CA72-4、CA19-9、CEA联合检测在胃癌诊断中的应用

目的探讨CA72-4、CA19-9、CEA联合检测在胃癌诊断中的应用价值。方法对124例胃癌病人联合检测CA72-4、CA19-9、CEA。结果124例胃癌病人的CA72-4、CA19-9、CEA及联合检测的阳性率分别为41.9%、38.7%、30.6%、70.9%。结论CA72-4、CA19-9、CEA联合检测可提高胃癌病人的阳性检出率,有一定的应用价值。     

胃癌病人中血清CA72-4和CA19-9值的比较以及与复发的相关性

癌胚抗原(CEA)检测胃癌的特异性不高,CA19-9的敏感性变异很大,可在15%～72%之间,联合测定CEA和CA19-9也不提高其敏感性.近期发现一种新的肿瘤相关糖蛋白抗原TAG-72,可在胃肠道腺癌病人的血清中检出,现用的药盒用CA72-4分析,应用单克隆抗体B72.3和CC49的双重决定因子免疫分析法.初步报告CA72-4是胃癌的可靠肿瘤标记物,并可补充CA19-9测定的效果.取32例经内镜和病理证实的胃良性病变和52例经手术切除的胃腺癌病人进行测定,两组病人的中位值年龄分别为36岁和61岁.胃癌病人中,属TNMⅠ、Ⅱ、Ⅲ和Ⅳ期分别占7、5、11和29例.结果凡CA72-4和CA19-9的血清值分别超过6.7kU/L和22kU/L者列为阳性结果.在32例良性胃病变中,CA72-4和CA19-9的阳性率分别为0和28%;而在52例胃癌病人中,则分别为42%和46%,这两种肿瘤标记物具有相似的敏感性,但CA19-9的特异性较低.进一步分析示良性病变者的CA19-9血清值变异较CA72-4为大.在Ⅰ、Ⅱ期和Ⅲ、Ⅳ期胃癌中,CA72-4的阳性率分别达25%和48%,CA19-9的阳性率分别为17%和55%,     

一种新的胃癌标记物—CA72-4

迄今证实,根据血清肿瘤标记物渡度处置胃癌病人是不可靠的。21%～61%胃癌病人的CEA升高,15%～72%胃癌病人CA 19-9升高,这两种肿瘤标记物联合应用并未显著增加其敏感度。为此作者对新的胃癌标记物CA 72-4进行了研究。     

血清TK1、CA72-4、CA19-9水平变化在胃癌筛查诊断中的应用

探讨血清细胞质胸苷激酶（TK1）、糖类抗原72-4(CA72-4)、糖类抗原19-9(CA19-9)在胃癌筛查诊断中的应用价值。选取青岛市中心医院2020年1月至2022年7月经胃镜取活组织或手术后病理学检查确诊的86例胃癌患者作为胃癌组,同期确诊的萎缩性胃炎患者90例作为胃炎组,健康体检对象90例作为健康组,比较三组研究对象的血清TK1、CA72-4、CA19-9水平。根据试剂盒阳性判断标准,以病理学诊断结果为金标准,绘制2×2四格表并计算诊断价值;按照TNM分期、胃癌分化程度、淋巴结转移、病灶长径进行分层对比分析。胃癌组血清TK1、CA72-4、CA19-9水平显著高于胃炎组、健康组,差异具有统计学意义（P<0.05）;胃炎组血清TK1、CA72-4、CA19-9水平与健康组比较,差异均不具有统计学意义（P>0.05）;TK1、CA72-4、CA19-9、TK1+CA72-4+CA19-9四种方式筛查诊断胃癌的灵敏度分别为47.67%、51.16%、44.19%、90.70%;特异度分别为83.89%、79.44%、88.33%、77.78%。TNM分期>Ⅱ期、低...     

血清CEA、CA72-4、CA19-9及胃蛋白酶原水平对胃癌早期诊断的临床价值

目的：探讨血清癌胚抗原（CEA）、糖类抗原72-4(CA72-4)、糖链抗原19-9(CA19-9)、胃蛋白酶原Ⅰ（PGⅠ）、胃蛋白酶原Ⅱ（PGⅡ）及PGⅠ/PGⅡ比值（PGⅠ/PGⅡ,PGR）水平在胃癌患者中的表达情况及其早期诊断的临床价值。方法：选取胃癌患者117例,根据胃癌病情进展及临床病理分期分为早期胃癌组（n=63）和进展期胃癌组（n=54）及Ⅰ～Ⅱ期组（n=67）和Ⅲ～Ⅳ期组（n=50）。另选择60例胃良性病变患者和50例健康对照者。采用化学发光法测定各组血清CEA、CA72-4及CA19-9水平,酶联免疫吸附法检测PGⅠ、PGⅡ及PGR水平。应用受试者工作特征（ROC）曲线分析CEA、CA72-4、CA19-9、PGⅠ、PGⅡ及PGR水平对早期胃癌的诊断价值。结果：胃癌组血清CEA、CA72-4及CA19-9水平均明显高于良性病变组和健康对照组（均P<0.001）,而血清PGⅠ及PGR水平均明显低于良性病变组和对照组（均P<0.001）。进展期胃癌组血清CEA[(44.56±13.75)ng/m L比（25.70±7.42）ng/m L]、CA72-4 [(5...     

联合检测肿瘤标志物、血清胃蛋白酶原及胃泌素-17在胃癌诊断中的应用

目的探讨联合检测CA19-9、CA72-4、癌胚抗原(CEA)、血清胃蛋白酶原Ⅰ(PGⅠ)、胃蛋白酶原Ⅱ(PGⅡ)、PGⅠ/PGⅡ比值(PGR)和胃泌素-17(G17)在胃癌诊断中的应用价值。方法回顾性收集中国人民解放军联勤保障部队第九四〇医院于2016年1月至2018年8月期间收治的100例胃癌患者为观察组,收集同期110例胃部良性病变患者为对照组,检测2组患者的血清CA19-9、CA72-4、CEA、PGⅠ、PGⅡ、PGR及G17水平,探索单独检测和联合检测的诊断价值。结果观察组的血清CA19-9、CA72-4、CEA及G17水平均高于对照组(P0.05),PGⅠ和PGR水平均低于对照组(P0.05)。观察组的血清CA19-9、CA72-4、CEA、G17、PGⅠ及PGR阳性率均高于对照组,且联合检测的阳性率也高于对照组(P0.05)。联合检测的灵敏度和准确度均优于各项指标单独检测(P0.05)。Ⅲ+Ⅳ期、中低分化程度、发生远处转移、肿瘤直径5 cm及印戒细胞癌患者的血清CA19-9、CA72-4、CEA及G17水平相应高于Ⅰ+Ⅱ期、高分化程度、未发生远处转移、肿瘤直径≤5 cm及腺癌患者(P0.05),但血清PGⅠ和PGR水平相应低于Ⅰ+Ⅱ期、高分化程度、未发生远处转移、肿瘤直径≤5 cm及腺癌患者(P0.05)。结论联合检测血清CA19-9、CA72-4、CEA、PGⅠ、PGⅡ、PGR及G17可有效提高胃癌诊断的准确率,并且它们均与胃癌患者的病理学特征密切相关。     

肿瘤标志物在胃癌患者中的诊断及预后价值

目的 探讨肿瘤标志物CEA、CA19-9、CA72-4及CA242在胃癌诊断及预后判断中的应用价值.方法 回顾性分析2002-2007年间在北京肿瘤医院就诊的160例胃癌患者血清肿瘤标志物、临床病理参数以及预后资料.结果 160例胃癌患者中CEA、CA19-9、CA72-4及CA242的初诊阳性率分别为37.7％、26.7％、37.6％及21.3％,4种标志物联合检测阳性率为62.9％.CEA阳性与淋巴结转移有关（P=0.029）;CA72-4阳性与脉管浸润及Ⅲ、Ⅳ期胃癌有关（P=0.039,P=0.011）.CA19-9阳性和阴性患者中位生存期分别为17.0和32.0个月,CA72-4阳性和阴性患者中位生存期分别为14.8和37.5个月,差异有统计学意义（P＜0.01）.多因素生存分析提示,CA72-4可以作为独立预后因子（P=0.012）,CA72-4阳性患者的死亡危险系数是阴性患者的2.147倍.结论 肿瘤标志物CEA、CA19-9、CA72-4及CA242在胃癌患者的诊断和预后判断中有重要价值,联合检测可提高阳性率;其中CA72-4可以作为独立预后因子,CA19-9及CA72-4与胃癌患者预后相关.     

血清CA19-9、CA242、CEA及CA125在胰腺癌诊断和预后中的价值

目的探讨CA19-9、CA242、CEA和CA125四种肿瘤标志物单独检测或联合检测在胰腺癌诊断和预后中的价值。方法测定并分析我院2007年1月至2009年12月期间收治的63例胰腺癌患者、33例胆管癌和27例胰腺良性疾病患者血清中CA19-9、CA242、CEA和CA125水平,并对术后胰腺癌患者进行随访。结果胰腺癌患者血清中CA19-9、CA242、CEA和CA125水平明显高于胰腺良性疾病患者和胆管癌患者(P<0.05)。单项检测中血清CA19-9的敏感性最高,达79.4%(50/63),但其特异性(61.7%)低于CA242(83.3%)和CEA(80.0%)。联合检测CA19-9+CA242+CEA的特异性最高,达93.3%(56/60)。当肿瘤位于胰腺体/尾部时CA19-9水平显著高于其在胰腺头部或全胰腺时(P<0.05)。胰腺癌Ⅳ期患者的CA19-9和CA242水平显著高于Ⅰ或Ⅱ/Ⅲ期患者(P<0.05)。本组失访15例,48例获得随访,随访时间平均6个月(2~12个月)。胰腺癌患者术后0.5及3个月血清中CA242、CA19-9较术前明显降低(P<0.05)。结论单项检测CA19-9可以提高胰腺癌诊断的敏感性,联合检测CA19-9+CA242+CEA可以提高胰腺癌诊断的特异性,CA19-9和CA242对胰腺癌的治疗效果及预后判断更具有价值。     

术前血清CEA、CA19-9水平检测对胃癌术后复发转移及预后的意义

目的探讨术前血清CEA和CA19-9水平在胃癌根治术后复发转移及预后中的应用价值。方法应用电化学发光法检测136例胃癌患者术前静脉血清CEA和CA19-9水平,分析CEA和CA19-9水平与患者临床病理学参数、术后复发转移和预后的关系。采用Kaplan-Meier法(log-rank检验)进行生存分析。结果 136例胃癌患者中术后复发转移67例。术前血清CEA阳性率为48.5%(66/136),CA19-9阳性率为43.4%(59/136)。CEA阳性与T分期、TNM分期、淋巴结转移及脉管浸润有关(P=0.011、P=0.018、P=0.021、P=0.024),CA19-9阳性与T分期和淋巴结转移有关(P=0.018、P=0.045)。CEA阳性组和CA19-9阳性组术后复发转移率分别为60.6%(40/66)和61.0%(36/59),CEA阴性组和CA19-9阴性组术后复发转移率分别为38.6%(27/70)和40.3%(31/77),CEA阳性组和CA19-9阳性组术后复发转移率分别明显高于CEA阴性组和CA19-9阴性组(P=0.010、P=0.016)。Kaplan-Meier生存分析显示CEA阳性组和CA19-9阳性组术后无瘤生存时间明显短于CEA阴性组和CA19-9阴性组(P=0.003、P=0.007)。结论术前血清CEA和CA19-9水平检测在胃癌术后复发转移和预后判断中具有重要价值,术前联合检测血清CEA和CA19-9水平有助于提高胃癌术后复发转移和预后的预测。     

术前血清CA125预测胃癌腹膜转移的单中心大样本临床研究

目的:探讨术前血清CA125等肿瘤标志物对胃癌腹膜转移的预测价值。方法:术前检测1 348例胃癌病人的血清CA125、CA19-9、CA72-4和CEA水平,其检测值与临床病理参数作分析。结果:受试者工作特征(ROC)分析显示,血清CA125对胃癌腹膜转移术前判断的准确率最高,CA125、CA19-9、CA72-4和CEA的ROC曲线下面积分别为0.85、0.61、0.71和0.43。ROC分析进一步显示,血清CA125预测腹水的诊断价值较高(ROC曲线下面积为0.97),并且血清CA125水平与腹水量密切相关(r=0.686,P0.001)。以35 u/mL作为血清CA125的临界值,血清CA125预测胃癌腹膜转移的灵敏度、特异度、阳性预测值、阴性预测值和准确率分别为43.6%(41/94)、96.5%(1210/1254)、48.2%(41/85)、95.8%(1 210/1 263)和92.8%(1 251/1 348)。此外,血清CA125对伴有腹水胃癌腹膜转移的灵敏度较无腹水的胃癌腹膜转移显著增高(79.4%比23.3%,P0.001)。结论:术前血清CA125对胃癌腹膜转移的预测价值较高,且血清CA125水平与腹水量密切相关。     

Significance of Serum Tumor Markers Carcinoembryonic Antigen, CA 19-9, CA 125, and CA 15-3 in Pre-Orthotopic Liver Transplantation Evaluation

Tumor markers are elevated in a variety of nonneoplastic clinical situations, including liver diseases. Their sensitivity and specificity are lower for tumor screening in these cases. In this study, we investigated the frequency and significance of elevated tumor markers in the pre-orthotopic liver transplantation (OLT) evaluation among patients with end-stage liver disease who did not develop tumors after a long follow-up post-OLT. We performed a retrospective analysis of clinical and biological parameters of 100 OLT candidates comparing data for CA 125, CA 19-9, CA 15-3, and carcinoembryonic antigen (CEA) levels. CA 125, CA 19-9, CA 15-3, and CEA levels were elevated in 59%, 53%, 29%, and 28% of cases, respectively. CA 125, CA 15-3, and CEA were associated with disease severity (Child-Pugh classification). CA 125 was also elevated among patients with ascites, esophageal varices, or alcohol-related cirrhosis. Elevated CA 19-9 levels were associated with increased CA 15-3 and CEA levels. CA 15-3 levels were also increased among patients with elevated alkaline phosphatase, while elevated CEA was related to ascites, bilirubin, and prothrombin time (PT) levels, as well as alcohol-related cirrhosis. There was no association between hepatocellular carcinoma and tumor markers. In conclusion, CA 125, CA 19-9, CA 15-3, and CEA were frequently elevated among end-stage liver disease patients. These elevations were not associated with tumor diseases in this population.     

血清CA153、CA125及CA19-9检测对乳腺癌的诊断价值

目的探讨血清CA153、CA125和CA19-9检测对乳腺癌早期诊断的价值。方法采用化学发光免疫法分别检测乳腺癌、乳腺良性疾病患者及正常健康体检者血清CA153、CA125和CA19-9的水平。结果乳腺癌患者血清的CA153、CA125和CA19-9的表达水平及表达阳性率均明显高于正常对照者和乳腺良性疾病患者(P<0.01);乳腺癌患者术后CA153、CA125及CA19-9表达水平较术前明显下降(P<0.01),与正常对照者比较差异无统计学意义(P>0.05)。结论肿瘤标志物CA153、CA125及CA19-9对乳腺癌有一定的诊断价值,且可作为监测乳腺癌病情进展、评估治疗疗效及预后的指标。     

Clinical utility of CEA, CA 19-9, and CA 72-4 in the follow-up of patients with resectable gastric cancer

BACKGROUND: The aim of this longitudinal study was to evaluate the effectiveness of the serum tumor markers CEA, CA 19-9, and CA 72-4 in the early diagnosis of recurrence of gastric cancer. METHODS: One hundred and thirty-three patients who had undergone potentially curative surgery were considered. Serum samples were obtained preoperatively, 1 week after surgery, and at every follow-up examination. Mean follow-up time for the entire patient population was 41 +/- 33 months, and 71 +/- 27 months for patients classified as disease-free. RESULTS: Preoperative positivity was 16% for CEA, 35% for CA 19-9, and 20% for CA 72-4. Recurrence of disease was found in 75 patients (56%). Marker sensitivity in recurrent cases was 44% for CEA, 56% for CA 19-9, and 51% for CA 72-4; the combined use of the three markers increased sensitivity to 87%, which reached 100% in patients with positive preoperative levels. Marker specificity, evaluated in 58 disease-free patients, was 79% for CEA, 74% for CA 19-9, and 97% for CA 72-4. CONCLUSIONS: The combined assay of CEA, CA 19-9, and CA 72-4 may be useful for early diagnosis of recurrence of gastric cancer; however, only CA 72-4 positivity should be considered a specific predictor of tumor recurrence.     

肿瘤标志物CA19-9、CA242、CEA和CA125联合检测在胰腺癌诊断中的意义

目的 探讨肿瘤标志物CA19-9、CA242、CEA和CA125单项检测和联合检测对胰腺癌患者的临床诊断价值.方法 检测48例胰腺癌患者以及48例健康体检者外周血清中四种肿瘤标志物的水平,并对结果进行分析.结果 胰腺癌患者血清中CA19-9、CA242、CEA与CA125的含量显著高于正常时照组,两者比较差异有统计学意义(P<0.01).单项检测时CA19-9、CA242、CEA与CA125的敏感性分别为79.2%、54.2%、50.0%和35.4%.特异性分别为87.5%、89.6%、79.2%和70.8%.联合检测时敏感性为93.8%,特异性为100%.结论 CA19-9、CA242、CEA与CA125联合检测敏感性和特异性都明显高于单项检测.联合检测较单项血清标志物检测能提高胰腺癌的诊断率.     

Effect of hemodialysis on the concentration of the seven tumor markers carcinoembryonic antigen, alpha-fetoprotein, squamous cell carcinoma-related antigen, neuron-specific enolase, CA 125, CA 19-9 and CA 15-3 in uremic patients.

The incidence of the 7 tumor markers carcinoembryonic antigen (CEA), alpha-fetoprotein (AFP), squamous cell carcinoma-related antigen (SCC), neuron-specific enolase (NSE), CA 125, CA 19-9 and CA 15-3 was studied before and after hemodialysis (HD) in 144 uremic patients who had no malignancies. Before HD, of all tumor markers, the mean concentration of SCC only exceeded the normal value. The positive rate was highest in SCC (95.1%), and that of CEA and NSE was 25.7 and 10.6%, respectively. However, AFP was within the normal range in all cases. Among CA antigens, the positive rate of CA 125 was 7.6%, of CA 19-9 was 6.3% and of CA 15-3 was 3.5%. After HD, the incidence as well as the mean concentration of all tumor markers increased. A parallel increment of total protein was observed after HD. The membrane filter used in HD appears to be insufficient to remove tumor marker proteins during HD. It is necessary to consider the clinical interpretation of elevated tumor markers in patients with uremia.     

血清CEA、CA15-3及CA125检测对乳腺癌诊断价值的临床评价

乳腺癌是女性最常见的恶性肿瘤之一,目前发病率在女性恶性肿瘤中已高居第一位.我国乳腺癌的特点是发病年龄较早,早期多无症状,就诊时病期相对偏晚,出现转移致存活期较短,所以早期诊断、早期治疗是提高其生存率的关键.     

Serum CA 19-9 and CA 50 antigens in hemodialysis patients

Serum concentrations of monoclonal antibody-defined tumor markers CA 19-9 and CA 50 were measured in 64 uncomplicated hemodialysis patients (Group 1) and in 8 hemodialysis patients with cancer (Group 2) in comparison with corresponding CEA determinations. From our results in Group 1 patients it appears that both CA 19-9 and CA 50 maintained an excellent specificity in these patients. As to the sensitivity of these tests, our findings in Group 2 patients are comparable with those reported in patients with cancer and normal renal function. It is concluded that, unlike CEA, these new tumor markers maintain their clinical value in chronic renal failure.