CEA、CA19-9、CA50水平与胰腺癌分期和肿瘤大小的关系

目的 探讨血清肿瘤标志物CEA、CA19-9、CA50水平与胰腺癌分期和肿瘤大小的关系.方法 分别测定35例胰腺癌和36例慢性胰腺炎患者血清CEA、CA19-9与CA50水平.外科手术和(或)病理学判定TNM分期和肿瘤大小,分析两者之间的关系.结果 血清CEA、CA19-9、CA50对胰腺癌诊断的敏感性分别为42%、82%、74%.特异性分别为75%、83%、77%.Ⅲ + Ⅳ期的CA19-9和CA50水平明显高于Ⅰ + Ⅱ期患者(P ＜ 0.05),CEA超过正常值者仅见于Ⅲ期以上胰腺癌患者.TS3 + TS4组的CEA、CA19-9、CA50水平比TS1 + TS2组明显增高(P ＜ 0.05).结论 胰腺癌血清CEA、CA19-9、CA50水平与胰腺癌分期和肿瘤大小有一定相关性,对手术前判断胰腺癌的可切除性有一定的参考价值.     

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。     

胰腺癌患者血清CEA、CA19-9和CA50水平变化及意义

目的观察胰腺癌患者血清癌胚抗原（CEA）、糖类抗原19-9（CA19-9）和CA50水平变化及其对胰腺癌分期和手术可切除性的术前预测价值。方法测定60例胰腺癌患者（胰癌组）血清CEA、CA19-9及CA50,根据手术和病理学检查判定TNM分期。以40例良性胰腺疾病患者作对照（对照组）,分析血清CEA、CA19-9、CA50水平与胰腺癌分期以及手术可切除性之间的关系。结果胰癌组血清CEA、CA19-9、CA50水平均明显高于对照组（P〈0.01）。胰癌组Ⅲ＋Ⅳ期患者的血清CEA、CA19-9、CA50水平明显高于Ⅰ＋Ⅱ期患者（P〈0.01）;姑息性手术患者的血清CEA、CA19-9、CA50水平显著高于根治性手术患者。结论血清CEA、CA19-9、CA50水平与胰腺癌分期有关,可作为判定胰腺癌能否行根治性手术切除的参考指标。     

43例胰腺癌患者血清CA19-9、CA125、CEA水平检测及分析

目的 探讨血清肿瘤标志物CA19-9、CA125及癌胚抗原（CEA）联合检测对胰腺癌诊断及疗效监测的价值.方法 采用全自动电化学发光分析仪测定43例胰腺癌患者（胰腺癌组）及40例健康查体者（对照组）血清CA19-9、CA125及CEA水平,其中胰腺癌组手术前及术后1个月各测定1次;根据试剂厂家提供的参考值计算三种标志物诊断胰腺癌的敏感性、特异性及准确性.结果 胰腺癌组手术前后血清CA19-9、CA125及CEA水平均显著高于对照组（P＜0.01）,尤以术前为著（P＜0.05）;三种肿瘤标志物术后阳性率均显著低于术前（P＜0.05）,联合检测上述三种肿瘤标志物诊断胰腺癌的敏感性、特异性及准确性均显著高于单一标志物检测（P＜0.05）. 结论联合检测血清CA19-9、CA125、CEA水平对胰腺癌的辅助诊断、疗效判定、病情监测等均有重要价值.     

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.     

CA19-9、CA125和碱性磷酸酶对胆囊癌临床分期的意义

背景：近年原发性胆囊癌的发病率明显上升,提高胆囊癌的早期诊断是改善治疗和预后、提高生存率和生活质量的关键。目的：探讨检测CA19-9、CA125和碱性磷酸酶（AKP）对胆囊癌的临床分期以及术前评估的意义。方法：收集2003年1月~2010年5月华中科技大学同济医学院附属协和医院经病理检查确诊为原发性胆囊癌的159例患者,对不同TNM分期胆囊癌患者的血清CA19-9、CA125和AKP进行比较分析。结果：Ⅰ＋Ⅱ＋ⅢA期、ⅢB期、Ⅳ期胆囊癌患者血清CA19-9、CA125和AKP水平相比差异有统计学意义（P〈0.01）;Ⅰ＋Ⅱ＋ⅢA期血清CA19-9阳性率和AKP异常率显著低于ⅢB期、Ⅳ期（P〈0.01）,而血清CA125阳性率显著低于Ⅳ期（P〈0.01）。Ⅰ＋Ⅱ＋ⅢA期血清CA19-9水平和阳性率以及AKP水平和异常率均显著低于ⅢB＋Ⅳ期（P〈0.01）,而血清CA125水平和阳性率均无明显差异。联合检测的阳性率明显高于单个指标的阳性率（P〈0.01）。结论：CA19-9、CA125、AKP可作为胆囊癌的辅助诊断手段,对胆囊癌的临床分期和术前评估具有较好的临床价值。联合检测可提高诊断效率。     

胃癌患者血清CEA、CA19—9变化及意义

目的探讨血清癌胚抗原（CEA）、癌抗原（CA）19—9在胃癌发生、发展中的作用。方法60例住院治疗的胃癌患者（观察组）及60例良性胃肠道病变患者（对照组），测定两组血清CEA、CAl9-9的含量，采用单因素分析法分析血清CEA、CAl9-9与胃癌临床病理参数的关系。结果观察组血清CEA、CAl9—9水平显著高于对照组（P均〈0．05）。血清CEA浓度升高与胃癌浸润深度、腹膜转移、淋巴结转移、肝转移、肿瘤直径、周围脏器受累有关；血清CAl9—9水平与胃癌的浸润深度、肿瘤大小、淋巴结转移、周围脏器受累相关（P均〈0．05）。结论CAl9-9、CEA浓度升高对胃癌的诊断和转移有重要的临床价值，可作为临床胃癌诊断的良好辅助检测手段。     

血清Cyfra21—1、CA19—9及CRP联合检测对食管癌诊断的价值

目的探讨血清肿瘤标志物细胞角蛋白19片段（Cyfra21-1）、糖链抗原19—9（CA19-9）与C．反应蛋白（CRP）联合检测在食管癌诊断中的价值。方法检测136例食管癌和120例健康对照人群血清Cyfra21．1、CA19-9及CRP水平;分析食管癌患者血清Cyfra21—1、CA19-9及CRP与临床分期的关系,以及联合检测对早期诊断的价值。结果食管癌患者血清Cyfra21—1、CA19—9及CRP水平均高于健康对照人群（P均〈0．01）。食管癌患者随着临床分期的递增血清Cyfra21—1、CA19-9及CRP水平逐渐上升（P均〈0．05）。食管癌患者血清Cyfra21．1、CA19-9及CRP联合检测的诊断敏感性、准确度和阴性预测值均高于单项检测（P均〈0．05）。结论血清Cyfra21—1、CA19-9及CRP水平联合检测有助于食管癌早期诊断。     

CA242,CEA,CA19-9在胃癌及癌前病变组织中表达的相关研究

目的研究胃癌及癌前病变组织中肿瘤相关抗原表达的临床意义。方法对所有病例均行电子胃境检查，经胃镜取3块病变组织（直径约0．5cm）送病理。经病理诊断分为胃癌组32例．癌前病变组33例，对照组（浅表胃炎组）30例，同时取病变组织2块放入5％EDTA二纳液1ml中消化分离细胞，测3组病人病变组织中CA242、CEA、CA19-9的含量，同时测血清中CA242、CEA、CA19-9的含量：对3组病人组织及血清中CA242、CEA、CA19-9的含量及组织／血清比值分别进行比较。结果（1）CA242、CEA、CA19-9在胃癌及癌前病变组织中的表达明显高于血清中的表达（P〈0，01）。（2）CA242、CEA、CA19-9。在癌前病变组织中的表达明显高于对照组（P〈0.01），且在重度癌前病变组织中的表达明显高于在 中度癌前病变组织中的表达（P〈0．01），而血清中癌前病变组肿瘤相关抗原的含量与对照组差异无显著性（P〉0．05），（3）组织中CA242、CEA，CA19-9检测对胃癌诊断的灵敏度分别是84．3％、90．63％、87．50％；特异性分别是66．67％、63．49%、69．84%。结论对组织CA232、CEA、CA19-9表达的检测可预测癌前病变的危险程度，能提高早期胃癌诊断率，而血清CA242、CEA、CA19-9。检测对癌前病变的危险程度及早期胃癌的诊断价值不大。     

结直肠癌患者根治术前血清CEA和CA19-9表达水平对预后的预测价值

目的探讨结直肠癌患者根治术前CEA、CA19-9水平对预后的预测价值。 方法回顾性分析复旦大学附属肿瘤医院2003年12月至2007年1月间491例接受根治性切除的Ⅱ、Ⅲ期结直肠癌患者临床资料,包括患者术前血清CEA和CA19-9水平、临床病理资料及预后情况。利用单变量和多变量分析患者年龄、性别、肿瘤部位、肿瘤分化、TNM分期、肿瘤侵犯深度及淋巴结转移个数与预后的关系。 结果患者术前血清CEA和CA19-9水平、TNM分期、淋巴结转移数、肿瘤侵犯深度、肿瘤的分化都与预后相关。在多变量分析中,CEA和CA19-9水平、TNM分期、肿瘤分化是总生存的独立预测因素,CA19-9水平、TNM分期、肿瘤分化是无病生存的独立预测因素。 结论术前血清CA19-9与CEA水平均对结直肠癌患者的预后有预测价值。CA19-9水平应该作为常规的术前检查指标,对CEA检测结果有补充作用。     

Biliary cystadenoma with elevated CA 19.9.

We report a case of a large biliary cystadenoma occupying the entire peritoneal cavity, manifesting as an abdominal swelling for years and an elevation of CA 19.9 serum levels. Serum CA 19.9 levels fell to normal values after surgical excision. Recognition and management of this rare hepatic lesion is discussed.     

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.     

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.     

Tumour markers CA 19-9 and CA 50 in digestive tract malignancies.

CA 19-9 and CA 50 are tumour marker tests measuring the same carbohydrate structure, sialosyl-fucosyl-lactotetraose--that is, the sialylated Lewis blood group antigen. In addition, the C50 antibody reacts with sialosyl-lactotetraose, which may be expressed in small amounts in some carcinomas. In this study we compared these tests in sera from patients with benign and malignant digestive tract diseases. The sensitivity of the markers for different cancers was also compared at several specificity levels with patients with benign diseases as reference groups. Both markers showed a high sensitivity for pancreatic cancer (77% for CA 19-9; 69% for CA 50) and biliary cancer (88%). The figures in colorectal cancer were almost as high as those reported for CEA; 16-21% elevated values in Dukes A and B tumours and 44-47% in Dukes C and D tumours. The sensitivity for gastric cancer was 48% for both markers. CA 50 had a higher sensitivity for liver cancer (55%) than CA 19-9 (9%), but the proportion of elevated values in benign liver diseases was also higher (33% versus 15%, respectively). Overall, there was good correlation between the CA 19-9 and CA 50 levels, and the difference in sensitivity and specificity was marginal. In clinical practice the greatest value of CA 19-9 and CA 50 is in the diagnosis of pancreatic cancer.     

CA 125 in ovarian cancer.

The serum tumour marker CA 125 is useful in the management of ovarian cancer, although it has its limitations. Approximately 85% of the ovarian cancer patients have an increased serum CA 125 at the start of treatment. There is a good correlation between the course of CA 125 and the clinical response of the tumour. Patients with an increasing CA 125 are found to have progressive disease in 97%. In these patients further examinations to document progression should be performed. A decrease in serum CA 125 corresponds in 87% of the patients with tumour regression. A normal serum CA 125, however, does not exclude tumour. More than 40% of the patients with a normal CA 125 still have microscopic or macroscopic tumour at second look surgery. On the other hand, an increased serum CA 125 corresponds in 90% of the patients with the presence of tumour or tumour progression shortly after the second look. The same holds for secondary debulking surgery. Patients with an increasing serum CA 125 before secondary debulking surgery have progressive disease at or shortly after surgery, even if an adequate tumour debulking has been performed. In these patients surgery should be omitted as long as no effective second line therapy is available. The course of serum CA 125 during the first 3 months of treatment is of prognostic value for response rate as well as time to progression and overall survival. Patients with a serum half-life of more than 20 days, or a CA 125 which is still high 3 months after the start of treatment, have a significantly lower response rate and progression-free survival. Whether it is possible to improve the prognosis of these patients by dose-intensification will have to be investigated in randomized trials. Serum CA 125 is not specific for ovarian cancer. High levels can also be found in patients with non-ovarian gynaecological and non-gynaecological tumours as well as patients with benign diseases and even in apparently healthy persons. In view of this aspecificity, serum CA 125 cannot be proposed for mass screening. For the same reason, serum CA 125 and the immunohistochemical staining with OC 125 are of limited value in the differential diagnosis between a primary ovarian tumour and metastatic disease in an ovary, as well as for differential diagnosis of pelvic tumours.     

CA 125 and its relation to cardiac function.

BACKGROUND: CA 125, known as a marker for ovarian cancer with hypothetical but hitherto uncharacterized biologic functions, was reported to be elevated in some not-well-defined benign conditions. There are no reports on fluctuations of CA 125 related to cardiac function, especially the failing heart and neurohumoral factors such as norepinephrine or atrial natriuretic peptid/e. METHODS AND RESULTS: CA 125 blood levels were determined in patients with heart failure before and after heart transplantation (HTx). In 71 patients, parallel determinations of norepinephrine, atrial natriuretic peptide, pulmonary capillary wedge pressure, and right atrial filling pressure were done. CA 125 levels also were prospectively studied in patients with heart failure with stabilization (n = 25) or worsening of the clinical status (n = 9) and after HTx (n = 25). Parallel determinations of the tumor markers CEA, CA 199, CA 153, TPS, and TPA were also done. The results were grouped according to the clinical status (New York Heart Association class) of the patients. CA 125 was significantly correlated with neurohormones and filling pressures. Follow-up investigations revealed a decrease of CA 125 levels after HTx (401 +/- 259 U/L vs 33 +/- 22 U/L, P <.001, n = 25) or stabilization (429 +/- 188 U/L vs 78 +/- 35 U/L, P <.001, n = 25) and an increase during worsening of heart failure (42 +/- 25 U/L vs 89 +/- 32 U/L, P <.01, n = 9). In 4 patients after HTx, unexpected death was preceded by rising CA 125 levels. CEA, CA 199, CA 153, TPS, or TPA did not correlate with heart failure status or clinical events. CONCLUSIONS: CA 125 is a marker of the clinical and hemodynamic status and the course of patients with heart failure before and after heart transplantation. The determination of CA 125 serum levels may be an additional tool in the management of these patients. In patients with cancer, these "nonspecific" changes must be considered when CA 125 levels are determined. Whether CA 125 has a specific biologic role in heart failure deserves further studies.