for both p53 and CEA (p = 0.0002). Survival time was statistically significant with respect to sex, p53, CEA, and Duke's stages (p = 0.006, 0.024, 0.001, 0.017, respectively). Cox regression model showed that the prognosis of colorectal cancer is influenced by sex, p53, CEA reactivity, and CRC Duke's stages (p = 0.014, 0.006, 0.019, 0.014, respectively). In conclusion, the use of more than one tumor marker may successfully aid in the prediction of colorectal cancer prognosis.     

p53 overexpression as a prognostic factor in patients with Dukes B colorectal adenocarcinoma

To investigate the relationship of p53 overexpression with clinicopathological factors and prognosis, we examined p53 expression in 257 colorectal adenocarcinomas by immunohistochemistry using monoclonal antibody DO-1. Nuclear p53 staining was detected in 113 tumors. p53 overexpression was increased in DNA non-diploid tumors (p=0.004) and in the tumors with higher proliferative activity (p=0.02). Overexpression of p53 predicted unfavorable prognosis in patients with Dukes B tumors in both univariate (p=0.02) and multivariate analyses including DNA ploidy (p=0.04). No correlation was found between p53 expression and patient sex and age, tumor site, stage, differentiation or growth pattern. Our results indicate that p53 overexpression detected by antibody DO-I might be a useful tool in optimizing care of patients with Dukes B tumors.     

结直肠癌患者外周血CK19 mRNA检测的意义

目的:检测结直肠癌患者外周血中上皮性骨架蛋白CK19 mRNA,分析比较其与不同临床病理指标之间的关系,探讨其对临床术后治疗的指导意义。方法:应用RT-PCR方法,选择特异性CK19 mRNA引物,避开假基因CK19b的干扰,检测39例结直肠癌患者外周血中上皮性骨架蛋白CK19 mRNA。用DNA直接测序法排除假基因CK19a的可能。结果:39例外周血CK19 mRNA总检出率为79.5％(31/39),Dukes C、D期(16/16,100.0％)高于Dukes A、B期(15/23,65.2％)(P<0.05)。有淋巴结转移者外周血CK19 mRNA均阳性(16/16),明显高于无淋巴结转移者(65.2％,P<0.05)。而外周血CK19 mRNA的表达与其他临床病理指标无相关性。结论:各期结直肠癌患者外周血均有较高CK19 mRNA表达,随病期进展,阳性率更高。     

大肠癌患者外周血CEAmRNA、HNP1-3的检测及临床意义

目的：研究大肠癌患者外周血中CEAmRNA、HNP1-3的表达及临床意义。方法：采用NestedRT-PCR法检测外周血CEAmRNA、ELISA法检测血清HNP1-3在大肠癌患者术前组、术后组及正常对照组中的表达。结果：外周血CEAmRNA在大肠癌患者术前组、术后组及正常对照组的阳性率分别为54%、34%、5%,术前组和术后组相比存在显著差异（P=0.044）,二者与正常对照组比较,有统计学差异（P〈0.001、P=0.012）;CEAmRNA与患者性别、年龄、肿瘤部位及分化程度无关,但与Dukes＇分期、淋巴结转移有关;外周血CEAmRNA对大肠癌的诊断敏感性和特异性分别为54%、95%。大肠癌患者术前组血清HNP1-3浓度中位数为20.33ng/ml,正常对照组7.69ng/ml,术后组14.35ng/ml;术前组、术后组血清HNP1-3水平均明显高于正常对照组,差异有统计学意义（P〈0.001、P=0.005）;并且血清HNP1-3水平也与Dukes＇分期、淋巴结转移有关;血清HNP1-3对大肠癌的诊断敏感性、特异性分别为62%、95%。联合检测外周血CEAmRNA与血清HNP1-3的敏感性（72%）及特异性（100%）均高于单一指标。结论：大肠癌患者外周血中CEAmRNA表达较正常对照组明显增高,且与Dukes＇分期、淋巴结转移密切相关。HNP1-3在大肠癌患者血清中呈高表达,且具有较高的敏感性及特异性,有望成为一种新的大肠癌肿瘤标志物。联合检测外周血CEAmRNA表达及血清HNP1-3水平可提高检测敏感性和特异性,对发现大肠癌微转移可能有重要的临床意义。     

Combined role of tumor angiogenesis, bcl-2, and p53 expression in the prognosis of patients with colorectal carcinoma.

BACKGROUND: The objective of this study was to evaluate intratumoral neoangiogenesis in Dukes Stage B and Stage C (AJCC/UICC Stage I and III) colorectal adenocarcinoma and its correlation with nuclear p53 oncoprotein accumulation and cytoplasmic bcl-2 expression as well as to assess the prognostic significance of these features in patient outcome. METHODS: Paraffin embedded specimens from 55 patients with Dukes Stage B (AJCC/UICC Stage I) and 51 patients with Dukes Stage C (AJCC/UICC Stage III) colorectal adenocarcinoma who were treated with surgery were assessed. Patients with lymph node involvement (Dukes Stage C [AJCC/UICC Stage III]) also were treated with postoperative pelvic radiotherapy and adjuvant chemotherapy with 5-fluorouracil and leucovorin with or without interferon-alpha. Immunohistochemistry was performed using the anti-CD31 monoclonal antibody (MoAb) for vessel staining, the DO7 MoAb for nuclear p53 expression, and the clone 124 for cytoplasmic/perinuclear bcl-2 expression. Patient follow-up ranged from 4-70 months (median, 28 months). RESULTS: High vascular grade (microvessel score [MS] >/= 40) was observed in 39 of 106 specimens (37%), a medium MS (16-39) was observed in 29 of 106 cases (27%), and a low MS (7-15) was observed in 38 of 106 cases (36%). Positive expression of the bcl-2 protein in > 10% of cells was observed in 33 of 106 cases (31%), whereas p53 nuclear oncoprotein accumulation in > 10% of cells occurred more frequently (44 of 106 cases [42%]). No correlation among p53 expression, bcl-2 expression, and vascular grade was observed. Stroma infiltration by CD31 positive lymphocytes was associated strongly with increased vessel density (P = 0.0001). In univariate analysis Dukes stage was the only significant prognostic parameter (P = 0.02), whereas p53 and vascular grade showed marginal prognostic significance (P = 0.07 and P = 0.09, respectively). In Dukes Stage C (AJCC/UICC Stage III) patients, high vascular grade was the only parameter that predicted a worse overall survival (P = 0.04). Double stratification showed that patients with high vascular grade and positive p53 expression had a poorer survival (P = 0.03). CONCLUSIONS: The results of the current study suggest that p53 mutations, loss of bcl-2 expression, and tumor angiogenesis are events linked to the processes of metastases and local invasion in patients with colorectal carcinoma. Increased vascularization appears to be the most important prognostic factor in patients with Dukes Stage C (AJCC/UICC Stage III) colorectal adenocarcinoma.     

Expression of high p53 levels in colorectal cancer: a favourable prognostic factor.

The expression of p53 protein was examined in a series of 111 colorectal cancer adenocarcinomas with a long follow-up. A quantitative luminometric immunoassay (LIA) was used for the measurement of wild-type and mutant p53 protein in extracts from colorectal tumour cytosols, p53 being detected in 42% of the samples (range 0.0-52 ng (mg-1)). Using an arbitrary cut-off value of 2.7 ng mg(-1), 25% of the tumours were classified as manifesting high p53 levels. There was no association of p53 expression with patient age, sex, serum preoperative carcinoembryonic antigen (CEA) levels, tumour site and size, nodal status or TNM stage. Significant and independent correlation was found to exist between high p53 levels and prolonged disease-free survival (P = 0.05) at a median follow-up of 60 months. This survival advantage was most apparent among stage III cancer patients. The results from this study would suggest that expression of high p53 levels appear to be useful in selecting a group of colorectal cancer patients with a better prognosis.     

The expression of p53 tumor-suppressor protein during progression of gastric and colorectal carcinomas

The expression of p53 was immunohistochemically determined in sets of biopsies from primary and recurrent colorectal (12) and gastric (17) tumours that had progressed to more advanged stages in the following 6-54 months. At presentation 7 carcinomas overexpressed p53 protein in the cell nucleus and 22 tumours had normal, undetectable levels of p53. In most patients, the p53 phenotype was maintained during the process of tumour progression. In two gastric and two colorectal carcinomas p53 overexpression was subsequently detected in recurrent tumour growth at the primary site and was also associated with the development of metastases. These results suggests that in some cases p53 alterations may contribute to the conversion to malignancy and in others to tumour progression and metastatic capacity.     

不同年龄组大肠癌预后多因素分析的比较

目的研究青年、中年和老年组大肠癌预后的影响因素,指导临床治疗。方法对842例行根治术后的大肠癌患者,按发病年龄分为青年组（≤40岁）、中年组（41～64岁）和老年组（≥65岁）。用SPSS软件分别对3组患者的35个临床病理因素进行单因素生存分析和多因素Cox比例风险模型回归分析。结果842例大肠癌的5,10,15年生存率分别为66．3％、54、2％和48．5％,青年组大肠癌的5,10年生存率分别为53．13％和42．7％,低于其他年龄组患者。多因素分析显示,Dukes分期和家族肿瘤史为青年和中年组大肠癌患者的共同影响因素;慢性便秘是中年组大肠癌预后的独立影响因素;肠梗阻、手术时间、转移淋巴结数为老年组大肠癌的预后因素。病程（从出现症状到手术时间）不是影响青年组大肠癌的主要原因。青年组Dukes A期患者的5,10年生存率分别为82．6％和64．5％,B期分别为73.3％和67．4％,C期分别为37、3％和27．13％,D期分别为33．3％和22．2％。青年组A期和B期患者生存率与中老年组相近,但C期和D期的生存率低于中老年组。有家族肿瘤史的青年组患者预后好,其5,10年生存率分别为73．1％和64．5％,显著高于无家族肿瘤史患者的48．1％和37、3％。结论不同年龄组大肠癌预后影响因素有差异,青年组大肠癌的生存率明显低于其他年龄组。在青年组,大肠癌Dukes分期晚和无家族肿瘤史的患者预后差,病程不是影响预后的因素,青年组大肠癌患者预后羞与就诊时间晚、延误诊断无关。     

反向被动血凝法检测粪便潜血对大肠癌人群筛检的效果评价

Evaluation of reverse passive hemagglutination (RPHA) fecal occult blood (FOB) test in screening for colorectal cancer was carried out in a group of subjects (3034 persons) with history of rectal polyp and ulcer. All subjects were examined by 60 cm fiberoptic colonoscopy, RPHA and benzidine (BT) FOB tests. Among this high risk population, 10 cases of colorectal cancer and 1 case of rectal carcinoid were detected by colonoscopy and pathology. Regarding the findings under fiberoptic colonoscopy as a reference standard, the sensitivity of RPHA and BT in screening for colorectal cancer was 63.6% and 72.7%; the specificity was 81.9% and 61.7%; the general indicator--Youden index was 0.46 and 0.34, respectively. In 7 cases of colorectal cancer with both FOB tests positive, 5 (71%) had lesions in early stages (Dukes A and B). The results indicate that comparing with BT, RPHA has slightly lower sensitivity but higher specificity. RPHA fecal occult blood test could be used as preliminary screening for colorectal cancer.     

Preoperative serum levels of CEA and CA 242 in colorectal cancer.

Preoperative serum levels of CEA and CA 242 were determined in 260 patients with colorectal cancer and in 92 patients with benign colorectal diseases. The overall sensitivity of the CEA test was 43% and of the CA 242 test 39%. The corresponding specificities were 90% and 87% respectively, using 5 ng ml-1 as cut-off level for CEA and 20 U ml-1 for CA 242. The sensitivity of CEA was 26%, 32%, 38% and 77% for Dukes A, B, C and D colorectal cancer, and the sensitivity of CA 242 was 26%, 26%, 40% and 67%, respectively. The correlation between CEA and CA 242 was low. Concomitant elevation of both markers was seen in 5%, 12%, 18% and 59% of patients with Dukes A, B, C and D colorectal cancer, respectively. Of all the patients, 23% showed elevation of both the CEA and the CA 242 level, whereas CEA alone was elevated in 20% and CA 242 alone in 15% of the patients with colorectal cancer. Combined use of both markers raised the overall sensitivity from 43% to 58%, but reduced the specificity from 90% to 80%. The increase in sensitivity by combining the two markers was most marked in Dukes A, B and C colorectal cancer. Either or both of the markers were elevated in 46%, 46% and 60% of the patients respectively. The clinical value of combining CEA and CA 242 seems very promising and should be further investigated in prospective studies.