CEA,CA 19-9与CA 125联合检测对良恶性腹水的鉴别诊断价值

目的探讨联合检测腹水和血清CEA,CA 19-9和CA 125对良恶性腹水鉴别诊断的价值。方法应用蛋白质芯片技术分别测定良性和恶性腹水病人腹水和血清的CEA、CA 19-9和CA 125水平,并评价多项肿瘤标志物联合检测对良恶性腹水的诊断价值。结果恶性腹水组腹水和血清CEA,CA 19-9水平较良性腹水组升高(P0.01),恶性腹水组腹水CA125水平较良性腹水组升高(P0.05),但两组血清CA 125水平没有显著性差异(P0.05)。腹水CEA、CA 19-9、CA 125联合检测诊断恶性腹水的敏感性、特异性和准确性分别为81.8%、68.0%和85.1%;血清CEA、CA 19-9联合检测的敏感性、特异性和准确性分别为77.3%、56.0%和83.0%。结论检测肿瘤标志物CEA、CA 19-9及CA 125有助于良恶性腹水的鉴别诊断,腹水利血清CEA、CA 19-9和CA 125联合检测可提高诊断恶性腹水的敏感性和准确性。     

联合检测CEA、CA19-9和CA125对鉴别良恶性腹水的价值

目的探讨检测CEA(癌胚抗原)、CA19-9(糖类抗原19-9)和CA125(糖类抗原125)对鉴别良、恶性腹水的临床价值。方法化学发光法检测120例患者腹水CEA、CA19-9和CA125的含量。结果化学发光法检测恶性腹水中的CEA、CA19-9和CA125分别为(37±16)ng/ml、(236±78)U/ml和(602±211)U/ml,良性腹水分别为(13±2)ng/ml、(34±3)U/ml和(32±3)U/ml,差异均有统计学意义(P<0.05)。同时,3种抗原检测的敏感性和特异性各有特点,需要联合检测。结论联合检测良、恶性腹水中CEA、CA19-9和CA125水平对鉴别诊断有一定临床意义。     

联合检测生化、肿瘤标志物和血清腹水白蛋白梯度在腹水诊断中的价值

[目的]评价腺苷脱氢酶（ADA）、乳酸脱氢酶（LDH）、癌胚抗原（cEA）、糖类抗原19—9（CAl9—9）和血清-腹水白蛋白梯度（SAAG）单项和联合检测在鉴别良恶性腹水中的诊断意义,以提高对良恶性腹水诊断的准确率。[3-法395例诊断明确的腹水患者（其中良性组62例,恶性组33例）均接受ADA、LDH、CEA、CA19—9和SAAG检测,比较2组间水平差异,并计算单项和联合指标对恶性腹水诊断的敏感性、特异性、准确性和尤登指数。[结果]2组除LDH外,ADA、CEA、CA19—9和SAAG水平均差异有统计学意义（P〈0．01）。单项指标分析,敏感度最高的指标为SAAG（84．85％）,而CEA的特异性、准确性和尤登指数均为最高,分别为70．97％、73．68％和0．49。联合ADA、CEA和SAAG三项指标分析,则其敏感性、特异性、准确性和尤登指数分别为63．64％、88．71％、80．00％和0．43。[结论]ADa、CEA、CA19—9和SAAG中单项指标均存在敏感性、特异性不高或敏感性高但特异性差的不足,联合应用后其敏感性虽有所降低,但特异性和准确性均明显升高。     

腹水/血清肿瘤标志物对良恶性腹水的鉴别价值

目的:评价同时测定腹水和血清中5种肿瘤标志物AFP,CEA,CA19-9,CA50,CA125水平及其腹水／血清(F／S)比值对良恶性腹水鉴别诊断的价值．方法:对明确诊断的腹水患者105例(良性57 例,恶性48例)同时采血和抽取腹水,采用化学发光法测定AFP和CEA,免疫放射分析法测定 CA19-9,CA50和CA125．结果:腹水中肿瘤标志物的水平高于血清正常上限值(AFP>25 μg／L,CEA>5 μg／L, CA19-9>37 kU／L和CA50>20 mg／L)时,良性腹水的F／S比值都小于1．2,而恶性腹水的绝大多数F／S比值大于1．2．腹水AFP,CEA, CA19-9．CA50的上述上限值结合F／S比值大于1．2,诊断敏感性分别为18．8％,62．5％,58．3％和72．9％,除AFP外,皆显著高于单纯的腹水浓度和F/S比值的敏感性(16．7％,37．5％,29．2％和47．9％)(P<0．01)．四项联合诊断敏感性达 91．7％,特异性100％．结论:与单纯血清或腹水中浓度测定相比,同时测定肿瘤标志物AFP,CEA,CA19-9和CAS0 的腹水浓度和F/S比值能显著提高诊断的敏感性和特异性,对良恶性腹水的鉴别诊断具有较大的价值．     

血清TSGF、CA125、CA19-9联合SCC检测在老年宫颈癌诊断中的价值

目的探讨血清肿瘤特异性生长因子(TSGF)、糖类抗原125(CA125)、糖类抗原19-9(CA19-9)联合鳞状细胞癌抗原(SCC)检测对老年宫颈癌的诊断价值。方法选择宫颈癌患者45例、宫颈上皮内瘤样病变(CIN)患者34例和健康志愿者30例,分别设为恶性组、良性组和对照组,检测三组受试者血清TSGF、CA125、CA19-9、SCC,分析单项及联合检测对宫颈癌的诊断价值。结果恶性组TSGF、CA125、CA19-9、SCC分别为(78.29±19.82)U/ml、(44.43±16.08)U/ml、(40.69±15.26)U/ml、(3.61±1.98)ng/L,均显著高于良性组和对照组(P<0.05);良性组TSGF显著高于对照组(P<0.05),两组CA125、CA19-9、SCC比较无统计学差异(P>0.05)。TSGF、CA125、CA19-9、SCC单项检测诊断宫颈癌敏感度较低,联合诊断后敏感度升高,而特异度降低,其中四项联合诊断的敏感度最高,为93.33%,与其他诊断方式相比有统计学差异(P<0.05)。结论宫颈癌患者血清TSGF、CA125、CA19-9、SCC出现不同程度升高,四项联合检测可以提高对宫颈癌的诊断敏感度。     

TB—DNA、TAA和AA对良恶性腹水的鉴别价值

应用放射免疫法（RIA），聚合酶链反应（PCR）法和高效液相色谱法（HPLC）对106例良，恶性腹水（良性组35例，结核组35例，恶性组36例）进行了结核菌DNA（TB－DNA），肿瘤相关抗原（TAA）的癌胚抗原（CEA），糖链抗原（CA19－9，CA50）和17种氨基酸（AA）测定分析。结果：（1）TAA三项指标；恶性组显著高于良性组和结核组（P＜0．01）。单项CEA，CA19－9和CA50对恶性腹水的敏感性分别为58％，70％，69％，特异性均为100％，联合三项检测诊断恶性腹水的敏感性为96％。特异性为100％；（2）TB－DNA：对结核性腹水的敏感性，特异性分别为97．14％，95．75％；（3）AA分析；良性组，结核组和恶性组三者腹水均有AA含量改变但无鉴别意义（P＞0．05）。     

联合检测血清、腹水肿瘤标志物对良、恶性腹水的鉴别诊断价值

目的 探索肿瘤标志物对良、恶性腹水的鉴别诊断价值.方法 回顾性分析我院2008年12月～2013年2月收治的126例腹水患者的病历资料.根据病因将其分为恶性腹水组（58例）和良性腹水组（肝硬化腹水36例,结核性腹水32例）,比较血清和腹水中甲胎蛋白（AFP）、糖链抗原（CA） 19-9、CA125、CA72-4、癌胚抗原（CEA）在良恶性腹水患者的差异,并对有统计学意义的指标构建受试者工作特征曲线（ROC曲线）图,以期寻找最佳临界值.结果 恶性腹水患者血清及腹水中CA19-9、CA72-4、CEA含量均高于良性腹水患者,差异有统计学意义（P＜0.05）,良、恶性腹水患者腹水及血清中AFP、CA125含量差别均无统计学意义（P＞0.05）.血清CA72-4、腹水CA19-9、CA72-4和CEA的ROC曲线下面积分别为0.701、0.783、0.752和0.848,准确度最高时其临界值分别为4.03 U/ml、19.33 U/ml、1.895 U/ml和1.41 ng/ml,腹水和血清CA19-9、CA72-4、CEA 3项指标联合检测的敏感性均较单项检测指标高,差异有统计学意义（P＜0.05）,敏感性和特异性分别为48.28％、79.41％、71.43％和91.18％.结论 血清和腹水中CA19-9,CA72-4,CEA水平的检测有助于良恶性腹水的鉴别诊断,构建ROC曲线可为恶性腹水的诊断提供最佳生化指标的组合.     

肝硬化患者血清CA19-9和CA125检测的临床意义

目的探讨肝硬化患者血清CA19-9和CA125水平浓度的变化及可能的意义。方法肝硬化患者67例，其中肝硬化无腹水患者37例，肝硬化伴腹水患者30例，检测所有患者血清CA19-9和CA125水平。结果两组肝硬化患者血清CA19-9和CA125水平浓度均明显高于正常人。肝硬化合并腹水患者血清CA19-9和CA125水平显著高于无腹水患者（P〈0．01），经治疗腹水消退后，血清CA19-9和CA125水平明显下降（P〈0．01）。结论肝硬化患者血清CA19-9和CA125水平升高与腹水的存在有关。     

CYFRA21—1、NSE、CA125、CEA联合检测在肺癌诊断中的应用

目的评价外周血细胞角蛋白19片段（CYFRA 21-1）、神经特异性烯醇化酶（NSE）、糖类抗原（CA125）和癌胚抗原（CEA）联合检测对肺癌的临床诊断价值。方法采用化学免疫发光法测定100例肺癌（肺癌组）、50例良性肺部疾病（良性组）患者和50例健康人（对照组）外周血中的CYFRA21—1、NSE、CA125、CEA。结果肺癌组CYFRA21—1、NSE、CA125、CEA阳性率分别为57％、28％、54％、58％,良性组分别为8％、10％、12％、18％,对照组分别为6％、8％、6％、8％。4项联合检测灵敏性、特异性和准确性分别为72．0％、90.0％、78．0％。结论血清CY—FRA21—1、NSE、CA125、CEA联合检测有利于肺癌的临床诊断。     

胆汁细胞学检查和血清肿瘤标志物检测对胆道恶性狭窄的诊断价值

目的探讨胆汁细胞学检查和血清肿瘤标志物检测对胆道恶性狭窄的诊断价值。方法2005年8月至2009年4月对47例胆管狭窄病例经ERCP抽取胆汁行细胞学检查并行血清肿瘤标志物检测,其中胆管恶性狭窄39例,胆管良性狭窄8例。结果39例胆道恶性狭窄病例中胆汁细胞学检查阳性26例,敏感性66．7％,血清CA19-9检测阳性28例,敏感性71．8％;8例良性狭窄病例中胆汁细胞学检查阴性8例,特异性100．0％,血清CA19—9阴性7例,特异性87．5％。26例胆管癌病例中血清CA19-9检测阳性18例,敏感性69．2％。胆汁细胞学检查和血清CA19-9联合检测,平行法联合检测敏感性89．7％,系列法联合检测特异性100．0％。结论胆汁细胞学检查能够为胆道恶性狭窄疾病的诊断提供病理学依据,具有临床应用价值。联合检测胆汁细胞学和血清CA19．9,提高了诊断敏感性,具有重要的临床应用价值。     

5-羟色胺在大鼠海马CA1、CA2、CA3脑区的分布与表达

目的通过观察5-羟色胺(5-HT)在海马神经环路的分布和表达,为研究5-HT参与学习记忆的作用机制提供形态学依据。方法采用免疫组织化学技术观测抗5-HT的抗体阳性神经元在海马CA1、CA2和CA3区的分布特征。结果①抗5-HT的抗体在海马CA1、CA2和CA3的细胞中广泛分布。②海马中分子层阳性细胞数较少,排列不规则。锥体层细胞从内到外排列整齐,密集成带,染色强烈。多形层细胞染色细胞散在分布。③空白对照切片未见抗5-HT抗体的阳性神经元胞体。结论 5-HT在大鼠海马分布广泛,可能参与了海马学习记忆有关的过程。     

血清CA125,CA19-9,CA50含量对消化系肿瘤的诊断价值

目的评价血清CA125,CA19-9,CA50含量对消化系肿瘤的诊断价值.方法消化系肿瘤患者158例,其中肝癌38例,食管癌21例,胃癌56例,结直肠癌36例,胰腺癌7例;消化系良性疾病患者106例,其中肝硬变57例,消化性溃疡49例;正常对照者40例.全部受测对象均空腹抽静脉血,分离血清,-20℃贮存备测.采用RIA法测定血清CA125,CA19-9,CA50含量,使用国产SN-695型γ计数仪.数据均用()±s表示,以正常()±2s作为上限计算阳性率.结果肝癌、胃癌、胰腺癌、结直肠癌和食管癌血清(CA含量均以kU/L表达)CA125(分别为222±116,79±17,135±79,69±23和72±26),CA19-9(237±108,281±132,838±224,252±136和273±146)和CA50含量(25±9,20±7,18±9,18±8和17±7)显著高于正常对照组及消化道良性病变组(P＜0.01).消化道肿瘤有腹腔及远处转移者,其血清CA125,CA19-9,CA50含量升高更为明显.结论血清CA125,CA19-9,CA50均为较好的肿瘤标记物,有助于诊断消化系统肿瘤.     

胃癌患者血清CA199、CA724、CA242联合检测及其临床意义

目的 探讨血清肿瘤相关抗原CA199、CA724和CA242水平与胃癌的关系.方法 采用放射免疫法分别对63例胃癌患者血清CA199、CA724和CA242水平进行检测,并与30例慢性萎缩性胃炎伴重度不典型增生(CAGD)、30例正常对照组比较,分析其与胃癌恶性程度、转移和临床分期的关系.结果 胃癌患者血清CA199、CA724和CA242水平均明显高于CAGD与正常对照组(P均<0.01),血清CA199、CA724和CA242的阳性率与胃癌恶性程度、转移和临床分期有关(P<0.05),三项指标联合检测可明显提高胃癌诊断的敏感度及准确性.结论 胃癌患者血清CA199、CA724和CA242水平是胃癌发生、发展的重要因素,三者联合检测对胃癌患者诊断、治疗和预后判断等具有重要意义.     

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.     

宫颈癌患者血清CA125和CA72-4水平及其临床意义

目的探讨治疗前不同的CA125和CA72-4值对判断宫颈癌的临床分期、病情及预后估测的价值.方法利用放射免疫分析方法检测125例宫颈癌患者治疗前血清CA125,CA72-4值.结果Ⅳ期宫颈癌患者CA125和CA72-4值明显高于I,II期.治疗前血清CA125>35u/mL 预测宫颈癌的灵敏性、特异性分别为:35.2%,94%,治疗前血清CA72-4>3.8ng/mL 预测宫颈癌的灵敏性、特异性分别为:28.8%,92%.结论 CA125>35u/mL 结合CA72-4>3.8ng/mL可明显提高诊断的灵敏性(46.4%)及特异性(94%),并对判断宫颈癌的临床分期、病情和预后估测有一定的价值.     

CA125,CA19—9检测在卵巢癌诊断及治疗中的价值

应用酶联免疫（ＥＬＩＳＡ）方法进行ＣＡ１２５、ＣＡ１９－９检测,结果显示ＣＡ１２５在卵巢术前患者中灵敏度为８７．５％,特异度为９０％,准确率为８８．７１％,明显高于其它疾病;卵巢癌术后ＣＡ１２５数值明显下降,与术前相比有显著性差异;ＣＡ１２５与ＣＡ１９－９联检可提高卵巢癌检出率。     

Intralobar pulmonary sequestration presenting increased serum CA19-9 and CA125

A 39-year-old man was admitted to our hospital for further evaluation of a consolidated shadow and clarification of the cause of serum tumor marker elevation (CA19-9 496.2 U/ml, CA125 160.6 U/ml). Chest computed tomography revealed a well-defined homogeneous nodule in the left S(10). Angiography showed one aberrant artery, branching from the ascending aorta. Intralobar pulmonary sequestration was diagnosed and the sequestrated lung was resected. Microscopic findings of the sequestrated lung showed a mucus-containing cystically dilated bronchus, which was covered with ciliated cylindrical epithelium. Immunohistochemical staining showed positive staining for CA19-9 and CA125 in both the ciliated cylindrical epithelium and mucus. Serum values of tumor markers returned to their normal range after surgery.     

钙结合蛋白在老年人海马CA1和CA3区的分布

目的　探讨老年人海马中钙结合蛋白 (CalbindinD 2 8K ,CaBP)的分布及表达 ,并分析其在人衰老过程中对神经元的生理、病理变化的影响。方法　收集 12例 6 0岁以上老年人非脑部疾病尸检左侧大脑半球的海马组织 ,经病理常规处理后 ,切片 ,用免疫组织化学ABC染色法检测海马CA1与CA3区CaBP的分布。结果　CaBP阳性产物出现在神经元的细胞质中 ,CA1区的CaBP免疫阳性细胞数多于CA3区。结论　CaBP在老年人海马CA1、CA3中均有表达 ,但有差别。提示CaBP在老年人海马的功能活动中可能起重要作用。     

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.