血清CA19—9、CA125、CA242、CEA联检诊断胰腺癌的临床价值

目的：评价血清糖类抗原19—9（CA19—9），糖类抗原125（CA125），糖类抗原242（CA242）及癌胚抗原（CEA）四项指标联检对胰腺癌的诊断价值。方法：四项标志物均应用全自动化学免疫分析检测。结果：胰腺癌患者血清CA19—9、CA125、CA242、CEA水平明显高于胰腺良性病组，差异均有显著性（P〈0．01）。四项指标联检诊断胰腺癌的敏感性为91．7％，特异性92．1％。结论：血清CA19—9、CA125、CA242及CEA单项检测在胰腺癌诊断中特异性均偏低，且四项联检可提高胰腺癌的敏感性及特异性，临床诊断价值更大。     

Diagnostic value of carcinoembryonic antigen and carcinoma antigen 19-9 for colorectal carcinoma

Objective: The purpose of this study was to evaluate the diagnostic efficiency of colorectal carcinoma (CRC) with the tumor markers Carcinoembryonic Antigen (CEA) and Carbohydrate Antigen 19-9 (CA 19-9), in addition to investigating whether CA 19-9 can be used to screen the disease process in patients with CRC who had no elevation of CEA levels. Methods: Serum levels of CEA and CA 19-9 were measured in: 138 patients with CRC; 111 patients with benign colorectal diseases. The diagnostic value was performed using the logistic regression equation and receiver operating characteristic curves (ROC). Results: The serum levels of CEA and CA 19-9 in the patients with CRC were significantly higher than those in the patients with benign colorectal diseases (P < 0.001). Receiver operating characteristic curves (ROC) in the patients with CRC versus those with benign colorectal disease yielded the optimal cut-off value of 3.36 ng/ml for CEA and 23.9 U/ml for CA 19-9, respectively. The area under ROC curve (AUC) was 0.789 for CEA, 0.690 for CA 19-9 and 0.900 for the combination of the two tumor markers. The combination resulted in a higher Youden index and a sensitivity of 85.3%. Conclusion: The combined detection of serum CEA and CA 19-9 could play a pivotal role in the diagnosis of CRC, and could drastically improve the sensitivity for the diagnosis of CRC. CA 19-9 might be a tumor biomarker in addition to CEA for CRC.     

血清肿瘤标志物CEA、CA724、CA242、CA19-9联合检测诊断肺癌的临床价值分析

目的 分析血清肿瘤标志物癌胚抗原(CEA)、糖类抗原724(CA724)、糖类抗原242(CA242)、糖类抗原19-9(CA19-9)联合检测与肺癌诊断及预后的相关性.方法 选取2014年5月至2017年1月我院收治的肺癌患者120例为研究对象,并纳入观察组,以同期入院体检的良性肺疾病患者55例为对照组,测定两组血清CEA、CA724、CA242、CA19-9水平,对比四种肿瘤标志物在不同病理类型肺癌中表达水平,分析CEA、CA724、CA242、CA19-9联合检测与单项、2联、3联检测诊断肺癌的灵敏度、特异度、准确度、阳性预测值、阴性预测值,比较CEA、CA724、CA242、CA19-9阳性或阴性患者在预后随访中无复发生存率、远处转移率.结果 观察组血清CEA(30.24±1.75)μg/L、CA724(14.85±1.11)kU/L、CA242(38.18±1.05)kU/L、CA19-9(41.24±1.57)kU/L均较对照组高(P<0.05);CEA、CA242在腺癌中表达水平最高,CA724、CA19-9在腺癌与鳞癌中表达水平差异无统计学意义(P>0.05);CEA、CA724、CA242、CA19-9联合检测诊断肺癌的灵敏度98.18%、准确度80.00%、阴性预测值80.00%,均高于上述指标单项或2联、3联检测(P<0.05);CEA、CA724、CA242、CA19-9阳性患者与阴性患者比较,无复发生存率明显较低,远处转移率显著较高(P<0.05).结论 血清肿瘤标志物CEA、CA724、CA242、CA19-9联合检测诊断肺癌的灵敏度、准确度较单项、2联及3联检测明显提高,且上述指标可用于预测预后,值得在临床推广应用.     

胃癌患者手术治疗前后血清CEA、CA242、CA72-4和CA19-9检测的临床意义

目的：探讨了胃癌患者手术治疗前后血清CEA、CA242、CA72-4和CA19-9水平的变化及意义。方法：应用放射免疫分析对31例胃癌患者进行了手术治疗前后血清CEA、CA242、CA72-4和CA19-9检测,并与35名正常健康人作比较。结果：在手术前,胃癌患者血清CEA、CA242、CA72-4和CA19-9水平均非常显著地高于正常人组（P〈0.01）经手术治疗后3个月则与正常人组比较无显著性差异（P〉0.05）。结论：检测胃癌患者手术治疗前后血清CEA、CA242、CA72-4和CA19-9水平的变化对了解病情、观察预后均有重要的价值。     

Clinical significance and prognostic value of CA72-4 compared with CEA and CA19-9 in patients with gastric cancer

Carcinoembryonic antigen (CEA) and CA 19-9 are both widely used in the follow up of patients with gastrointestinal cancer. More recently another tumor marker, named CA 72-4 has been identified and characterized using two different monoclonal antibodies B72.3 and CC49. Several reports evaluated CA 72-4 as a serum tumor marker for gastric cancer and compared its clinical utility with that of CEA or CA 19-9; few reports concerned its prognostic value. In the present study, CA 72-4 is evaluated and compared with CEA and CA 19-9 in various populations of patients with gastric cancer and benign disease; for 52 patients with gastric adenocarcinoma and 57 patients without neoplastic disease CEA, CA 19-9 and CA 72-4 were evaluated before treatment. Sensitivity of the tumor markers CA 72-4, CA 19-9 and CEA at the recommended cut-off level in all 52 patients were 58%, 50% the sensitivity increased to 75%. of these markers, for non metastatic patients, multivariate analyses indicated that none of the markers were significant, when adjusted for gender and age (which were indicators of poor prognosis); patients with abnormal values of CA72-4 tended to have shorter survival than patients with normal values (p<0.07). In the metastatic population, only high values of CA19-9 (p<0.02) and gender (women) p<0.03) were indicators of poor prognosis in univariate analysis; multivariate analysis revealed that both CA72-4 (p=0.034) and CA19-9 p=0.009), adjusted for gender were independent prognostic factors. However, CA72-4 lost significance (p=0.41) when adjusted for CA19-9 and gender, indicating that CA19-9 provides more prognostic information than CA72-4. When limited to the metastatic male population with normal values of CA 19-9 and CEA, CA 72-4 pretherapeutic positive levels were associated with a worse prognosis (p<0.005). In conclusion, this study suggests that the addition of CA 72-4 to CEA and/or CA 19-9 could improve sensitivity in gastric cancer. The prognostic role of this marker is not yet clearly demonstrated but its usefulness in the monitoring of gastric cancer should be taken into account.     

Comparison between clinical significance of serum proinflammatory proteins (IL-6 and CRP) and classic tumor markers (CEA and CA 19-9) in gastric cancer

Gastric cancer (GC) is a second most common cause of cancer-related death and represents an inflammation-driven malignancy. It has been suggested that interleukin 6 (IL-6) and C-reactive protein (CRP) play a potential role in the growth and progression of GC. The aim of the present study was to compare clinical significance of IL-6 and CRP with classic tumor markers—carcinoembryonic antigen (CEA) and carbohydrate antigen (CA 19-9) in GC patients. The study included 92 patients with GC and 70 healthy subjects. The serum concentrations of IL-6, CEA and CA 19-9 were determined using immunoenzyme assays, whereas CRP using immunoturbidimetric method. We defined the diagnostic criteria and prognostic value for proteins tested. In GC patients, the serum concentrations of all the proteins tested were significantly higher than in healthy subjects. The IL-6, CEA and CA 19-9 levels correlated with nodal metastases, while CRP with tumor stage, gastric wall invasion, presence of nodal and distant metastases. Diagnostic sensitivity of IL-6 was higher (85%) than those of other markers (CRP 66%, CA 19-9 34%, CEA 22%) and increased in combined use with CRP or CEA (88%). The area under ROC curve for IL-6 was larger than those of CRP and classic tumor markers (CEA and CA 19-9). None of the proteins tested was independent prognostic factor for the survival of GC patients. Our findings indicate better usefulness of serum proinflammatory proteins—IL-6 and CRP than classic tumor markers—CEA and CA 19-9 in the diagnosis of GC.     

多种肿瘤标志物在胰腺癌中的诊断价值及相关性研究

目的：探讨血清肿瘤标志物联合检测对胰腺癌的诊断价值及相关性。 方法：选取2013年1月至2016年5月我院胰腺癌患者146例,非胰腺癌患者128例和健康体检者124例,放射免疫分析仪检测各组血清CA19-9、CA242、CA50、CA125、CEA及TSGF水平,并进行各组间比较。绘制受试工作特征曲线（ROC）分析各肿瘤标志物在胰腺癌患者中的诊断价值,线性相关分析各肿瘤标志物的相关性。应用多元Logistic回归模型分析胰腺癌的独立危险因素。结果：胰腺癌组血清CA19-9、CA242、CA50、CA125、CEA及TSGF水平明显高于对照组和非胰腺癌组,差异有统计学意义（P<0.05或P<0.01）。Ⅳ期和Ⅲ期患者血清CA19-9、CA242、CA50、CA125及TSGF水平明显高于Ⅰ期和Ⅱ期（P<0.01）,且Ⅳ期患者血清CA19-9、CA242、CA125及CEA水平明显高于Ⅲ期（P<0.01）。胰腺癌组血清CA19-9、CA242、CA50、CA125、CEA及TSGF的阳性率明显高于对照组和非胰腺癌组（P<0.01）。ROC曲线显示,血清CA19-9的AUC高于其他单项指标,其最佳临界值、灵敏度和特异度分别为114.5 U/ml、81.2%和79.3%。6项联合检测的诊断效能均优于各单项检测,其灵敏度和特异度分别为92.4%和76.5%。相关性分析显示,血清CA19-9与CA242、CA50及CA125均呈正相关（r=0.703,P=0.005;r=0.572,P=0.024;r=0.439,P=0.036）。多元Logistic回归分析显示,吸烟、不正确的饮食习惯、糖尿病史、胆系疾病史及CA19-9、CA242、CEA进入回归模型,其OR值及95%CI分别为1.717（0.736～2.359）、2.865（2.217～3.685）、2.614（2.186～3.127）、3.527（2.842～4.377）、4.214（3.570～4.962）、2.315（2.114～2.539）、1.876（1.175～2.852）。 结论：血清肿瘤标志物联合检测有助于提高早期胰腺癌诊断的准确性,吸烟、不正确的饮食习惯、糖尿病史、胆系疾病史及高水平的CA19-9、CA242、CEA是胰腺癌的独立危险因素。     

胃癌患者手术前后血清SE-CAD、CEA和CA19-9检测的临床意义

目的:探讨了胃癌患者手术治疗前后血清SE-CAD、CEA和CA19-9水平的变化及意义.方法:分别应用酶免法和放免法测定了32例胃癌患者手术治疗前后血清SE-CAD、CEA和CA19-9水平的变化,并与30名正常健康人作比较.结果:胃癌患者手术前血清SE-CAD、CEA和CA19-9水平显著地高于正常人组(P＜0.01),手术治疗后6个月则与正常人组比较无显著性差异(P＞0.05).结论::检测胃癌患者血清中SE-CAD、CEA和CA19-9水平的变化对临床观察预后有重要的临床价值.     

血清CEA、AFP、CA19-9和SA联检对HCC的诊断价值

目的：探讨了肿瘤标志物癌胚抗原（CEA）、甲胎蛋白（AFP）、糖类抗原CA19-9（CA19-9）和唾液酸（SA）联检对原发性肝癌（HCC）的临床评价。方法：应用放免法和生化法对36例HCC患者进行了血清CEA、AFP、CA19-9和SA检测,并与35名正常健康人作比较。结果：以单一指标阳性作为诊断标准,CEA、AFP、CA19-9和SA对HCC的敏感性分别为33.3%、69.4%、58.3%、61.1%,特异性分别为60.4%、81.3%、68.8%、64.6%。联检结果二项或二项以上阳性作为标准。本文患者诊断灵敏度为94.4%、特异性为95.8%。结论：联检血清CEA、AFP、CA19-9和SA对HCC的辅助诊断有较高的临床实用价值。     

卵巢癌患者手术治疗前后血清CA125、CA19-9、CEA和SA检测的临床评价

目的:探讨了卵巢癌患者手术治疗前后血清CA125、CA19-9、CEA和SA检测的变化及临床意义.方法:应用放射免疫分析和化学法对32例卵巢癌患者进行了手术治疗前后血清CA125、CA19-9、CEA和SA检测,并与35名正常人作比较.结果:卵巢癌患者在治疗前血清CA125、CA19-9、CEA和SA水平非常显著地高于...     

食管癌患者手术治疗前后血清CEA,CA19-9和SS检测的临床意义

目的：探讨了食管癌患者手术治疗前后血清CEA、CA19-9和SS水平的变化及临床意义。方法：应用放射免疫分析对32例食管癌患者进行了手术治疗前后血清CEA、CA19-9和SS检测,并与35名正常健康人作比较。结果：食管癌患者在手术治疗前血清CEA、CA19-9和SS水平非常显著地高于正常人组（P〈0.01）,且CEA、CA19-9和SS水平呈明显正相关（r=0.5184、0.6012,P〈0.01）手术治疗3个月后则无显著差异（P〉0.05）。结论：检测食管癌患者手术治疗前后血清CEA、CA19-9和SS水平的变化对了解病情、指导临床实践均具有重要的临床价值。     

联合检测癌胚抗原、糖链抗原19-9和C反应蛋白对结肠癌的诊断价值

目的 探讨联合检测血清癌胚抗原(CEA)、糖链抗原19-9 (CA19-9)、C-反应蛋白(CRP)对结肠癌诊断的临床应用价值.方法 分别利用电化学发光法检测CEA及CA19-9、乳胶颗粒增强免疫浊度法检测CRP在正常对照组、结肠息肉和结肠癌组中的表达量.结果 与正常对照组相比较,结肠癌组CEA、CA19-9和CRP均...     

CA50、CA19-9、CEA联检在胰腺疾病诊断中的价值

目的 :分析CA19- 9、CEA和CA5 0在胰腺疾病诊断中的价值。方法 :4 6 9例胰腺疾病患者采用放射免疫分析测定血清CA5 0水平。采用电化学发光法测定血清CA19- 9和CEA水平。结果 :诊断胰腺癌 ,CA19- 9敏感性和特异性分别为 92 5 7%和 90 73% ;联合检测CA19- 9、CEA、CA5 0其敏感性提高为97 6 4 %。阳性诊断率为 99 16 %。结论 :采用以CA19- 9为主的肿瘤标志物联合检测 ,对胰腺疾病 ,特别是胰腺癌的诊断有着极其重要的意义。     

Urine diacetylspermine as a novel tumor marker for pancreatobiliary carcinomas

A novel urine tumor marker, diacetylspermine, was compared with two conventional serum tumor markers, carcinoembryonic antigen (CEA) (highly specific for pancreatic cancer) and carbohydrate antigen (CA) 19-9 (highly sensitive for pancreatic cancer), in 125 patients with bilio-pancreatic tumors. When the diagnoses of benign or malignant conditions were examined, the sensitivity of urine diacetylspermine (75%) was shown to be higher than that of CEA (44%; P = 0.044) and CA19-9 (75%). The specificity of urine diacetylspermine (81%) was lower than that of CEA (92%) and as high as that of CA19-9 (80%). These results suggest that urine discetylspermine is a highly sensitive and specific novel marker for bilio-pancreatic carcinoma.     

乳腺超声光散射成像联合血清CA15-3、CEA检测在乳腺肿瘤中的诊断价值

目的 探究乳腺超声光散射成像与血清糖链抗原(CA15-3)、癌胚抗原(CEA)联合检测对乳腺肿瘤诊断的临床价值.方法 回顾性分析2014年1月至2016年1月我院收治的200例经术后病理学确诊为乳腺肿瘤患者的临床资料,其中乳腺癌、乳腺良性肿瘤患者各100例,另选取同期来我院进行体检的健康妇女50例作为对照组,对其临床资料进行回顾性分析.均采用超声光散射乳腺断层成像系统对总血红蛋白水平进行测量,同时采用化学发光免疫法对血清肿瘤标志物(CEA、CA15-3)水平进行检测.分析并比较三者联合检测与单一检测对乳腺肿瘤诊断的价值.结果 乳腺癌组的MHC测定值及血清CEA、CA15-3水平均高于乳腺良性肿瘤组及对照组,各项指标组间比较差异具有统计学意义(P<0.05);OPTIMUS联合血清CEA及CA15-3水平检测在乳腺癌中的检出阳性率最高,明显高于OPTIMUS、CEA及CA15-3三者的单独检测,差异具有统计学意义(P<0.05);OPTIMUS联合血清CEA、CA15-3水平检测诊断乳腺癌的灵敏度、准确率及阴性预测值分别为92.0%、94.0%、92.3%,均明显高于三者的单独检测,组间比较差异具有统计学意义(P<0.05).结论 乳腺超声光散射成像联合血清糖链抗原、癌胚抗原检测在乳腺肿瘤的诊断中具有重要的临床价值,可提高诊断灵敏度及准确率,值得在临床推广应用.     

血清CA125、CA15．3、CA242联合检测对乳腺癌诊断的价值

目的评价血清标志物糖类抗原125（CA125）、15．3（CA15．3）、242（CA242）联合检测对乳腺癌诊断的价值。方法对长海医院肿瘤科2003年9月至2005年9月期间收治的73例乳腺癌患者及60例健康人血清进行CA125、CA15．3、CA242检测。结果乳腺癌组三种肿瘤标志物检测的阳性率显著高于对照组（Х^2检验,P〈0．01）。乳腺癌组CA125、CA15．3、CA242及联合检测的阳性率由高到低依次为联合检测（68．49％）、CA15．3（49．32％）、CA125（34．25％）、CA242（28．77％）,CA15．3阳性率与三种标志物联合检测的阳性率差异有统计学意义（Х^2=5．546,P〈0．05）,即联合检测的阳性率高于CA15．3单独检测的阳性率。结论CA125、CA15．3、CA242联合检测能明显提高乳腺癌的检出率。     

血清TSGF的水平与结肠癌诊断及术后疗效的关系

目的 探讨肿瘤特异性生长因子（TSGF）在结肠癌诊断及术后疗效观察的价值.方法 采用比色法测定的120例结肠癌患者手术前及术后及50名对照组血清中TSGF水平,采用电化学分析的方法分别测定CEA、CA19-9水平并进行比较.结果 与结肠癌术后及对照组相比,结肠癌术前的TSGF、CEA、CA19-9水平的差异有统计学意义（P＜0.01）;结肠癌术后及对照组的TSGF、CEA、CA19-9的差异无统计学意义（P＞0.05）;术前组的TSGF、CEA、CA19-9的阳性率中,TSGF阳性率最高.结论 血清TSGF是对结肠癌的早期诊断及疗效观察具有一定的临床价值,TSGF、CEA、CA19-9三项指标的联合检测可提高对结肠癌检测的阳性率.     

Diagnostic utility of clinical and biochemical parameters in pancreatic head malignancy patients with normal carbohydrate antigen 19-9 levels

BackgroundCarbohydrate antigen (CA)19-9 that is the most widely used biomarker for pancreatic cancer has certain limitations in diagnosis, which results in a tough job to distinguish pancreatic cancer from benign tumors with normal CA19-9. The aim of this study was to investigate the diagnostic utility of clinical parameters and serum markers in patients with pancreatic head masses but without elevated CA19-9.MethodsRetrospectively, 106 (69 malignant, 37 benign) of 487 patients admitted for pancreatic head masses were enrolled with CA19-9 level of <37u/ml. Clinical parameters and serum biomarkers were assessed. Among the patients with pancreatic head mass, male individuals (p=0.025) and elder individuals (p<0.001) were more likely to have cancer; and cancer patients were more likely to present with abdominal-pain (p=0.023), weight-loss (p=0.013) and jaundice (p<0.001). Serum bilirubin levels among malignancies, including total bilirubin (p<0.001), direct bilirubin (p<0.001) and indirect bilirubin (p<0.001), were considerably higher than those of benign ones. Logistic regression further concluded that age-distribution, abdominal-pain and direct-bilirubin were three independent factors correlating with final diagnosis. However, CEA (p=0.156) was not sufficient enough to exclude pancreatic cancer.ConclusionsIn patients with pancreatic head masses and CA19-9 of <37u/ml, age-distribution, abdominal-pain and direct bilirubin might be helpful in differential diagnosis. CEA was insufficient for exclusion of malignancy.     

肺癌患者血清CEA、NSE、CA19-9和VEGF检测的临床意义

目的：探讨了血清CEA、NSE、CA19-9和VEGF水平在肺癌患者中的变化。方法：分别应用放射免疫分析和ELISA对31例肺癌患者进行了血清CEA、NSE、CA19-9和VEGF测定,并与35名正常健康人作比较。结果：肺癌患者血清CEA、NSE、CA19-9和VEGF水平均非常显著地高于正常人组（P〈0.01）,且CEA、NSE、CA19-9和VEGF呈明显正相关（r=0.6218、0.6101、0.6317,P〈0.01）。结论：检测肺癌患者血清CEA、NSE、CA19-9和VEGF水平的变化对了解病情、指导临床实践均具有重要的临床价值。     

IL-6、IL-23、CEA和CA19-9在结直肠癌患者的血清学表达及意义

目的:探讨单独或联检血清IL-6、IL-23、CEA和CA19-9在结直肠癌诊断中的价值,分析它们与结直肠癌临床分期的关系.方法:分别检测75例结直肠癌患者、60例结直肠良性病变患者和58例健康者IL-6、IL-23、CEA和CA19-9血清水平,分析它们对结直肠癌诊断的临床价值及其与临床病理因素之间的关系.结果:结直...