胃癌相关基因在癌前病变中的表达

目前认为癌的形成过程是多阶段、多过程的,包括多个连续的独立的事件,是多个遗传物质即基因积累改变的结果．与胃癌发生、发展有关的基因有3种：癌基因、抑癌基因、程序死亡基因．原癌基因的激活和抑癌基因的失活可使细胞增生,程序死亡基因的失活可能使细胞永生化,在胃癌的发生、发展的各个阶段,至少有两种以上的基因突变,他们各自发挥不同作用．研究胃癌相关基因在癌前病变中的表达,总结基因改变在癌变过程中的作用和地位．可以从分子水平揭开胃黏膜癌变的本质,进而明确胃癌发生、发展的分子机制．     

胃癌及癌前病变组织中MUCl基因的表达及其意义

目的：揭示胃癌及肠化组织中的MUCl基因的表达与临床病理行为之间的联系。方法：用BCl抗体和免疫组织化学SP法检测人正常胃肠遭粘膜、肠化粘膜以及胃癌组织中MUCl基因核心蛋白的表达。结果：人正常胃粘骥组织中广泛分布MUCl基因产物(100％)、而肠化组织及胃癌组织的表达阳性率分别为759%、63．0%；胃癌组织中MUCl基因表达与癌组织大小(P<001)、淋巴结转移（P<0．05)和临床分期(P<0．01)有明显的相关；胃癌组织中MUCl基因表达程度与淋巴结转移及临床分期相关(P<0．05)．随着MUCl基因表达的增强，淋巴结转移减少，临床Ⅰ-Ⅱ期的比例增多。不同类型肠化中MUCl基因表达无差异(P>O、05)。结论：上述结论强烈提示用BCl抗体检测的MUCl基因是胃癌进展有用标志、与胃癌的嵇床病理行为密切相关，而与肠化分型无关。     

CEA、CA19-9和CA242联合检测诊断老年胃癌的临床意义

胃癌的诊断除内镜和影像学检查外，血清学肿瘤标记物检测是常用的辅助检测方法之一。CEA、CA19-9、CA242作为肿瘤标记物作为消化系统恶性肿瘤的辅助诊断已逐步用于临床，但单项肿瘤标记物检测均有其局限性。本文对老年胃癌患者CEA、CA19-9、CA242联合检测结果进行分析，探讨三者联合检测对老年胃癌患者的临床诊断价值。     

胃癌和癌前病变组织中端粒酶、PCNA的表达及意义

目的探讨端粒酶、增殖细胞核抗原（PCNA）在胃癌发生发展中的作用。方法采用免疫组化SP法检测40例胃癌和18例癌前病变（其中慢性萎缩性胃炎伴肠化生10例,非典型增生8例）组织中端粒酶及PCNA。结果端粒酶在胃癌中的阳性表达率为80.00%,癌前病变为22.22%,两者相比,P〈0.05;PCNA分别为72.50%、27.78%,两者相比,P〈0.05。结论端粒酶和PCNA参与了胃癌的发生发展过程。检测端粒酶、PCNA对胃癌的早期诊断有一定的参考价值。     

CEA、CA19-9、CA72-4检测诊断大肠癌的价值

应用电化学发光免疫分析法测定60例大肠癌患者术前、术后癌胚抗原（CEA）、癌相关糖抗原CA199、CA72-4单项表达情况,将3种标记物组合为4种方式进行联合检测．并对其中45例患者术后随访4个月～2a。结果Ⅰ、Ⅱ、Ⅳ期大肠癌患者3项标记物均明显增高（P均〈0．05）．其敏感性与病理分期程度相关。术后水平均明显下降（P〈0．05）;转移、复发者标记物明显增高至术前水平。CEA＋CA72-4及CEA＋CA19-9＋CA72-4组合方式检测的敏感性显著高于任一单项（P均〈0．05）,但后一种组合方式的特异性有所降低。认为3项肿瘤标记物对大肠癌中晚期的诊断、术后疗效监测具有实用价值,CEA和CA72-4联合检测可作为首选项目。     

血清CA19-9、CA724、CEA检测在胃癌复发诊断中的价值

目的探讨血清糖抗原19-9（CA19-9）、糖抗原724（CA724）、癌胚抗原（CEA）诊断胃癌复发的价值。方法将61例胃癌术后患者分为复发组31例和无复发组30例,采用罗氏Cobase 41601型电化学发光免疫分析仪检测两组CA19-9、CA724、CEA水平,观察两组阳性率,并分析三指标联合及单独检测诊断胃癌复发的敏感性、特异性、准确性、阳性预测值、阴性预测值。结果复发组CA19-9、CA724、CEA水平及阳性率均高于无复发组,P〈0.05或0.01。三指标联合检测敏感性、准确性、阴性预测值均高于单指标检测,特异性低于单指标检测;阳性预测值高于CEA,低于CA19-9、CA724。结论肿瘤标志物联合检测对胃癌的复发诊断具有较高的临床应用价值。     

CA19-9在胰腺癌中的应用价值及局限性

胰腺癌的诊治是世界性难题,糖类抗原CA19-9对于胰腺癌的诊断、疗效观察及预后判断等方面具有一定的临床价值,与其他肿瘤标志物比较,具有较好的敏感性及特异性,是最常用的胰腺癌的标志物。但其也存在诸多的局限性,尤其是具有较高的假阳性率及在Lewis a阴性基因型患者中的假阴性,极大限制了其作为胰腺癌诊断标准的应用。因此,血清CA19-9水平的升高需结合影像学及组织学证据,才能做出正确判断。     

血清TSGF、CEA、AFP、CA72-4、CA199联合检测在胃癌诊断中的价值

目的探讨联合检测血清恶性肿瘤特异性生长因子（TSGF）、癌胚抗原（CEA）、甲胎蛋白（AFP）、糖类抗原72-4（CA72-4）、CA199在胃癌诊断中的价值。方法选择胃癌、胃癌前病变、胃良性病变及健康体检者各60例,采用生化比色法检测血清TSGF,采用同位素法检测血清CEA、AFP、CA199、CA72-4。结果胃癌患者血清TSGF、CEA、AFP、CA72-4、CA199水平明显高于其他患者（P均〈0.05）,联合检测对胃癌诊断的敏感性为96.7%、特异性为81.1%、阳性预测值为63.1%、阴性预测值为98.6%。结论血清TSGF、CEA、AFP、CA72-4、CA199联合检对胃癌的诊断有一定价值。     

胰腺癌患者血清中CA19-9、CA50、CA242、CEA的水平变化及意义

目的探讨胰腺癌患者血清肿瘤标志物血清糖类抗原(CA)19-9、CA50、CA242、癌胚抗原(CEA)水平,及其与胰腺癌术前诊断、临床分期、肿瘤大小以及预后的关系。方法分别测定38例胰腺癌(观察组)和25例胰腺良性病变(对照组)患者血清中CA19-9、CA50、CA242和CEA。探讨其与胰腺癌临床分期、肿瘤大小及预后的关系。结果观察组血清CA19-9、CA50、CA242和CEA水平明显高与于对照组,术后血清CA19-9、CA50、CA242和CEA水平较术前明显下降,TS3+TS4、Ⅲ+Ⅳ期患者血清CA19-9、CA50、CA242和CEA水平分别高于TS1+TS2、Ⅰ+Ⅱ期者(P均<0.05)。结论胰腺癌患者血清CA19-9、CA50、CA242和CEA水平对胰腺癌患者术前诊断、临床分期和肿瘤大小的判断有一定的参考意义。     

rasP21,GST—π在胃癌及癌前病变组织中的表达

ｒａｓＰ2 1是ｒａｓ基因共同编码的一种分子量为 2 1ＫＤ的蛋白质 ,ｒａｓ癌基因激活致Ｐ2 1过量表达[1] ,人胎盘型谷胱苷肽Ｓ 转移酶 (ＧＳＴ π)是一种重要的肿瘤标志[1] ,本研究应用免疫组化技术 (Ｓ Ｐ法 )对ｒａｓＰ2 1、ＧＳＴ π进行检测 ,观察其在胃癌及癌前病变组织中的表达 ,观察其分布和量的变化 ,探讨胃粘膜癌变过程中两种标记物复合表达的内在联系及意义。材料和方法一、材料选择我院病理科 1993年 6月至 2 0 0 0年 9月期间胃镜活检或手术切除标本共 168例 ,其中肠上皮化生4 0例 ,不典型增生 76例 (轻度 2 0例 ,中度 34例 ,重…     

胰腺癌患者血清中巨噬细胞因子-1、糖链抗原19-9、糖链抗原242及癌胚抗原的检测分析

目的 探讨血清巨噬细胞因子-1（MIC-1）、糖链抗原（CA）19-9 、CA242及癌胚抗原（CEA）在胰腺癌中的应用价值.方法 分析129例胰腺癌患者和120例健康体检者4项肿瘤标志物的检测结果,计算各肿瘤标志物组合方式对提高胰腺癌诊断的作用.结果 胰腺癌患者血清中各项肿瘤标志物的水平与对照组比较差异有统计学意义（P〈0.05）.MIC-1＋CA19-9组合的敏感性与单项检测敏感性最高的MIC-1比较,差异有统计学意义（P〈0.05）;MIC-1＋CA19-9组合的特异性与单项检测特异性最高的CA19-9比较,差异无统计学意义（P〉0.05）.Ⅲ~Ⅳ期胰腺癌患者血清CA19-9、CA242水平与Ⅰ~Ⅱ期比较,差异有统计学意义（P〈0.05）.结论 4项肿瘤标志物的检测对胰腺癌的诊断均有一定的价值,MIC-1＋CA19-9联合检测可提高诊断的敏感性,同时未降低其特异性.CA19-9、CA242对判断胰腺癌的预后有一定价值.     

Comparison of tumor marker CA 242 with CA 19-9 and carcinoembryonic antigen (CEA) in pancreatic cancer

BACKGROUND/AIMS: Although there are a variety of tumor markers used for diagnosis of pancreatic carcinoma, the sensitivity and specificity of those markers have not yet reached an ideal level. The aim of this study was to compare the diagnostic value of CA 242 with CA 19-9 and CEA in the patients with pancreatic cancer. METHODOLOGY: Serum CA 242, CA 19-9 and CEA levels were determined in 135 subjects in the following groups: Pancreatic cancer (n = 40), cholangiocellular carcinoma (n = 15), hepatocellular carcinoma (n = 10), cirrhosis (n = 7), chronic active hepatitis (n = 7), choledochal stone (n = 12), chronic pancreatitis (n = 9), acute pancreatitis (n = 6), and healthy controls (n = 29). RESULTS: An elevated serum CA 242 concentration (> 20 U/mL) was found in 30 out of 40 (70%) (mean; 2163 +/- 838 U/mL) patients with pancreas cancer, in 11 out of 15 patients with cholangiocellular carcinoma (93.3%) (mean 916 +/- 529 U/mL), in none of patients with hepatocellular carcinoma and healthy controls. Slightly elevated CA 242 concentration was found in 6 out of 41 patients with benign hepatobiliary and pancreatic disease (range 0.4-97.8 U/mL) (1 acute pancreatitis, 2 chronic pancreatitis, 1 cirrhosis, 2 choledochal stone). Mean serum CA 242, CA 19-9 and CEA levels of the pancreas cancer group were significantly higher than those of the other groups except the cholangiocellular carcinoma group. There was no significant difference between the stage of pancreas cancer regarding mean serum CA 242, CA 19-9 and CEA level. There was positive correlation between serum CA 242 and CA 19-9 level. In the pancreas cancer, the sensitivity of CA 242, CA 19-9 and CEA was 75%, 80%, 40%, respectively and the specificity of those markers was 85.5%, 67.5% and 73%, respectively. CONCLUSIONS: In conclusion, the advantage of CA 242 compared to CA 19-9 is that its specificity is higher than that of CA 19-9 in the diagnosis of pancreas cancer.     

Serum level of TSGF, CA242 and CA19-9 in pancreatic cancer

AIM: To establish a method to detect the expression of the tumor specific growth factor TSGF, CA242 and CA19-9 in serum and evaluate their value in diagnosis of pancreatic cancer. METHODS: ELISA and Biochemical colorimetric assay were used to detect the serum content of TSGF, CA242 and CA19-9 in 200 normal cases, 52 pancreatitis patients and 96 pancreatic cancer patients. RESULTS: The positive likelihood ratios of TSGF, CA242 and CA19-9 were 5.4, 12.6 and 6.3, respectively, and their negative likelihood ratios were 0.10, 0.19 and 0.17, respectively. With single tumor marker diagnosed pancreatic cancer, the highest sensitivity and specificity of TSGF were 91.6% and 93.5%. In combined test with 3 markers, when all of them were positive, the sensitivity changed to 77.0% and the specificity and the positive predictive value were 100%. The levels of TSGF and CA242 were significantly higher in the patients with pancreatic cancer of head than those in the patients with pancreatic cancer of body, tail and whole pancreas, but the expression of CA19-9 had no correlation with the positions of the pancreatic cancer. The sensitivity of TSGF, CA242 and CA19-9 was increased with the progress in stages of pancreatic cancer. In stage I, the sensitivity of TSGF was markedly higher than CA242 and CA19-9. CONCLUSION: The combined use of TSGF, CA242 and CA19-9 expressions can elevate the specificity for pancreatic cancer diagnosis. And it shows that it plays an important role to differentiate positions and tissue typing. It is a forepart diagnosis for the pancreatic cancer by combination checking. There is very important correlation between the three markers and the pancreatic cancer.     

肿瘤标志物CA242与CA19-9对胰腺癌的诊断价值

目的:比较血清肿瘤标志物CA242与CA19-9对胰腺癌的诊断价值。方法:1996年4月至1997年6月,北京医院对门诊及住院197例患者进行了血清CA19-9的检测,148例进行了CA242的检测,其中25例为临床明确诊断为胰腺癌,12例为急性胰腺炎,18例为良性阻塞性黄疸。结果显示:胰腺癌患者血清CA19-9和CA242较对照明显增高,其中25例胰腺癌患者有21例CA19-9阳性,检测的灵敏度为84％,特异性为74.4％,有17例CA242阳性,检测的灵敏度为68％,特异性为87.8％。CA242与CA19-9比较,灵敏度无显著差异(0.10相似文献   

阻癌胃泰冲剂治疗胃癌癌前病变的胃粘膜形态学及幽门螺杆菌变化

用阻癌胃泰冲剂治疗胃癌癌前病变并比较治疗前后胃粘膜形态学、胃粘膜内幽门螺杆菌（HP）变化。结果用阻癌胃泰冲剂治疗后胃粘膜颗粒样或结节状隆起、充血水肿、糜烂、溃疡、粘膜变薄等变化明显减轻。治疗前后比较有极显著性差异（P＜0．01），治疗组疗效亦明显高于对照组（P＜0．01）。治疗组对HP的感染具有抑制和清除效果，与对照组比较有极显著性差异（P＜0．01）。总有效率达80．23％。     

The tumor markers CEA, TPA and CA 19-9 in gastric cancer

In gastric cancer the tumor markers CEA, TPA and CA 19-9 display relatively low sensitivity, which in relation to a specificity of 90% lies between 20% and 25%. Compared with the simple ESR method, these sensitivities are not remarkably greater. But a combination of parameters based on discriminant analysis achieves distinctly greater sensitivities.     

Diagnostic value of serum CA242, CA 19-9, CA 15-3 and CA 125 in patients with carcinoma of the gallbladder.

BACKGROUND: Tumor markers have an increasing significance in the diagnosis and evaluation of tumor, but their role in gallbladder cancer has not been established. The present study was undertaken to determine the utility of serological markers in carcinoma of the gallbladder (CaGB). METHODS: This study was carried out in 55 cases and 8 healthy controls presenting to a single surgical unit of the University Hospital, Varanasi, India. CA242, CA19-9, CA15-3 and CA125 were assayed preoperatively in serum of patients with carcinoma of the gallbladder (39), cholelithiasis (16) and healthy controls (8) using ELISA technique. RESULTS: Mean concentration of all tumor markers was significantly raised in carcinoma of the gallbladder when compared with cholelithiasis. CA 242 was 12.10 vs 42.19 u/ ml, CA19-9 was 211.27 vs 86.06 uml, CA 15-3 was 71.42 vs 1.93u/ml and CA125 was 253.61 vs 65.5 u/ml <0.05). Sensitivity and specificity were calculated at various cut off points. Significant changes in CAl9-9 and CA242 occurred with advanced stage (p <0.05) and grade of tumor (p<0.00 1). When two tumor markers were combined, like CA242 and CA125, sensitivity and specificity improved to 87.5% and 85.7% respectively. Diagnostic accuracy is highest with a combination of CA 19-9 and CA 125 (80.65%). However, combination of tumor markers did not improve any further sensitivity or specificity of markers. CONCLUSION: Assay of CA242, CA15-3, CA19-9 and CA 125 are fairly good markers for discriminating patients of carcinoma of the gallbladder from cholelithiasis. CA242 and CA125 when used together achieved best sensitivity and specificity. Serum markers seem to be less sensitive when used individually in carcinoma of the gallbladder but may prove useful in combination.     

不同中药复方对大鼠胃癌前病变的疗效及抗氧化作用的研究

目的 :观察不同中药复方对实验性胃癌前病变 (GPL)的疗效及抗氧化作用的研究。方法 :建立大鼠 GPL模型。应用益气、活血、解毒中药复方及三者合方治疗 12周后 ,统计各组大鼠 GPL 的发生率 ,同时测定血清及胃粘膜超氧化物歧化酶 (SOD)、丙二醛 (MDA)水平。结果 :活血组、益气组、益气活血解毒组大鼠中、重度 GPL 及肿瘤发生率明显低于模型组 (P <0 .0 5 ) ;益气组及益气活血解毒组血清及胃粘膜 SOD含量明显高于模型组 (P <0 .0 1) ,活血组、益气组和益气活血解毒组胃粘膜 MDA含量显著低于模型组 (P <0 .0 1)。结论 :中药复方能有效改善实验性大鼠胃癌前病变 ,抗氧化损伤作用可能是中药复方治疗实验性 GPL 取效的因素之一。     

结直肠癌患者血清CEA、CA19-9的检测价值

目的 探讨癌胚抗原（ＣＥＡ）、糖链抗原（ＣＡ１９－９）在结直肠癌的诊断、观察预后、监测复发转移中的应用价值。方法 ＣＥＡ采用ＥＬＩＳＡ法、ＣＡ１９－９采用放免法,对１９例结肠癌、２６例直肠癌、３０例正常人进行了分析,并在术后定期检查。ＣＥＡ、ＣＡ１９－９水平下降,可恢复至正常：术后复发ＣＥＡ、ＣＡ１９－９重又异常升高,伴广泛转移者升高更加显著,并且ＣＥＲＡ、ＣＡ１９－９的升高出现在临床症状和Ｘ线异     

The Prognostic Value of Preoperative Serum Levels of CEA and CA19–9 in Patients with Gastric Cancer

Objectives : The clinical significance of preoperative serum levels of tumor markers CKA and CA19-9 was evaluated in gastric cancer patients. Methods: Serum levels of CEA and CA19-9 were measured in 663 patients with gastric cancer who underwent laparotomies over a recent 4-yr period (1990-1993). The correlations between the serum levels of tumor markers and several clinic opathological factors were evaluated by univariate analysis. The significance of the tumor markers as prognostic factors was assessed by multivariate analysis. Results : The positivity rates of CEA and CA19-9 were 16.6% and 16.0%, respectively. The positivity of CEA correlated well with the sex of the patients, hepatic, peritoneal, and nodal metastases and the depths of tumors, hut it correlated weakly with a tumor's histological type. The positivity of CA19-9 correlated well with various forms of metastases, depths, and tumor size. A significant difference in prognosis was observed between patients positive and negative for CA19-9 among those undergoing R0 resection. Multivariate analysis also revealed that serum CA19-9 level was better than CEA as a prognostic factor. Conclusions: CA19-9 in the preoperative sera is a good prognostic factor in gastric cancer patients, although tumor markers continue to have only limited diagnostic usefulness.