血清肿瘤标志物CEA、CA19-9和CA72-4在胃癌术后监测中的意义

目的 研究血清肿瘤标志物CEA、CA19-9和CA72-4在胃癌术后复发、转移监测中的意义.方法 采用电化学发光法检测228例手术后胃癌患者血清CEA、CA19-9和CA72-4含量;并结合临床及随访资料进行分析.结果 胃癌术后复发、转移患者CEA、CA19-9和CA72-4的含量和阳性率均显著高于未发生复发、转移患者.术后复发、转移的胃癌患者血清CEA、CA19-9和CA72-4检测灵敏度和特异度分别为46.2%和94.7%,52.3%和97.4%,47.1%和90.6%.结论 血清CEA、CA19-9和CA72-4升高与胃癌复发、转移密切相关,在术后随访过程中检测血清肿瘤标志物有助于早期诊断胃癌复发、转移.     

血清肿瘤标志物CEA、CA19-9和CA72-4在胃癌术后监测中的意义

目的研究血清肿瘤标志物CEA、CA19—9和CA72—4在胃癌术后复发、转移监测中的意义。方法采用电化学发光法检测228例手术后胃癌患者血清CEA、CA19—9和CA72—4含量;并结合临床及随访资料进行分析。结果胃癌术后复发、转移患者CEA、CA19—9和CA72—4的含量和阳性率均显著高于未发生复发、转移患者。术后复发、转移的胃癌患者血清CEA、CA19—9和CA72—4检测灵敏度和特异度分别为46．2％和94．7％,52．3％和97．4％,47．1％和90．6％。结论血清CEA、CA19—9和CA72-4升高与胃癌复发、转移密切相关,在术后随访过程中检测血清肿瘤标志物有助于早期诊断胃癌复发、转移。     

胃癌患者血清CA72-4、CEA及CA19-9水平及其与临床病理特征的相关性

目的:探讨血清CA72-4、CEA及CA19-9水平与胃癌患者病理特征的相关性。方法:选择2011年6月-2013年3月收治的86例胃癌患者,56例胃良性肿瘤患者,60例普通胃病患者,比较三组患者CA72-4、CA19-9和CEA水平;CA72-4、CA19-9和CEA单项检测及联合检测胃癌患者的阳性率;CA72-4、CA19-9和CEA水平与胃癌病理特征的关系。结果:胃癌组患者血清CA72-4、CA19-9和CEA水平均高于胃良性肿瘤组患者（P＜0.05),胃癌良性组患者均高于对照组（P＜0.05);三种胃癌肿瘤标志物中CA72-4诊断胃癌的阳性率最高,肿瘤3项标志物的阳性检测率要显著高于单项CA72-4、CA19-9、CEA的阳性检出率（P＜0.05）;肿瘤越大、TNM分期越高,CA72-4、CA19-9和CEA水平越高。结论:采用CA72-4、CA19-9和CEA联合检测是诊断胃癌比较理想的组合。CA72-4、CA19-9和CEA水平的变化可以反应胃癌患者的病理特征。     

血清肿瘤标志物在预测胃癌病理学分期的应用研究

目的?探讨血清肿瘤标志物在预测胃癌病理学分期的应用价值。方法?分析2014年8月至2017年8月广东省东莞东华医院收治的174例胃癌患者。所有患者均经病理组织活检确诊并分期,均检测血清肿瘤标志物CEA、CA125、CA72-4、CA19-9水平。分析CEA、CA125、CA72-4、CA19-9肿瘤标志物在不同病理学分期胃癌患者中的表达以及阳性表达率,分析其与胃癌病理分期的相关性。结果?血清肿瘤标志物CEA、CA125、CA72-4、CA19-9在Ⅰ期、Ⅱ期、Ⅲ期、Ⅳ期胃癌患者中的表达水平依次增高,差异有统计学意义（P＜0.05）。胃癌患者CEA、CA125、CA72-4、CA19-9阳性表达率Ⅰ期、Ⅱ期、Ⅲ期、Ⅳ期胃癌患者中依次增高, CEA、CA125、CA72-4、CA19-9阳性表达率与病理分期呈正相关,r值分别为0.691、0.582、0.768、0.550,P值分别为0.000、0.004、0.000、0.006,差异有统计学意义（P＜0.05）。结论?血清肿瘤标志物CEA、CA125、CA72-4、CA19-9在预测胃癌病理学分期中具有较好的应用效果,对其进行监测,能为其诊断及病情评估提供参考。     

血清肿瘤标志物对胃癌患者术后复发转移的预测价值及影响因素分析

目的 探讨癌胚抗原(CEA)、糖类抗原(CA)19-9及CA72-4血清肿瘤标志物对胃癌患者术后复发转移的预测价值及影响因素分析.方法 检测170例胃癌患者的血清CEA、CA19-9、CA72-4水平;采用受试者工作特征(ROC)曲线和曲线下面积(AUC)评估CEA、CA19-9、CA72-4对胃癌患者术后复发转移的预测价值;胃癌患者术后复发转移的危险因素采用多因素Logistic回归分析.结果 不同TNM分期胃癌患者血清CEA、CA19-9、CA72-4水平比较,差异均有统计学意义(P﹤0.01),胃癌患者的TNM分期越晚,血清CEA、CA19-9、CA72-4水平越高,差异均有统计学意义(P﹤0.05).ROC曲线显示,CEA、CA19-9、CA72-4水平预测胃癌患者术后复发转移的AUC分别为0.830、0.683、0.725,cut-off值分别为51.62μg/L、69.38 U/ml、26.67 U/ml.截至随访终点,170例胃癌患者中,复发转移75例,未复发转移95例,复发转移率为44.12％,依据复发转移情况,将所有胃癌患者分为复发转移组(n=75)和未复发转移组(n=95),复发转移组和未复发转移组患者年龄、肿瘤大小、TNM分期、浸润深度、脉管癌栓、术后辅助治疗情况、CEA水平、CA19-9水平、CA72-4水平比较,差异均有统计学意义(P﹤0.05).Logistic回归分析结果显示,浸润深度达浆膜层、TNM分期为Ⅲ～Ⅳ期、合并脉管癌栓、未接受术后辅助治疗、CEA≥51.62μg/L、CA19-9≥69.38 U/ml、CA72-4≥26.67 U/ml均是胃癌患者术后复发转移的独立危险因素(P﹤0.05).结论 CEA、CA19-9、CA72-4水平与肿瘤细胞浸润转移有关,可用于临床预测胃癌患者术后复发转移情况,筛选高危人群.     

术前血清CA19-9水平对胃癌患者生存预后的影响

  目的   探讨胃癌患者术前检测血清CA19-9的必要性及其对患者预后评估的意义。   方法   收集2003年1月至2008年10月间天津医科大学肿瘤医院收治的513例术前检测血清CA19-9的胃癌患者的临床病理资料，分析CA19-9水平与临床病理因素的关系及其与预后的关系。   结果   513例患者中CA19-9升高者86例（16.8%），CA19-9升高与高龄、大体分型（BorrmannⅢ、Ⅳ型）、组织学类型（低分化、未分化）及浸润深度相关。CA19-9正常（< 39 U/mL）和升高（≥39 U/mL）患者5年生存率分别为45.7%和25.6%，差异有统计学意义（P < 0.001）。分层分析显示，CA19-9水平仅与TNM Ⅲ期患者预后相关（P=0.001）。多因素预后分析证实，CA19-9升高是影响胃癌患者根治术后生存的独立危险因素（HR=1.47，P=0.008）。   结论   术前检测血清CA19-9可为胃癌患者预后评估提供信息，CA19-9升高可能是胃癌根治术后影响患者预后的独立危险因素。      

血清CEA、CA125及CA72-4在胃癌腹膜转移中的临床意义

背景与目的:胃癌腹膜转移多处于疾病终末期,但每种肿瘤标志物在胃癌腹膜转移中的临床意义仍不是很明确.该研究探讨血清肿瘤标志物CEA、CA125及CA72-4在胃癌腹膜转移中的诊断价值及其临床意义.方法:收集延边大学附属医院肿瘤科2008年1月—2013年12月间经影像学、手术和病理学等检查确诊、并接受静脉及腹腔灌注化疗的108例胃癌腹膜转移患者为研究对象,分别于确诊时、每次化疗前检测血清CEA、CA125及CA72-4,分析单独、2或3种肿瘤标志物同时检测在胃癌腹膜转移的诊断敏感性,并分析其与临床病理因素、化疗疗效及生存期之间的相关性.结果:在胃癌腹膜转移患者CEA、CA125和CA72-4的阳性率各为20.4%、46.3%和45.4%,联合CEA/CA125、CEA/CA72-4、CA125/CA72-4及CEA/CA125/CA72-4的阳性率分别为54.7%、52.8%、69.5%和79.6%,3种标志物联合检测明显优于单独检测(P<0.05).CEA、CA125和CA72-4水平均与ECOG分级存在相关性(P<0.05).CA125阳性与腹水有关(P<0.001).CA72-4阳性与卵巢转移相关(P<0.05).确诊时血清CEA、CA125和CA72-4阳性患者中位生存期短于CEA、CA125和CA72-4阴性的患者(P<0.05).在3周期化疗后3种肿瘤标志物较治疗前均下降,差异有统计学意义(P<0.05).化疗后CA125下降与腹水量的减少有明显相关性(P<0.05).确诊时肿瘤标志物阳性患者经化疗3个周期后转为阴性的患者生存期明显延长(P<0.001).结论:联合检测血清CEA、CA125和CA72-4可明显提高胃癌腹膜转移的诊断率.     

联合检测CEA、CA19-9在D2胃癌术后随访中的价值

目的：探讨联合检测血清肿瘤标志物癌胚抗原（ CEA）和糖类抗原19-9（ CA19-9）在D2胃癌术后患者随访中的应用价值。方法：采集271例D2胃癌术后病人血清,利用免疫荧光分析法检测血清中CEA和CA19-9含量,并根据检验结果划分为CEA（-）/CA19-9（-）、CEA（﹢）/CA19-9（-）、CEA（-）/CA19-9（﹢）和CEA（﹢）/CA19-9（﹢）四个组。采用Kaplan-meier法进行生存率分析,利用Log-rank检验进行统计学差异性比较,χ2检验进行组间单因素分析。结果：两种肿瘤标志物CEA和CA19-9的联合检测时,两个同时为阳性组患者生存期远远低于单一阳性组;CEA（﹢）/CA19-9（-）组与CEA（-）/CA19-9（﹢）组比较,CEA（-）/CA19-9（﹢）组患者生存期要低于对照组,具有统计学差异（ P＜0.05）。结论：联合检测血清肿瘤标志物CEA和CA19-9在D2胃癌术后患者随访中,CA19-9阳性者提示更差的预后。     

喉癌患者血清中SCCAg、CEA、CA19-9、CA72-4和CYFRA21-1的检测及意义

目的 分析肿瘤标志物鳞状细胞癌相关抗原(SCCAg)、癌胚抗原(CEA)、糖类抗原19-9(CA19-9)、糖类抗原72-4(CA72-4)和细胞角化素蛋白19片段(CYFRA21-1)在喉癌患者血清中的表达及意义.方法 以接受手术治疗的喉癌患者112例为研究对象,设为观察组,另抽取50例健康体检者为对照组,比较两组患者血清中肿瘤标志物的水平.结果 观察组喉癌患者术前血清中的SCCAg、CEA、CA19-9、CA72-4、CYFRA21-1水平,均显著高于对照组和术后(P<0.05);高～中分化喉癌患者血清肿瘤标志物水平显著低于低分化者(P<0.05);TNM分期Ⅰ～Ⅱ期者血清肿瘤标志物水平显著低于Ⅲ～Ⅳ期者(P<0.05);血清肿瘤标志物SCCAg、CEA、CA19-9、CA72-4、CYFRA21-1中,CYFRA21-1敏感度最高,其次为SCCAg、CEA,CA19-9最低;CA19-9特异度最高,其次为CA72-4、CEA,CYFRA21-1最低;SCCAg+ CYFRA21-1两项联合检测与五项联合检测的敏感度均显著高于单项检测,特异度低于单项检测(P<0.05),五项联合检测的敏感度高于SCCAg+ CYFRA21-1两项联合检测,特异度低于两项联合检测,但差异无统计学意义(P>0.05).结论 血清肿瘤标志物SCCAg、CEA、CA19-9、CA72-4、CYFRA21-1检测在喉癌患者的早期辅助诊断中具有一定的价值,其中CYFRA21-1和SCCAg的诊断价值最高.     

胃癌联合检测CA72-4 CA242 CA19-9和CEA的临床意义与诊断价值

目的:检测胃癌患者血清CA72-4、CA242、CA19-9和CEA,结合其临床病理特征,评价联合检测对胃癌的诊断价值和意义.方法:将203例胃癌患者的4项检测值和临床指标转化为等级型变量,对多个指标的等级变量形式求和构建新的等级变量,分析联合检测值与胃癌临床特征的相关性.结果:CA242和CEA组合值≥2者肿瘤分期较晚.CA72-4和CA242组合值≥2者肿瘤体积较大.TNM分期中,CA72-4指标值≥1者肿瘤T分期较晚,CA242和CEA组合值≥2者N分期较晚,CA72-4和CA19-9组合值≥1者M分期较晚的比例更高.病理组织学类型和肿瘤标志物各检测指标均无显著关联.针对这4项指标.联合检测CA72-4和CEA的检测功效与4项或3项联合的功效相当.结论:上述4项肿瘤标志物联合检测并不增加检测功效,但能为预测胃癌的病期、转归和预后提供更多信息.     

Prognostic significance of CEA, CA 19-9 and CA 72-4 preoperative serum levels in gastric carcinoma.

The prognostic value of preoperative serum levels of CEA, CA 19-9 and CA 72-4 tumor markers was investigated in 153 patients resected for gastric cancer. The positivity rates for CEA, CA 19-9 and CA 72-4 were 20.9, 34.6 and 28.1%, respectively. Multiple logistic regression analysis for positive levels of tumor markers indicates that CEA positivity is significantly related to the depth of invasion (p < 0.005) and the presence of distant metastasis (p < 0. 05), CA 19-9 positivity is related to nodal involvement (p < 0.05) and the depth of invasion (p < 0.05), whereas CA 72-4 positivity is influenced by tumor size (p < 0.005) and noncurative surgery (p < 0. 05). Positive levels of each tumor marker were associated with a worse prognosis if compared with negative cases using univariate analysis. Multivariate analysis of curatively resected cases identified depth in gastric wall (p < 0.0001), nodal status (p < 0. 0005), and tumor location in the upper third (p < 0.05) as significant prognostic variables; CEA, CA 19-9 and CA 72-4 serum positivity did not reach statistical significance. However, when the positivity of the three markers was associated, a p value < 0.05 was observed. The analysis of survival curves stratified by tumor stage revealed that marker positivity significantly affects survival in stages I, II and IV (p < 0.05). The combined assay of CEA, CA 19-9 and CA 72-4 preoperative serum levels provides additional prognostic information in patients resected for gastric cancer; patients with preoperative positivity for one of these tumor markers should be considered at high risk of recurrence even in early stages of gastric carcinoma.     

Prognostic value of carcinoembryonic antigen, CA 19-9 and CA 72-4 in gastric carcinoma.

The prognostic value of preoperative serum levels of carcinoembryonic antigen (CEA), CA 19-9 and CA 72-4 tumor markers was investigated in patients with gastric cancer. Eighty-two patients who underwent surgical resection of gastric cancer were entered in the study. Correlation analyses showed that CA 72-4 was more frequently positive in patients with advanced tumors (p = 0.04), lymph node invasion (p = 0.02), liver metastasis (p = 0.02) and peritoneal involvement (p = 0.03). CA 19-9 was more frequently positive in patients with advanced tumors (p = 0.01) and with serosal (p = 0.04), lymph node (p = 0.008) and peritoneal involvement (p = 0.02). CEA was more frequently positive in patients with liver metastasis (p = 0.03). Low 3-year cumulative survival was significantly associated with elevated serum levels of CA 72-4 (p = 0.004), CA 19-9 (p = 0.001) and CEA (p < 0.001). Age, tumor stage and CA 72-4 provided prognostic information in the multivariate analysis. Patients with elevated serum levels of CA 72-4 showed a 4.2 times higher risk of death than patients with low levels of the marker. Our results suggest that CA 72-4 has prognostic value in gastric cancer, and patients with a high preoperative serum level of CA 72-4 have a greater risk of death due to gastric cancer.     

Combined Detection of CEA,CA 19-9, CA 242 and CA 50 in the Diagnosis and Prognosis of Resectable Gastric Cancer

Our aim was to investigate the value of combined detection of serum  carcinoembryonic antigen (CEA), carbohydrate antigen (CA) 19-9, CA 242 and CA 50 in diagnosis and assessment of prognosis in consecutive gastric cancer patients. Clinical data including preoperative serum CEA, CA 19-9, CA 242, and CA 50 values and information on clinical pathological factors were collected and analyzed retrospectively. Univariate and multivariate survival analyses were used to explore the relationship between tumor markers and survival. Positive rates of tumor markers CEA, CA 19-9, CA 242 and CA 50 in the diagnosis of gastric cancer were 17.7, 17.1, 20.4 and 13.8%, respectively, and the positive rate for all four markers combined was 36.6%. Patients with elevated preoperative serum concentrations of CEA, CA 19-9, CA 242 and CA 50, had late clinical tumor stageand significantly poorer overall survival. Five-year survival rates in patients with elevated CEA, CA 19-9, CA 242 and CA 50 were 28.1, 25.8, 27.0 and 24.1%, respectively, compared with 55.0, 55.4, 56.4 and 54.5% in patients with these markers at normal levels (p<0.01). In multivariate Cox proportional hazards analyses, an elevated CA 242 level was determined to be an independent prognostic marker in gastric cancer patients. Combined detection of four tumor markers increased the positive rate for gastric cancer diagnosis. CA 242 showed higher diagnostic value and CA 50 showed lower diagnostic value. In resectable gastric carcinoma, preoperative CA 242 level was associated with disease stage, and was found to be a significant independent prognostic marker in gastric cancer patients.     

Comparison of Serum Assays for TAG-72, CA19-9 and CEA in Gastrointestinal Carcinoma Patients

Tumor-associated glycoprotein (TAG-72) has been shown to beexpressed in a wide variety of epithelial malignant tissues.We have investigated serum levles of TAG-72 antigen in patientswith gastrointestinal cancer with a solid phase radioimmunometricassay (RIA), CA72-4, utiliz ing murine monoclonal antibodiesCC49 and B72.3 which recognize the TAG-72 antigen. Elevatedlevels of serum TAG-72 antigen were found in 48% of 56 gastriccarcinoma patients and 67% of 45 colorectal carcinoma patients.The serum concentrations of TAG-72 were compared to those ofCA19-9 and CEA. The positive rates of CA19-9 in gastric carcinomaand colorectal carcinoma patients were 29% and 54%, and thoseof CEA were 52% and 60%, respectively. Elevated serum levelsof TAG-72, CA19-9 and CEA were observed in 7%, 14% and 24%,respectively, of patients with benign disease, thus indicatinga preferential expression of TAG-72, compared to CA19-9 andCEA, in gastrointestinal carcinoma patients versus in patientswith benign disorder. A cocktail of CA72-4, CA19-9 and CEA RIAsincreased positive rates to 68% in sera of gastric cancer patientsand 84% in sera of colorectal cancer patients. Combination assays using CA72-4, CEA and CA19-9 RIM for patients with benigngastrointestinal disorder, however, also increased the positiverate to 31%. These results indicate that CA72-4, CA19-9 andCEA RIA may be complementary in detecting circulating tumor-associatedantigens. It must be emphasized, however, that interpretationof the data provided by the combination serum as says requirescareful consideration.     

Evaluation of seven tumor markers (CA 50, CA 19-9, CA 19-9 TruQuant, CA 72-4, CA 195, carcinoembryonic antigen, and tissue polypeptide antigen) in the pretreatment sera of patients with gastric carcinoma.

Preoperative serum levels of the tumor markers CA 50, CA 19-9, CA 19-9 TruQuant, CA 72-4, CA 195, carcinoembryonic antigen (CEA), and tissue polypeptide antigen (TPA) were measured in 94 patients with well-staged adenocarcinoma of the stomach and in 15 patients with benign gastric diseases. In all patients with carcinoma, a laparotomy was done. The serum levels were correlated with the stage of disease, the location of the primary tumor, and the resectability and grade of differentiation. The marker CA 50 was the best, with an overall positivity of 59.5%. For CA 19-9, this figure was 34%; for CA 19-9 TruQuant, 22%; for CA 72-4, 34%; for CA 195, 29%; for CEA, 33%; and for TPA, 50%. The best combination of two markers was CA 50 and TPA; this combination gave a positivity of 81%. There was no evident correlation with stage of disease and the percentage of positive serum levels or the median serum levels. The marker CA 50 gave the widest range of elevated serum levels between the cutoff level and the 90th percentile (54%). Patients with carcinoma of the cardia had higher preoperative serum levels than those with a tumor in other parts of the stomach. There was no correlation with the resectability of the tumor and the preoperative serum level. Patients with an undifferentiated tumors did not have significantly lower serum levels than those with more differentiated tumors. Currently, preoperative determination of serum tumor marker levels in patients with gastric carcinoma has no significant in clinical practice.     

CA 72-4 measurement of tumor-associated glycoprotein 72 (TAG-72) as a serum marker in the management of gastric carcinoma.

The presence of three distinct serum markers of carcinoma, tumor-associated glycoprotein 72 (TAG-72; as measured by the CA 72-4 assay), CA 19-9, and carcinoembryonic antigen (CEA), was evaluated in 194 patients diagnosed with either malignant (n = 94) or benign (n = 100) gastric disease. Of the 94 patients diagnosed with gastric carcinoma, the percentage of patients whose serum samples were positive for TAG-72, CA 19-9, or CEA was 42.6, 31.9, and 20.2%, respectively. Furthermore, fewer false positive samples were observed for TAG-72 than either CA 19-9 or CEA. The analysis of serum TAG-72, CA 19-9, and CEA levels in patients diagnosed with early (stage I and II) versus advanced (stage III and IV) disease revealed a significantly higher level of TAG-72 and CA 19-9 in the serum of patients with advanced stage gastric carcinoma. The serum samples were also analyzed to determine whether any advantage might be gained by simultaneously measuring two or more of the tumor markers. The data clearly indicate that the measurement of TAG-72 with CA 19-9 significantly increased the percentage of gastric carcinoma patients with positive serum levels of either antigen. This advantage was achieved with no significant increase in the number of false positives. Twenty-one patients were followed postsurgically for up to 3 years to determine whether the appearance or reappearance of TAG-72, CA 19-9, or CEA accurately predicted disease recurrence. Positive serum TAG-72 levels correlated with disease recurrence in 7 of 10 patients, compared with 5 and 2 patients for CA 19-9 and CEA, respectively. The findings suggest that serum TAG-72 as measured by the CA 72-4 assay may be a useful marker for late stage gastric carcinoma and its measurement alone or in combination with CA 19-9 may have utility in the clinical management of gastric carcinoma.