Biological variation and reference change values of CA 19‐9, CEA,AFP in serum of healthy individuals

Objective. The use of tumour markers in diagnosis and monitoring is very common. Tumour marker results vary – preanalytical sources of variation, total random analytical error (CV_a), and within‐subject (intraindividual) normal biological variation. There are not so many studies evaluating the biological variations and reference change values (RCV) of these parameters. The aim of our study was to assess: (i) the average inherent intra‐ and inter‐individual biological variation (CV_i and CV_g) for CA 19‐9, CEA, AFP in a group of healthy individuals; (ii) the significance of changes in serial results of each marker; and (iii) the index of individuality. Material and methods. The study group comprised 49 healthy volunteers ranging in age between 18 and 60 years (25 M and 24 F). Four blood samples were obtained from each subject; one at each 14‐day interval. Each sample from one individual was assayed in duplicate. CA 19‐9, CEA, AFP levels were measured by an immunoluminometric assay on a random‐access analyser (Architect i2000; Abbott Diagnostics Division). The intra‐ (CV_i) and inter‐individual (CV_g) biological variations were estimated from the data generated. Reference change value (RCV) was calculated. Results. The intra‐individual/inter‐individual biological variations (CVs) for CA 19‐9, CEA, AFP were 27.2/64.24?%, 30.87/37.14?% and 26.67/43.65?%, respectively. The critical differences (RCVs) of CA 19‐9, CEA, AFP were 64.71?%, 72.57?% and 62.62?%, respectively (Z = 1.65 for unidirectional changes; p<0.05). Conclusions. Intra‐individual biological variation contributes to the variation in serial results and should therefore be included in the criteria for serum tumour marker assessment.     

CA72-4联合AFP、CEA、CA19-9检测在胃肠道疾病中的临床应用价值研究

目的探讨糖类抗原72-4(CA72-4)联合甲胎蛋白(AFP)、癌胚抗原(CEA)、糖类抗原19-9(CA19-9)检测在胃肠道良、恶性疾病中的临床价值。方法收集2017-2018年该院就诊的胃癌(55例)、胃肠道其他癌(71例)、胃肠道良性疾病(556例)患者的临床资料与血清AFP、CEA、CA72-4、CA19-9检查结果,分析肿瘤标志物在不同疾病组间的表达差异。结果(1)血清CA72-4水平在胃癌组与良性疾病组、胃癌组与其他癌组比较,差异有统计学意义(P<0.05)。血清CA72-4在胃癌组的阳性率(30.91%)明显高于其他癌组(18.84%)及良性疾病组(17.99%)。(2)血清CA72-4在胃溃疡、胃息肉、慢性胃炎、急性胃肠炎、十二指肠溃疡、肠息肉等良性疾病的阳性率分别为15.00%、19.12%、11.02%、25.53%、24.07%、19.58%,各组间CA72-4水平及阳性率比较差异无统计学意义(P>0.05);(3)CEA单项检测用于胃癌诊断的灵敏度为23.64%,CA72-4+CEA+CA19-9联合检测用于胃癌诊断的灵敏度为47.27%;CA19-9单项检测用于胃肠道其他癌诊断的灵敏度为24.64%,AFP+CEA+CA19-9联合检测用于胃肠道其他癌诊断的灵敏度为66.20%,差异有统计学意义(P<0.05)。结论血清CA72-4联合CEA、CA19-9检测,可更好地识别胃癌;血清AFP联合CEA、CA19-9检测,可更好地识别胃肠道其他恶性肿瘤。     

肿瘤标志物在诊断消化系恶性肿瘤中的应用价值

目的探讨联合检测血清中肿瘤标志物甲胎蛋白（AFP）、癌胚抗原（CEA）、糖类抗原125（CA125）、CA19-9对消化系恶性肿瘤的诊断价值。方法采用电化学发光免疫分析法，对53例消化系恶性肿瘤患者和62例消化系良性疾病患者血清中AFP、CEA、CA125、CA19—9的含量进行检测、比较。结果肿瘤标志物联合检测的敏感性为88．68％，明显高于单项检测的敏感性，其中单项检测的敏感性分别是：AFP为63．46％、CEA为58．56％、CA125为47．17％、CA19—9为52．83％。结论联合检测血清肿瘤标志物AFP、CEA、CA125、CA19—9可提高消化系恶性肿瘤的诊断率。     

肿瘤标志物CEA、AFP、CA19-9和CA72-4的检测在消化系统恶性肿瘤中的应用

目的探讨肿瘤标志物癌胚抗原(CEA)、甲胎蛋白(AFP)、糖类抗原19-9(CA19-9)和糖类抗原72-4(CA72-4)联合检测在消化系统恶性肿瘤中的意义。方法采用电化学发光法对2015年1-12月于该院就诊并经病理检查证实的106例消化系统恶性肿瘤患者(恶性肿瘤组)、110例消化系统良性疾病患者(良性疾病组)及60例健康体检者(对照组),分别进行CEA、AFP、CA19-9和CA72-4水平的检测,分析各组的差别,并比较4项标志物在消化系统恶性肿瘤患者中的阳性检出率。结果恶性肿瘤组血清CEA、AFP、CA19-9和CA72-4水平明显高于良性疾病组和对照组(P0.05);良性疾病组和正常对照组比较差异无统计学意义(P0.05)。血清CEA、AFP、CA19-9和CA72-4单项检测时,AFP在肝癌中的阳性率最高,为74.19%;CA72-4在胃癌中的阳性率最高,为60.71%;CA19-9在胰腺癌中的阳性率最高,为75.00%;CEA在各项肿瘤疾病中,阳性率均不高,无特异性。4项联合检测时,阳性率明显高于单项检测(P0.05)。结论肿瘤标志物CEA、AFP、CA19-9和CA72-4的检测有利于肿瘤类型的鉴别,同时可提高消化系统肿瘤的检出率,有助于患者的早期诊断和治疗。     

Biological variation and analytical imprecision of CA 125 in patients with ovarian cancer

Despite the availability of serial data on CA 125 in ovarian cancer, the problem of interpreting a change over time is still unsolved. Changes in marker concentrations are due not only to patients improving or deteriorating but also to analytical imprecision and normal intra-individual biological variation. The aim of this study was to assess the analytical imprecision (CV(A)) and the intra- and inter-individual biological variation (CV(I) and CV(G), respectively) of CA 125 in a group of 26 patients with clinically stable ovarian cancer. Furthermore, the critical difference for a change between two consecutive CA 125 concentrations calculated as square root(2) x Z x (CV(A)2 + CV(I)2)(1/2) (Z =1.65 for unidirectional and 1.96 for bidirectional changes, p < or = 0.05) and the index of individuality calculated as ((CV(A)2+CV(I)2)/CV(G)2)(1/2) were estimated. After the exclusion of outliers, CV(A) and the average CV(I) and CV(G) were 12.1%, 24.0%, and 43.1%, respectively. The index of individuality was 0.62 and the critical difference calculated for unidirectional changes was 62.6%. CV(A) and CV(I) contribute considerably to the variation in serial results and should, therefore, be included in the criteria for serum tumor marker assessment during monitoring of patients with ovarian cancer. The cut-off value of CA 125 is of minor value in detecting unusual results for an individual subject, when previous measurements from an individual are available. These measurements should be preferred as reference for interpretation of new results.     

联合应用CA19-9、CEA和AFP对胃癌的诊断价值评价

目的选择合理的肿瘤标志物并联合应用以提高胃癌的诊断正确率。方法采用化学发光法检测受试者血清CA19-9、CEA和AFP水平，统计学分析方法对比优劣。结果通过血清CA19-9、CEA和AFP检测发现胃癌人群的血清显著高于健康人群。血清CA19-9的 AUC 为0．644，CEA 的 AUC 为0．550，AFP的 AUC 为0．590。而联合应用 CA19-9、CEA 和AFP ，AUC达0．818（95％ CI：71．1-92．5），敏感性为72．2％，特异性为78．8％，敏感性和特异性都有明显提高。结论血清CA19-9、CEA和AFP联合应用增强胃癌筛查检测的正确率，在临床胃癌的诊断筛查方面是值得临床应用的方法。     

子宫腺肌病患者4种血清肿瘤标记物的检测及意义

目的：探讨4种血清肿瘤标记物对子宫腺肌病的诊断价值。方法：采用免疫放射法测定子宫腺肌病患者89例、子宫肌瘤患者66例血清中CA125、CA19-9、AFP、CEA的水平。结果：子宫腺肌病组CA125值显著高于子宫肌瘤组，P〈0．01。CA125在子宫腺肌病组中阳性率为78．65％，其敏感性、特异性、阳性预测值、阴性预测值分别为77．3％、92．2％、92．1％、77．6％，CA19-9，、AFP、CEA值与子宫肌瘤组差异无显著性。结论：子宫腺肌病血清CA125升高，对子宫腺肌病有较好的诊断预测价值。     

Biological variation of vitamins in blood of healthy individuals

BACKGROUND: Components of biological variation can be used to define objective quality specifications (imprecision, bias, and total error), to assess the usefulness of reference values [index of individuality (II)], and to evaluate significance of changes in serial results from an individual [reference change value (RCV)]. However, biological variation data on vitamins in blood are limited. The aims of the present study were to determine the intra- and interindividual biological variation of vitamins A, E, B(1), B(2), B(6), C, and K and carotenoids in plasma, whole blood, or erythrocytes from apparently healthy persons and to define quality specifications for vitamin measurements based on their biology. METHODS: Fasting plasma, whole blood, and erythrocytes were collected from 14 healthy volunteers at regular weekly intervals over 22 weeks. Vitamins were measured by HPLC. From the data generated, the intra- (CV(I)) and interindividual (CV(G)) biological CVs were estimated for each vitamin. Derived quality specifications, II, and RCV were calculated from CV(I) and CV(G). RESULTS: CV(I) was 4.8%-38% and CV(G) was 10%-65% for the vitamins measured. The CV(I)s for vitamins A, E, B(1), and B(2) were lower (4.8%-7.6%) than for the other vitamins in blood. For all vitamins, CV(G) was higher than CV(I), with II <1.0 (range, 0.36-0.95). The RCVs for vitamins were high (15.8%-108%). Apart from vitamins A, B(1), and erythrocyte B(2), the imprecision of our methods for measurement of vitamins in blood was within the desirable goal. CONCLUSIONS: For most vitamin measurements in plasma, whole blood, or erythrocytes, the desirable imprecision goals based on biological variation are obtainable by current methodologies. Population reference intervals for vitamins are of limited value in demonstrating deficiency or excess.     

Prognostic value of preoperative CEA,CA 19-9, CA 72-4, and AFP levels in gastric cancer

INTRODUCTION: Recent research has suggested that serum tumor markers can give valuable prognostic information in gastric cancer. In this study, we examined the relationship between preoperative serum carcinoembryonic antigen (CEA), carbohydrate antigen (CA) 19-9, CA 72-4, and alfa fetoprotein (AFP) levels on clinicopathologic significance in gastric cancer patients. METHODS: Preoperative plasma levels of CEA, CA 19-9, CA 72-4, and AFP were retrospectively examined in 95 patients who underwent surgical resection for gastric cancer, and the prognostic value of the tumour markers were estimated. RESULTS: The percentage of CA 19-9, CA 72-4, CEA, and AFP-positive cases were 41%, 32.6%, 24.2%, and 8.4%, respectively. CEA was more frequently positive in the patients with liver metastases (P=0.02). CA 19-9 was more frequently positive in patients with lymph node (P=0.005), peritoneal (P=0.01), and serosal (P=0.03) involvement. CA 72-4 was more frequently positive in patients with lymph node (P=0.01), peritoneal (P=0.03), and liver (P=0.01) involvement. Low 3-year cumulative survival was associated significantly with elevated serum levels of CEA (P=0.001), CA 19-9 (P=0.001), CA 72-4 (P=0.001), and AFP (P=0.01). In multivariate analysis, age, tumor stage, and CA 72-4 were the only independent prognostic factors. Being positive for CA 72-4 was associated with a 3.8-fold higher risk of death (95% confidence intervals: 1.3, 10.9). CONCLUSION: Our results suggest that high preoperative serum levels of CA 72-4 in gastric cancer patients are associated with a higher risk of death due to gastric cancer.     

术前血清CEA、CA19-9、CA50、AFP、TPS检测在结直肠癌肝转移中的预测价值

目的探讨在结直肠癌肝转移预测中,术前血清癌胚抗原(CEA)、糖类抗原19-9(CA19-9)、糖类抗原50(CA50)、甲胎蛋白(AFP)、组织多肽特异性抗原(TPS)检测的应用价值。方法选取该院接诊的结直肠癌患者168例,根据术后病理结果,将发生肝转移的患者45例作为观察组,未转移患者123例作为对照组,对入组对象进行血清抽检,分析血清CEA、CA19-9、CA50、AFP、TPS表达。结果观察组血清CEA、CA19-9、CA50、AFP、TPS检测结果均高于对照组,差异有统计学意义(P<0.05);结直肠癌肝转移患者中,血清CEA、CA19-9在不同T分期患者所占百分比相比较,差异有统计学意义(P<0.05);血清指标单独检测阳性率与联合检测阳性率比较,差异有统计学意义(P<0.05);五项指标联用的灵敏度为84.44%,特异度为94.31%。结论在结直肠癌肝转移预测诊断中,术前血清CEA、CA19-9、CA50、AFP、TPS联合检测具有较高应用价值。     

多肿瘤标志物蛋白芯片检测系统在消化系统疾病的应用评价

目的评价多肿瘤标志物联合检测在消化系统疾病的应用。方法使用HD-2OO1A多肿瘤标志物蛋白芯片检测系统（C12）联合检测2007年2月至2010年2月消化科住院患者393例血清肿瘤标志物。结果恶性肿瘤组和良性疾病组C12单个肿瘤标志物阳性率分别为67.44%和30.68%,肿瘤组显著高于良性疾病组（P〈0.01）。肿瘤组敏感度较高的前四项组合为：肝癌组CA19-9、AFP、CA125、CEA;结直肠癌组、胃癌组、胰腺癌和胆管癌/胆囊癌、小肠癌CEA、CA19-9、CA242和CA125;食管癌CEA、CA125、CA153、FER。而肿瘤标志物在良性疾病的表达：急性胰腺炎组CA19-9（53.66%）;胃十二指肠溃疡组CEA（40.91%）;胆囊炎组CA19-9（57.89%）;肝硬化组CA125（87.5%）。结论运用蛋白芯片技术检测多肿瘤标志物可以明显提高恶性肿瘤诊断的敏感度,可作为肿瘤诊断及高危人群早期筛查等辅助检查。同时,多肿瘤标志物在消化道良性疾病也有表达,提示是否可作为疾病发展进程的监测指标有待进一步研究。     

血清肿瘤标志物的参考变化值和参考变化因子应用比较研究

目的 探讨常规肿瘤标志物参考变化值(RCV)和参考变化因子(RCF)单向、双向分别在不同概率下(P<0.05,P<0.01)的应用比较研究。方法 根据参考变化值(RCV)及参考变化因子(RCF)公式计算常规肿瘤标志物在不同概率下的数值。结果 常规肿瘤标志物的RCV(单向,双向在P<0.05时)分别为AFP(30.99%,36.81%),CEA(30.48%,36.21%),CA125(64.30%,76.39%),CA153(15.68%,18.62%),CA199(40.60%,48.23%)和tPSA(43.19%,51.30%)。RCV(单向,双向在P<0.01时)分别为AFP(43.76%,48.45%),CEA(43.05%,47.67%),CA125(90.81%,100.55% ), CA153(22.14%,24.52%),CA199(57.33%,63.48%)和tPSA(60.99%,67.53%)。RCF(单向,双向在P<0.05时)RCF_UP-DOWN分别为AFP(1.36%,0.74%,1.44%,0.69%),CEA(1.36%,0.74%,1.44%,0.69%),CA125(1.90%,0.53%,2.15%,0.47%),CA153(1.17%,0.85%,1.2%,0.83%),CA199(1.50%,0.67%,1.62%,0.62%)和tPSA(1.54%,0.65%,1.67%,0.60%)。RCF(单向,双向在P<0.01)RCF_UP-DOWN分别为AFP(1.55%,0.65%,1.62%,0.62%),CEA(1.54%,0.65%,1.61%,0.62%),CA125(2.48%,0.40%,2.73%,0.37%),CA153(1.25%,0.80%,1.28%,0.78%),CA199(1.77%,0.56%,1.89%,0.53%)和tPSA(1.84%,0.54%,1.96%,0.51%)。结论 在相同概率下,双侧RCV值高于单侧,而RCF值变化不大。参考变化值RCV仅适用两次检测结果之间的分析,在多于两个连续检测结果时应使用RCF,当RCF作为临床决策工具时可对首诊病人做出正面和负面的预测值,为临床诊断提供科学依据。     

Effect of freeze-thaw cycles on serum measurements of AFP, CEA, CA125 and CA19-9

AFP, CEA, CA125 and CA19-9 are commonly used serum tumour markers (TMs) in clinical practice, although their quantification by immunoassay may be influenced by pre-analytical sample handling. Though the effect of repetitive freeze-thaw cycles is generally recognized, it is not clear in detail. The present study measured (CLIA) these TMs in serum samples freshly separated and after each of five freeze-thaw cycles, in which the samples were frozen at -40 degrees C for 10 months at cycle 4 and 2 h at other cycles. Statistical analysis with the General Linear Model for Repeated Measures revealed significant decreases in the measurements of the four TMs, with the least decrease of 6.8 % for CA125 and the most decrease of 18.2 % for CA19-9 after the last cycle, and an overwhelming single cycle decrease of mean 7.7 % at cycle 4 for AFP, CEA and CA125, of 7.5 % and 9.3 % at cycles 4 and 5 for CA19-9. So it seems that measurements of AFP, CEA and CA125 are more readily affected by long-term frozen storage compared with frequent freezing-thawing, while CA19-9 is relatively unstable under both conditions.     

血清肿瘤标记物及HSP60联合检测对大肠癌诊断的意义

目的 探讨血清肿瘤标记物CEA、CA19-9及HSP60的水平与大肠癌生物学特性的关系及联合诊断的价值.方法 采用电化学发光法及酶联免疫法分别对45例大肠癌患者和44例正常对照者进行血清中CEA、CA19-9及HSP60含量的检测,分析其与大肠癌转移和临床分期的关系,并用ROC曲线分析癌症患者血清中CEA、CA19-9及HSP60的联合诊断价值.结果 大肠癌患者血清中CEA、CA19-9及HSP60水平明显高于正常对照组,尤其在Ⅲ-Ⅳ期以及有淋巴转移的患者血清中水平更高,ROC曲线结果显示三项联合检测敏感性、特异性及AUC值可达到80.0%、90.9%和0.90,与单项或者二项联合相比,可明显提高诊断的准确性.结论 血清中CEA、CA19-9及HSP60水平是大肠癌发生、发展的重要检测指标,三项联合检测对大肠癌患者诊断和预后等有着重要意义.     

C反应蛋白及肿瘤标志物检测在慢性乙型肝炎诊断中的应用

目的观察慢性乙型肝炎(简称乙肝)患者血清C反应蛋白(CRP)、甲胎蛋白(AFP)、癌胚抗原(CEA)、糖类抗原CA19-9的变化,探讨其在临床诊断中的应用价值。方法采用化学发光法检测AFP、CEA、CA19-9,免疫透射比浊法检测CRP。结果慢性乙肝患者血清CRP、AFP、CEA、CA19-9含量显著高于健康对照组(P0.01)。4项指标联合检测在各组中的阳性率明显高于单一指标的阳性率,差异有统计学意义(P0.005)。结论 CRP、AFP、CEA、CA19-9检测不仅能提高慢性乙肝的检出率,而且根据其血清水平能判断病情的严重程度。     

肿瘤标志物CA19-9、CEA、CA242、CA125和AFP评估胃癌化疗疗效的检验分析

目的探讨肿瘤标志物CA19-9、癌胚抗原(CEA)、CA242、CA125和甲胎蛋白(AFP)联合评估胃癌化疗疗效的检验分析。方法选取2010年1月至2013年12月该院收治的胃癌患者160例作为研究对象。分别检测患者治疗前和治疗后3个月相关肿瘤标志物的表达情况。并分析患者TNM分期与肿瘤标志物的关系,治疗前后肿瘤标志物的变化,复发转移与未复发转移患者体内肿瘤标志物的变化关系。结果不同TNM分期与相关肿瘤标志物的阳性表达率有显著相关性。Ⅲ期和Ⅳ期的患者相关肿瘤标志物的阳性表达率显著高于Ⅰ~Ⅱ期。患者经过化疗后CA19-9、CA242、CA125和AFP水平与治疗前相比均显著下降(P0.05),CEA水平治疗前后差异无统计学意义(P0.05)。经过治疗后,患者CEA、CA19-9、CA242、CA125以及AFP阳性表达率均下降,且与治疗前相比,差异有统计学意义(P0.05)。在复发转移患者与未复发转移患者血清相关肿瘤标志物的比较表明,复发转移患者的CEA、CA19-9、CA242、CA124和AFP水平均显著高于未复发转移组(P0.05)。结论 CA19-9、CEA、CA242、CA125和AFP与肿瘤患者TNM分期有着显著相关性,其表达水平以及阳性表达率与胃癌患者预后具有一定的相关性,值得临床重点关注。     

Clinical relevance of tumor markers

Tumour markers are often circulating tumour-associated indicators of tumour development. As such they are not suitable for tumour screening and localization, but valuable as adjuncts for medical follow-up care of tumour patients, where their serum level alterations may anticipate the clinical detection of tumour behaviour by a lead time of 1 to 6 months before other methods. The following tumour may be controlled by established markers: endocrine tumours by NSE, calcitonin, parathormone, 5-HIAA, catecholamines/metabolites etc.; head-neck tumours: SCC, CEA; thyroid carcinoma: TG, calcitonin; lung cancer: CEA, NSE, SCC; liver cancer: AFP (PLC), CA 19-9 (cholangiocell.), CEA (secondary): biliary tract and pancreatic cancer: CA 19-9; colorectal carcinoma: CEA, CA 19-9; squamous cell carcinoma (ENT, oesophagus, anal): SCC; breast cancer: CEA and CA 15-3; ovarian cancer: CA 125 (epithelial), CA 19-9 (mucinous); germ cell tumours (ovary including trophoblastic tumours/testes): AFP and HCG; prostatic cancer: PAP and PSA; bladder cancer: TPA.     

The reference intervals for CA125, CA15-3, CA19-9, CA72-4, AFP,CEA, NSE and CYFRA21-1

Tumor markers are noninvasive diagnostic tools for cancer. Their abnormal expression often occurs earlier than clinical symptoms or other detection signals. Appropriate reference intervals (RIs) of tumor markers are important for health evaluation, cancer diagnosis, therapy monitoring and prognosis assessment. In this study, we aimed to establish the RIs of cancer antigen 125 (CA125), CA15-3, CA19-9, CA72-4, alpha fetoprotein (AFP), carcino-embryonic antigen (CEA), neuron-specific enolase (NSE) and cytokeratin 19 fragment antigen 21–1 (CYFRA21-1) in apparently healthy Henan population. A total of 1705 apparently healthy participants (21–89?years) were recruited from five representative geographical regions in Henan province. Nonparametric 95th percentile intervals were used to define the RIs of CA125, CA15-3, CA19-9, CA72-4, AFP, CEA, NSE and CYFRA21-1. The test results of CA125, CA15-3, CA19-9, CA72-4, AFP, CEA, NSE and CYFRA21-1 can traceable to reference measurement procedures. The age- and gender-specific RIs of the tumor markers were established. We established age- and gender-specific RIs for CA125, CA15-3, CA19-9, CA72-4, AFP, CEA, NSE and CYFRA21-1. The newly established RIs should be more suitable for Henan population. It will be valuable for clinicians to make a medical diagnosis, therapeutic management decision and other physiological assessment.     

N末端B型利钠肽前体在慢性稳定性心力衰竭患者中的短期和长期生物学变异

目的 探讨N末端B型利钠肽前体(NT-proBNP)在慢性稳定性心力衰竭患者中的短期和长期生物学变异。方法 选取该院心血管内科2018年1-9月门诊的慢性稳定性心力衰竭患者29例,其中男15例、女14例,另选取同期体检健康者男女各10例。每个研究对象隔天同一时间采血一次,用于评估短期生物学变异;隔周同一时间采血一次,用于评估长期生物学变异。分别计算项目的个体内变异(CVI)、个体间变异(CVG)、个体指数(II)和参考变化值(RCV)。结果 健康人群NT-proBNP的总体短期CVI、CVG、RCV、II分别为32.55%、27.94%、92.21%、1.19,总体长期CVI、CVG、RCV、II分别为30.91%、25.52%、87.69%、1.24。慢性稳定性心衰患者总体短期CVI、CVG、RCV、II分别为12.96%、66.22%、37.89%、0.21,总体长期CVI、CVG、RCV、II分别为13.41%、65.51%、39.29%、0.22。所有人群的短期和长期、男性和女性比较差异无统计学意义(P>0.05)。结论 慢性稳定性心衰患者个体内生物学变异较体检健康者小,个体间的变异相对较大。临床在评估慢性稳定性心衰患者NT-proBNP两次检测结果是否有显著性病理改变时,使用参考值来判断的方法将不可取,更适合应用生物学变异计算的RCV来指导判断,推荐使用1.5倍RCV的值,即57.00%。     

肿瘤标志物AFP CEA CA19-9CA125联合检测在肿瘤诊断中的意义

目的 探讨人血中AFP、CEA、CA19-9、CA125在肿瘤诊断中的意义.方法 对162例肿瘤患者血清中AFP、CEA、CA19-9、CA125进行联合检测,均采用化学发光法.结果 162例肿瘤患者血清中AFP、CEA、CA19-9、CA125含量明显增高,其阳性率分别为消化道恶性肿瘤组82.1%,消化道良性肿瘤组为50%,肺癌组为72%,卵巢肿瘤组为87.5%.结论 联合检测AFP、CEA、CA19-9、CA125可以明显提高对消化道恶性肿瘤和肺癌的实验室阳性检出率,它们的联合检测具有互补性,是对肿瘤诊断的有效方法,早期发现,诊断、治疗.