子宫腺肌症和子宫肌瘤患者血清CA125测定的临床意义

目的探讨血清CA125测定在子宫腺肌症中的意义及在子宫腺肌症与子宫肌瘤鉴别诊断中的价值。方法用化学发光免疫分析法检测112例子宫腺肌症、166例子宫肌瘤患者及200例健康对照者血清CA125的水平。其中60例子宫腺肌症患者治疗后复检。结果子宫腺肌症组CA125值（82．3±70．5）IU／ml,阳性率为75．0％;子宫肌瘤组CA125值（33．2±21．3）IU／ml,阳性率为10．2％;健康对照组CA125值（25．1±17．6）IU／ml,阳性率为8．0％。子宫腺肌症组的CA125均值及阳性率较子宫肌瘤组和健康对照组为显著增高,差异有统计学意义（P〈0．01）;子宫肌瘤组患者血清CA125水平与健康对照组差异无统计学意义（P〉0．05）;子宫腺肌症患者治疗后血清CA125水平均较治疗前明显下降（P〈0．01）。结论结合其他检查手段,血清CA125可以作为子宫腺肌症与子宫肌瘤鉴别诊断及疗效评价的一个指标。     

子宫腺肌病患者血清肿瘤标记物的测定及临床意义

目的　探讨血清肿瘤标记物测定对子宫腺肌病的诊断价值。方法　选择子宫腺肌病组 3 7例、子宫腺肌病并子宫肌瘤组 3 8例、子宫肌瘤组 64例及正常对照组 3 2例为研究对象 ,采用免疫放射方法测定血清CA12 5、CA199、CA153 、AFP、CEA值。结果　腺肌病组及腺肌病并肌瘤组CA12 5值显著高于肌瘤组及对照组 ( 13 1.5± 15 .5、112 .2± 2 0 .9对 18.5± 5 .3、14 .4± 6.2U/ml,P <0 .0 1) ,CA199值也显著高于肌瘤组及对照组 ( 3 6.1± 10 .1、3 1.2± 13 .4对 13 .4± 4.3、12 .2± 2 .2U /ml,P <0 .0 1)。腺肌病组及腺肌病并肌瘤组CA12 5阳性率显著高于肌瘤组及对照组 ( 78.4%、76.3 %对 7.8%、6.3 % ,P <0 .0 1) ,CA199阳性率也显著高于肌瘤组及对照组 ( 2 7.0 %、2 1.1%对 4.7%、3 .1% ,P <0 .0 5 )。CA12 5在腺肌病组与腺肌病并肌瘤组中阳性率为 77.3 % ,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% ;CA199在腺肌病组与腺肌病并肌瘤组中阳性率为 2 4.0 % ,敏感性、特异性、阳性预测值、阴性预测值分别为 :2 4.0 %、95 .3 %、85 .7%、5 1.7%。结论　子宫腺肌病血清CA12 5及CA199浓度升高 ,CA12 5对子宫腺肌病有较好的诊断预测价值     

血清CA125在子宫腺肌病及子宫肌瘤中的诊断价值

【目的】探讨血清CA125对子宫腺肌病及子宫肌瘤的诊断价值。【方法】术前采用放射免疫法测定75例子宫腺肌病患者及93例子宫肌瘤患者的血清CA125值。【结果】在增生期子宫腺肌病及子宫肌瘤血清CA125的阳性率分别为89.36%和3.39%,分泌期分别为78.57%和2.94%,上述两组血清CA125平均水平在增生期分别为(90.70±54.71)kU/L和(13.16±72.99)kU/L,在分泌期为(108.81±69.72)kU/L和(15.14±13.10)kU/L。不论在增生期还是分泌期,子宫肌瘤组血清CA125阳性率及平均水平均显著低于腺肌病组,且差异有显著性(P<0.05)。【结论】测定血清CA125水平,对子宫腺肌病有重要的辅助诊断价值,且有助于与子宫肌瘤的鉴别诊断。     

妇科非恶性疾病临床诊断中肿瘤标志物的应用价值

目的探讨肿瘤标志物在妇科非恶性疾病临床诊断中的应用价值。方法对350例妇科患者进行癌胚抗原(CEA)、甲胎蛋白(AFP)、血清糖类抗原125(CA125)、血清糖类抗原199(CA199)测定。结果 CA125水平在盆腔炎、卵巢脓肿、子宫肌腺病、子宫内膜异位症时明显高于其他疾病(P0.01);子宫肌瘤、卵巢良性肿瘤及其他妇科非恶性疾病时CEA、AFP、CA125、CA199水平无明显增高。结论肿瘤标志物CEA、AFP、CA125、CA199水平可用于妇科良恶性肿瘤的诊断,同时可应用于卵巢脓肿与子宫肌瘤等非恶性妇科疾病的鉴别诊断。     

磁共振、超声检查及血清CA125测定诊断子宫腺肌病的临床评价

目的：评价磁共振（MRI）、超声检查（US）及血清CA125测定诊断子宫腺肌病的临床价值。方法：对术后病理确诊的子宫腺肌病38例和子宫肌瘤32例术前行MRI、US及血清CA125测定，分析其敏感性、特异性、准确率。结果：MRI敏感性为94．74％，特异性为100％，准确率为97．14％；US为76．31％、85．29％和81．43％；CA125测定敏感性为76．32％，特异性为87．88％，准确率为81．43％。结论：MRI、US及血清CA125测定对于诊断子宫腺肌病均有一定的价值，MRI具有高度的敏感性、特异性和准确率。因此，根据临床表现首选US及血清CA125测定，在鉴别诊断困难，而影响临床治疗时，再选用MRI。     

子宫腺肌病病灶范围及微囊腔大小与血清CA125的关系

【目的】探讨子宫腺肌病病灶范围及微囊腔大小与血清CA125颅的关系。【方法】采用放射免疫法（RIA）检测及比较76例子宫腺肌病患者（观察组）及76例子宫肌瘤患者（对照组）的血清CA125颅值。采用Jone Rosal描述方法测量观察组患者子宫腺肌病病变范围及病灶微囊腔大小。【结果】观察组患者血清CA125颅值（93．37±39．3μ／mL）明显高于对照组血清CA125颅（16．32±4．86μ／mL）差异有显著性（P〈0．05）,且观察组随子宫腺肌病病灶范围增大,病灶内微囊腔的增大,血清CA125颅值升高。【结论】血清CA125颅检测有助于子宫腺肌病的诊断。根据血清CA125颅值可粗略评估子宫腺肌症病灶情况。     

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。     

血清CA125测定及超声检查诊断子宫腺肌病的临床分析

作通过对比子宫腺肌病与子宫肌瘤患血清CA125测定及B超检查，探讨诊断子宫腺肌病的临床诊断价值。     

探讨肿瘤标记物CEA、CA15—3、CA19—9、CA125及AFP在胸腔积液中的诊断价值

目的探讨检测胸水和血清中的5种肿瘤标记物：CEA、CA15—3、CA19—9、CA125及AFP在良恶性胸腔积液鉴别诊断的应用价值。方法采用电化学发光法对42例恶性肿瘤患者的胸水、血清及40例非恶性肿瘤患者的胸水进行免疫蛋白定量检测．并加以分析。结果CEA、CA15-3、CA19-9及CA125在恶性胸水中的含量均明显高于良性胸水（P〈0．01或P〈0．05）。在恶性组中其胸水的水平也明显高于血清水平（P〈0．01或P〈O．05）。但AFP水平不论胸水还是血清中．恶性组和良性组均无明显差异（P〉0．05）。CEA、CA15—3、CA19—9、CA125及AFP对恶性胸水诊断的敏感性分别为66．7％、69％、47．6％、95．2％、9．5％;特异性为90％、85％、92．5％、7．5％、97．5％;准确性为78％、76．8％、69．5％、52．4％、52．4％。CEA与CA153联合检测其敏感性和特异性高达85．7％和85％,准确性为85.4％。结论检测胸水中的CEA、CA15—3、CA19—9及CA125有利于良恶性胸腔积液的鉴别诊断,其中CEA和CA15—3的联合检测为最佳组合。可显著提高对恶性胸水的诊断阳性率。     

子宫肌腺症和子宫内膜异位症患者血清CA125检测的临床意义

目的探讨血清糖类抗原（CA）125在子宫肌腺症和子宫内膜异位症中的临床价值。方法用化学发光免疫分析法检测子宫肌腺症、子宫内膜异位症、子宫肌瘤、卵巢囊肿患者及健康对照者血清CA125的水平，部分子宫肌腺症和子宫内膜异位症患者治疗后复测。结果子宫肌腺症和子宫内膜异位症组血清CA125水平[（69．5±32．0）IU／mL和（52．3±8．4）IU／mL]较子宫肌瘤组[（38．2±27．1）IU／mL]、卵巢囊肿组[（29．8±21．0）IU／mL]及健康对照组[（26．0±8．1）IU／mL]显著增高，差异均有统计学意义（P均〈0．01）；子宫肌瘤或卵巢囊肿患者血清CA125水平与健康对照组差异均无统计学意义（P〉0．05）。子宫肌腺症和子宫内膜异位症组治疗后血清CA125水平均较治疗前明显下降（P均〈0．01）。结论结合患者体征及影像学检查，血清CA125可作为子宫肌腺症与子宫肌瘤、子宫内膜异位症与卵巢囊肿鉴别诊断以及疗效评价的指标。     

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。     

Tumour marker CA 125 in patients with digestive tract malignancies.

The serum levels of tumour marker CA 125 were measured in 162 patients with various digestive tract malignancies and in 155 patients with benign digestive tract diseases. The highest frequency of elevated CA 125 values (greater than 35 U ml-1) was found in patients with liver cancer (78%), but the level was equally often elevated in liver cirrhosis (78%). Two-thirds of the patients with biliary tract cancer had an increased CA 125 concentration, while four patients with benign biliary diseases had an elevated value. The serum level of CA 125 was elevated in only 20% of 60 patients with primary colorectal cancer, and in none of those with local disease (Dukes A or B). The CA 125 concentration seldom increased in patients with recurrent colorectal carcinoma. Twenty-three per cent of 44 patients with gastric cancer had an elevated CA 125 value. Two of 33 patients with benign colorectal and one of 68 patients with benign gastric diseases had an increased CA 125 concentration. The serum values of CA 125 showed no correlation with those of tumour markers alphafetoprotein (AFP), carcinoembryonic antigen (CEA) or CA 19-9. AFP was superior to the other markers in the diagnosis of liver diseases, while CA 19-9 showed the greatest accuracy in gastric diseases. In colorectal diseases, CEA had a higher sensitivity, but a lower specificity than CA 125 and CA 19-9. CA 125 and CA 19-9 had similar sensitivities for biliary tract cancer.(ABSTRACT TRUNCATED AT 250 WORDS)     

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。     

肿瘤4项联合NLR、CEA在结肠癌中的诊断价值及与临床分期的相关性

目的探讨血清肿瘤4项[细胞角蛋白19片段(CYFRA21-1)、糖类抗原125(CA125)、糖类抗原15-3(CA15-3)、糖类抗原19-9(CA19-9)]联合中性粒细胞计数/淋巴细胞计数比率(NLR)、癌胚抗原(CEA)在结肠癌中的诊断价值,并分析血清肿瘤4项和NLR、CEA与结肠癌临床分期的相关性。方法选取进行结肠组织活检的284例患者为研究对象,根据病理诊断结果,其中良性病变203例(良性病变组),结肠癌81例(病例组)。比较两组患者CYFRA21-1、CA125、CA15-3、CA19-9、NLR、CEA的水平。采用受试者工作特征曲线(ROC曲线)分析血清肿瘤4项(CYFRA21-1、CA125、CA15-3、CA19-9)联合NLR、CEA在结肠癌诊断中的价值;采用Spearman相关分析血清肿瘤4项和NLR、CEA表达与结肠癌临床分期的相关性。结果病例组CYFRA21-1、CA125、CA15-3、CA19-9和NLR、CEA均高于良性病变组(P<0.05)。NLR、CEA联合血清肿瘤4项(CYFRA21-1、CA125、CA15-3、CA19-9)诊断结肠癌的灵敏度(89.71%)、特异度(90.08%)、准确率(92.31%)均高于各项指标单独检测。NLR(r=0.813,P=0.016)、CEA(r=0.881,P=0.013)、CYFRA21-1(r=0.853,P=0.014)、CA125(r=0.857,P=0.014)、CA15-3(r=0.851,P=0.014)、CA19-9(r=0.829,P=0.015)与临床分期呈正相关(P<0.05)。结论血清肿瘤4项和NLR、CEA与结肠癌临床分期密切相关,且血清肿瘤4项和NLR、CEA联合检测在结肠癌早期诊断中具有较高价值,值得临床推广使用。     

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.     

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。     

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.     

血清肿瘤标志物联合检测在胃癌诊断中的临床价值

[目的]评价联合检测血清肿瘤标志物CA19—9、CA242、CA125及癌胚抗原CEA四项指标对胃癌的诊断价值。[方法]选取65例胃癌患者作为病患组（A组）,70例同期住院的良性胃疾病患者作为良性胃疾病组（B组）,70例同期体检合格的健康成人作为正常对照组（c组）。采用化学发光免疫分析法检测三组人选对象的CA19—9、CA125、CA242、CEA血清水平并进行对比。[结果]胃癌患者血清CA19—9、CA125、CA242、CEA值均明显高于正常对照组及良性胃疾病组,差异均有统计学意义（P〈0．05）;CA19—9、CA125、CA242、CEA四项指标联合检测的敏感性（75．84％）和特异性（59．71％）较单测任何一项（CA19—9：23．12％、83．91％,CA125：38．45％、90．41％、CA242：21．33％、85．30％,CEA：35．11％、92．30％。）敏感性均有提高,差异均有统计学意义（P〈0．05）。[结论]联合检测血清CA19—9、CA125、CA242及CEA能提高对胃癌的阳性检出率,具有临床诊断价值。