肿瘤标志物联合检测对胰腺癌诊断的临床意义

目的:探讨血清CA19-9、CA24-2、TSGF联合检测对胰腺癌诊断的意义.方法:采用电化学发光检测CA19-9、CA24-2、,化学比色法测定TSGF.结果:胰腺癌患者血清CA19-9、CA24-2和TSGF水平及阳性率均明显高于正常对照组(P＜0.05);三项标志物联合检测的敏感性和诊断准确性均比单项检测高.结论:联合检测血清中的CA19-9、CA24-2、TSGF对胰腺癌的诊断具有重要的临床意义.     

血清肿瘤标志物检测对恶性肿瘤诊断及监测的临床意义

目的：检测恶性肿瘤血清中癌相关抗原（CA19－9、CA24－2、CA15－3）,以及恶性肿瘤特异性生长因子（TSGF）。评价其对恶性肿瘤的诊断、病情监测和预后判断的价值。方法：检测158例恶性肿瘤及30名健康人血清中CA19－9、CA24－2、CA15－3、TSGF的含量。结果：TSGF在全部恶性肿瘤组中含量与正常对照组比较均有非常显著差异（P＜0．001），TSGF在全部恶性肿瘤组的阳性率为85．4％。肝癌、胰腺癌、肠癌、肺癌组中CA19－9、CA24－2与正常对照组比较有非常显著差异（P＜0．01－0．001），CA19－9＋CA24－2＋TSGF的敏感性及准确性均较单项检测高。CA15－3在乳腺癌组中阳性率较高为57．7％，在肺癌组也有较高的阳性率（47．1％），与正常对照组比较有非常显著差异（P＜0．01－0．001），CA15－3＋TSGF的敏感性及准确性较CA15－3单项检测高。结论：血清肿瘤标志物的单独检测对某些肿瘤有显著意义，而联合检测应是临床发展的方向，对恶性肿瘤的早期诊断及病情监测有重要价值。     

联合检测血清肿瘤标志物对胰腺癌的诊断价值

目的探讨血清肿瘤标志物联合检测对胰腺癌的诊断价值。方法选取2016年7月至2019年4月间山东省职业卫生与职业病防治研究院收治的52例胰腺癌患者为胰腺癌组,58例胰腺良性患者为良性组,60例同期体检健康者为健康对照组。比较三组受试者血清糖链抗原19-9(CA19-9)、糖链抗原242(CA242)、胸苷激酶1(TK1)、肿瘤特异生长因子(TSGF)及不同临床分期的水平;评估CA19-9、CA242、TK1及TSGF联合检测对胰腺癌患者的临床诊断价值。结果三组受试者血清CA19-9、CA242、TK1及TSGF水平比较差异显著,且胰腺癌组上述指标高于其他两组,良性组上述指标高于健康对照组,差异均有统计学意义(均P <0. 05)。四期胰腺癌患者CA19-9、CA242、TK1及TSGF水平比较差异显著,且随着期数上升,CA19-9和CA242逐渐升高,Ⅲ～Ⅳ期胰腺癌患者TK1及TSGF均高于Ⅰ～Ⅱ期,差异均有统计学意义(均P <0. 05)。将CA19-9、CA242、TK1及TSGF四项纳入Logistic回归模型,四项联合敏感度和特异度为88. 5%和94. 8%,均高于单项检测。结论血清CA19-9、CA242、TK1及TSGF水平与胰腺癌关系显著,且联合检测敏感度和特异度较高,对胰腺癌的诊断和治疗具有重要价值。     

血清 K-ras基因突变检测联合 CA19-9测定在胰腺癌诊断中的应用

背景与目的：胰腺癌早期诊断困难,常用的肿瘤标记物如CA19-9,虽敏感度较高但特异性较差,胰腺癌中常有K-ras基因的突变,而且特异性较高,我们通过检测血清DNA中K-ras基因的突变以及测定血清CA19-9的含量,以探讨两者联合检测在胰腺癌诊断中的临床意义。方法：取39例胰腺癌患者的血清,抽提DNA,采用突变富集聚合酶链反应-限制性片段长度多态性法检测K-ras基因第12密码子突变,同时应用放免法测定血清CA19-9的含量,并与17例其他胰腺疾病患者和21例健康者的血清检测结果作对照。分析两者联合应用的临床诊断价值。结果：在28例胰腺癌和2例其它胰腺疾病患者血清中检测到K-ras基因突变,阳性率分别为71.79%和11.76%;而血清CA19-9测定的阳性率则分别为71.79%和41.18%。平行法联合检测K-ras和CA19-9诊断胰腺癌时敏感性增至94.87%。系列法联合检测时特异性增至94.12%,21例健康对照者血清中K-ras基因与CA19-9均无异常。结论：联合血清K-ras基因突变检测与CA19-9测定可提高胰腺癌诊断的特异性和敏感性,具有一定的临床应用价值。     

血清CEA、CA19—9、CA724检测对老年胃癌病理、临床分期的意义

目的：探讨血清CEA、CA19—9、CA724对老年胃癌的临床应用价值。方法：采用ELISA方法对87例老年胃癌患者进行回顾性分析。结果：老年胃癌患者CEA、CA19—9、CA724阳性率分别为25％、21％、21％,联合检测阳性率为41％,其中TNMIV期患者CA19—9、CA724、联合检测阳性率明显高于TNMⅠ＋Ⅱ期患者。TNMⅢ＋Ⅳ期患者CA19—9、CA724检测值明显高于Ⅰ＋Ⅱ期患者。CEA、CA19—9、CA724阳性率、其值大小与胃癌病理类型、分化无关。结论：CEA、CA19—9、CA724可用于老年胃癌的诊断、病情判断,联合检测可提高诊断效率,但早期诊断价值有限。     

血清CA19—9,CEA,CA50在大肠癌诊断中的作用

目的 我们应用外周血CA19—9、CEA、CA50的联合定量检测,探讨上述三者对大肠癌的临床诊断作用。方法 306例大肠癌患者和112例大肠良性疾病患者均于手术前后各一周抽取外周血测定此三种肿瘤标志物,然后采用免疫放射分析方法进行测定。所得结果采用t检验或X~2检验进行统计学处理。结果 CA19—9对大肠癌的敏感性和特异性分别为59％和84.8％,CEA分别为58.4％和83％,CA50分别为20.2％和60.7％。结论 CA19—9和CEA联合血清检测对诊断大肠癌有较高的特异性和敏感性,两者同时检测可以提高诊断率。CA50在联合检测中则不需选用。CA19—9和CEA在大肠癌的诊断中可作为一种常规测定方法。     

宫颈腺癌患者血清CA125和CA19-9检测的临床意义

目的：探讨CA125，CA19—9联合检测诊断宫颈腺癌的临床意义。方法：32例经病理证实为宫颈腺癌的患者于入院时和手术后4周进行CA125，CA19—9联合检测。结果：宫颈腺癌患者血清CA125和CA19—9含量及阳性率明显升高。CA125的敏感性为75％，特异性为92．6％；CA19—9的敏感性为46．9％，特异性为96．3％。CA125和CA19—9联合检测敏感性提高至81．3％，特异性没有明显下降。结论：CA125联合检测CA19—9可明显提高诊断的灵敏度，对诊断宫颈腺癌和预后估测有一定价值。     

消化道恶性肿瘤TSGF、CA19—9、CA242联合检测的临床评价

目的 探讨用恶性肿瘤特异性生长因子（TSGF）、糖抗原19－9（CA19－9）与糖抗原242（CA242）联合检测对消化道恶性肿瘤的临床评价。方法 采用酶免疫测定140例消化道肿瘤及30例正常人血清。结果 以单一指标阳性作为诊断标准CA242、CA19－9、TSGF对消化道恶性肿瘤的灵敏度分别为42．9％、55．7％、80．7％，准确度分别为52．9％、62．4％、81．8％，联合检测结果二项或二项以上阳性作为标准则本组患者的诊断的灵敏度为84．3％，准确度为87．6％。结论 联合检测血清TSGF、CA19－9与CA242对消化道恶性肿瘤的辅助诊断有较高的临床应用价值。     

血清肿瘤标志物CEA、CA19-9和CA72-4在胃癌术后监测中的意义

目的研究血清肿瘤标志物CEA、CA19—9和CA72—4在胃癌术后复发、转移监测中的意义。方法采用电化学发光法检测228例手术后胃癌患者血清CEA、CA19—9和CA72—4含量;并结合临床及随访资料进行分析。结果胃癌术后复发、转移患者CEA、CA19—9和CA72—4的含量和阳性率均显著高于未发生复发、转移患者。术后复发、转移的胃癌患者血清CEA、CA19—9和CA72—4检测灵敏度和特异度分别为46．2％和94．7％,52．3％和97．4％,47．1％和90．6％。结论血清CEA、CA19—9和CA72-4升高与胃癌复发、转移密切相关,在术后随访过程中检测血清肿瘤标志物有助于早期诊断胃癌复发、转移。     

CA153、CA125、TSGF联合检测在乳腺癌中的临床意义

目的：探讨CA125、CA153、TSGF三者联合检测在乳腺癌中的临床意义。方法：采用酶联免疫法检测52例乳腺癌患者及30例健康人血清CA125、CA153、TSGF水平。结果：乳腺癌患者CA125、CA153、TSGF明显高于健康人，三者联合检测阳性率明显高于任何单项检测阳性率。晚期乳腺癌患者CA125、CA153、TSGF明显高于早期患者。结论：CA125、CA153、TSGF三者联合检测对乳腺癌的早期诊断及治疗效果、预后判断有一定的意义。     

LRG1及CA19-9在胰腺癌患者血清中的表达及临床意义

目的:研究富含亮氨酸的α-2糖蛋白 1(leucine rich alpha-2 glycoprotein 1,LRG1)在胰腺癌患者血清中的表达,探讨联合检测LRG1、CA19-9对胰腺癌的诊断价值。方法:共纳入50例胰腺癌患者、30例慢性胰腺炎患者、50例健康志愿者;分别采用酶联免疫吸附法(enzyme linked immunosorbent assay,ELISA法)检测三组血清中LRG1和CA19-9水平,分析其与肿瘤临床分期的关系,比较单独检测LRG1和CA19-9与两者联合检测诊断胰腺癌的敏感性和特异性。结果:与慢性胰腺炎组及健康查体组相比,胰腺癌组血清中LRG1和CA19-9水平明显偏高(P<0.01),慢性胰腺炎组和正常对照组比较差异无统计学意义(P>0.05);胰腺癌临床分期与患者血清LRG1水平相关,Ⅲ、Ⅳ期恶性肿瘤患者血清LRG1水平明显高于I、Ⅱ期恶性肿瘤患者,差异有统计学意义(P<0.05);联合检测LRG1、CA19-9 受试者工作特征曲线下面积大于单独检测CA19-9(P<0.05)。结论:LRG1可作为胰腺癌诊断潜在的生物标志物,联合检测血清LRG1及CA19-9水平可提高胰腺癌的早期诊断率。     

Applicative Value of Serum CA19-9, CEA,CA125 and CA242 in Diagnosis and Prognosis for Patients with Pancreatic Cancer Treated by Concurrent Chemoradiotherapy

Objective: To evaluate the application value of serum CA19-9, CEA, CA125 and CA242 in diagnosis andprognosis of pancreatic cancer cases treated with concurrent chemotherapy. Materials and Methods: 52patients with pancreatic cancer, 40 with benign pancreatic diseases and 40 healthy people were selected. Theelectrochemiluminescence immunoassay method was used for detecting levels of CA19-9, CEA and CA125, anda CanAg CA242 enzyme linked immunoassay kit for assessing the level of CA242. The Kaplan-Meier methodwas used for analyzing the prognostic factors of patients with pancreatic cancer. The Cox proportional hazardmodel was applied for analyzing the hazard ratio (HR) and 95% confidential interval (CI) for survival timeof patients with pancreatic cancer. Results: The levels of serum CA19-9, CEA, CA125 and CA242 in patientswith pancreatic cancer were significantly higher than those in patients with benign pancreatic diseases andhealthy people (P<0.001). The sensitivity of CA19-9 was the highest among these, followed by CA242, CA125and CEA. The specificity of CA242 is the highest, followed by CA125, CEA and CA19-9. The sensitivity andspecificity of joint detection of serum CA19-9, CEA, CA125and CA242 were 90.4% and 93.8%, obviouslyhigher than single detection of those markers in diagnosis of pancreatic cancer. The median survival time of52 patients with pancreatic cancer was 10 months (95% CI7.389~12.611).. Patients with the increasing level ofserum CA19-9, CEA, CA125, CA242 had shorter survival times (P=0.047. 0.043, 0.0041, 0.029). COX regressionanalysis showed that CA19-9 was an independent prognostic factor for patients with pancreatic cancer (P=0.001,95%CI 2.591~38.243). Conclusions: The detection of serum tumor markers (CA19.9, CEA, CA125 and CA242)is conducive to the early diagnosis of pancreatic cancer and joint detection of tumor markers helps improve thediagnostic efficiency. Moreover, CA19-9 is an independent prognostic factor for patients with pancreatic cancer.     

Value of Combined Detection of Serum CEA,CA72-4, CA19-9 and TSGF in the Diagnosis of Gastric Cancer

Background: To explore whether combined detection of serum tumor markers (CEA, CA72-4, CA19-9 andTSGF) improve the sensitivity and accuracy in the diagnosis of gastric cancer (GC). Materials and Methods: Anautomatic chemiluminescence immune analyzer with matched kits were used to determine the levels of serumCEA, CA72-4, CA19-9 and TSGF in 45 patients with gastric cancer (GC group), 40 patients with gastric benigndiseases (GBD group) hospitalized in the same period and 30 healthy people undergoing a physical examination.The values of those 4 tumor markers in the diagnosis of gastric cancer was analyzed. Results: The levels ofserum CEA, CA72-4, CA19-9 and TSGF of the GC group were higher than those of the GBD group and healthyexamined people and the differences were significant (P<0.001). The area under receiver operating characteristic(ROC) curves for single detection of CEA, CA72-4, CA19-9 and TSGF in the diagnosis of GC was 0.833, 0.805,0.810 and 0.839, respectively. The optimal cutoff values for these 4 indices were 2.36 ng/mL, 3.06 U/mL, 5.72 U/mL and 60.7 U/mL, respectively. With combined detection of tumor markers, the diagnostic power of those 4indices was best, with an area under the ROC curve of 0.913 (95%CI 0.866~0.985), a sensitivity of 88.9% anda diagnostic accuracy of 90.4%. Conclusions: Combined detection of serum CEA, CA72-4, CA19-9 and TSGFincreases the sensitivity and accuracy in diagnosis of GC, so it can be regarded as the important means for earlydiagnosis.     

胰腺癌患者氩氦刀冷冻消融治疗前后CA242、CA199、CA125、CEA、TSGF的变化及临床意义

目的：探讨胰腺癌患者氩氦刀冷冻消融治疗前后血清糖类抗原242（CA242）、糖类抗原199（CA199）、糖类抗原125（CA125）、癌胚抗原（CEA）及恶性肿瘤特异生长因子（TSGF）水平变化及临床意义。方法：测定30例胰腺癌患者氩氦刀冷冻消融治疗前后及15例正常对照的血清CA242、CA199、CA125、CEA及TSGF的水平,并分析其与临床病理参数的相关性。结果：胰腺癌患者冷冻前后所有标志物的血清水平及阳性率均明显高于对照组（P〈0.05）,冷冻后CA199、CA125及CEA血清水平均明显下降（P〈0.05）,冷冻后CA199,CEA及TSGF的阳性检出率均明显降低（P〈0.05）。CEA血清水平与患者性别相关（P〈0.05）,CA242水平与肿瘤大小及临床分期均相关（P〈0.05）,CA199、CA125、CEA水平与患者年龄、肿瘤大小、临床分期、分化程度、淋巴结转移及肝转移均相关（P〈0.05）,而血清TSGF水平与所有的病理参数均无关（P〉0.05）。结论：CA199、CA125、CEA血清水平可作为胰腺癌疗效评估的重要指标,CA242、CA199、CA125及CEA在胰腺癌的预后评估中发挥重要的作用。     

大肠癌患者血清CA242、CA19-9和CEA水平测定的临床意义

目的：评价CA242、CA19-9和CEA在大肠癌诊断中的意义。方法：采用酶联免疫和放射免疫法分别检测40例健康人、42例炎性肠病患者和74例大肠癌患者CA242、CA19-9和CEA的含量。结果：大肠癌患者CA242、CA19-9和CEA抗原表达均分别高于健康人和炎性肠病患者。具有显著性差异。其中CA242特异性最好，为89．42％。在大肠癌患者中CA19-9检出率最高。为83．78％。CA242、CA19-9分别在结肠癌和直肠癌中的表达水平不同。其差异具有显著性意义。结论：血清CA242、CA19-9和CEA的联合检测有利于大肠癌的早期诊断，也可作为大肠癌治疗药物疗效评价的重要依据。     

血清NSE TSGF CA125 CYFRA21-1联合检测对肺癌的诊断价值

目的探讨血清NSE，CYFRA21-1，CA125，和TSGF联合检测对肺癌的诊断价值。方法应用ELISA技术，测定74例肺癌患者、40例肺良性疾病患者和20例体检正常者血清NSE、CYFRA21-1、CA125、TSGF的水平。结果肺癌组的4种标志物NSE、CYFRA21-1、CA125、TSGF的水平及检测阳性率均明显高于良性肺病及正常对照组（P〈0．01）。鳞癌、腺癌和小细胞肺癌分别以NSE、CYFRA21-1、CA125、TSGF升幅较为明显。NSE、CYFRA21-1、CA125、TSGF的灵敏度分别为47．3％、54．0％、59．46％、55．4％。但4种联合检测的灵敏度为91．89％，明显优于1种血清肿瘤标志物的单项测定。结论血清NSE、CYFRA21-1、CA125、TSGF联合检测提高肺癌的阳性检出率和检测特异性，对肺癌的早期诊断、疗效监测、预后判断有重要意义。     

Combined Detection of CEA,CA 19-9, CA 242 and CA 50 in the Diagnosis and Prognosis of Resectable Gastric Cancer

Our aim was to investigate the value of combined detection of serum  carcinoembryonic antigen (CEA), carbohydrate antigen (CA) 19-9, CA 242 and CA 50 in diagnosis and assessment of prognosis in consecutive gastric cancer patients. Clinical data including preoperative serum CEA, CA 19-9, CA 242, and CA 50 values and information on clinical pathological factors were collected and analyzed retrospectively. Univariate and multivariate survival analyses were used to explore the relationship between tumor markers and survival. Positive rates of tumor markers CEA, CA 19-9, CA 242 and CA 50 in the diagnosis of gastric cancer were 17.7, 17.1, 20.4 and 13.8%, respectively, and the positive rate for all four markers combined was 36.6%. Patients with elevated preoperative serum concentrations of CEA, CA 19-9, CA 242 and CA 50, had late clinical tumor stageand significantly poorer overall survival. Five-year survival rates in patients with elevated CEA, CA 19-9, CA 242 and CA 50 were 28.1, 25.8, 27.0 and 24.1%, respectively, compared with 55.0, 55.4, 56.4 and 54.5% in patients with these markers at normal levels (p<0.01). In multivariate Cox proportional hazards analyses, an elevated CA 242 level was determined to be an independent prognostic marker in gastric cancer patients. Combined detection of four tumor markers increased the positive rate for gastric cancer diagnosis. CA 242 showed higher diagnostic value and CA 50 showed lower diagnostic value. In resectable gastric carcinoma, preoperative CA 242 level was associated with disease stage, and was found to be a significant independent prognostic marker in gastric cancer patients.     

血清CA19—9的酶免测定及临床应用

本文用生物素—链霉亲和素酶联免疫吸附试验（BSA）对203例血清CA19－9水平进行定量测定。结果显示，在32例胰腺癌组为826±411U／ml，40例肝癌组为107±46．5U／ml，与76例正常人对照组21．2±9．24U／ml比较均有明显差异（P＜0．05），以胰腺癌组升高最显著。在39例胃癌组为25．4±11．0U／ml，与正常对照组比较均无明显差异（P＞0．05）。27例胰腺癌病人术前为910±452U／ml，术后为187±89．0U／ml，血清CA19－9水平明显下降（P＜0．05）。血清CA19－9水平分析对胰腺癌的鉴别诊断、疗效观察及预后评估有较高价值。