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ｘ±ｓ表示，以正常ｘ±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     

血清CA-50含量对消化系肿瘤的诊断价值

目的评价血清ＣＡ＿５０对消化系肿瘤的诊断价值．方法消化系肿瘤患者１７２例，其中肝癌５４例，胃癌４３例，大肠癌５７例，胰腺癌１８例；消化系良性疾病患者８８例，其中肝硬变３６例，胃良性病变（胃炎、胃溃疡）５２例；正常对照者６０例．全部受测对象均抽空腹静脉血，分离血清，－２０℃贮存备测．采用ＲＩＡ法测定血清ＣＡ５０含量．放免药盒由中国医学科学院肿瘤研究所提供，使用国产ＦＪ６３０型γ计数仪．数据均用ｘ±ｓ表示，以正常ｘ＋２ｓ作为上限计算阳性率．结果肝癌、胃癌、胰腺癌和大肠癌血清ＣＡ５０含量分别为２４０ｋＵ／Ｌ±２１８ｋＵ／Ｌ，１２１ｋＵ／Ｌ±１０６ｋＵ／Ｌ，１８２ｋＵ／Ｌ±１０７ｋＵ／Ｌ和１６１ｋＵ／Ｌ±１１３ｋＵ／Ｌ．显著高于正常对照组及消化道良性病变组（分别为５６ｋＵ／Ｌ±４４ｋＵ／Ｌ和５６ｋＵ／Ｌ±２１ｋＵ／Ｌ，Ｐ＜００１）．消化道肿瘤有腹腔及远处转移者，其血清ＣＡ５０含量升高更为明显．结论ＣＡ５０是较好的肿瘤标记物，有助于诊断消化道肿瘤．     

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。     

糖类抗原CA—50检测在消化系肿瘤诊断中的应用

用放射免疫法测定76例消化系恶性肿瘤、88例良性疾病及52例正常人的血清CA-50含量。正常值为3.95±0.41U/ml。恶性组的含量不仅明显高于正常组,并显著高于良性组(P<0.01)。提示血清CA-50可作为消化系肿瘤标记物,但无器官专一性。胆石症和良性肝病患者有黄疸时CA-50含量明显增高。     

血清糖链抗原19-9、糖链抗原24-2对良恶性胆道疾病的诊断价值

目的探讨并分析血清糖链抗原(CA)19-9、CA24-2在良恶性胆道疾病中的诊断价值。方法选取2012年1月-2015年10月于河北北方学院附属第一医院消化内科和普外科住院的胆道疾病患者214例,根据病变性质分为胆道良性病变组(n=162)和恶性病变(胆管癌)组(n=52),另选取同期体检中心健康体检者作为正常对照组(n=40)。所有研究对象均在空腹状态下抽取外周静脉血,检测血清TBil、DBil、IBil,采用放射免疫法测定血清CA19-9、CA24-2水平。计量资料多组样本间比较采用Kruskal-Wallis H检验,进一步两两比较采用Wilcoxon秩和检验;计数资料组间比较采用χ~2检验;采用Pearson相关分析法进行相关性分析。结果与正常对照组相比,良、恶性胆道病变组患者血清TBil、CA19-9水平均升高,差异均有统计学意义(P值均0.01);与胆道良性病变组相比,胆道恶性病变患者血清CA19-9和CA24-2水平均显著升高,差异均有统计学意义(P值均0.01)。血清CA19-9、CA24-2水平与胆管癌组织学肿瘤位置无关,与组织学不同分化程度有关(χ~2值分别为6.860、9.010,P值均0.05)。联合检测CA19-9与CA24-2诊断胆管癌的敏感度为88.5%,特异性为82.1%,高于二者单独检测的敏感度和特异性,差异均有统计学意义(P值均0.01)。良性胆道疾病与胆管癌患者血清CA19-9水平与血清TBil水平均呈正相关(r值分别为0.634、0.346,P值均0.05)。结论联合检测CA19-9和CA24-2对胆管癌早期诊断具有临床意义。     

血清CA125诊断肝癌的价值

目的研究血清ＣＡ１２５对肝癌的诊断价值．方法肝癌患者３２例，男２０例，女１２例，平均年龄４６岁±２５岁；肝硬变３６例，男２７例，女９例，平均年龄４２岁±２３岁；正常对照组４０例．全部受测对象均静脉采血，分离血清，－２０℃贮存备测．采用ＩＲＭＡ法测定血清ＣＡ１２５含量．结果肝癌患者血清ＣＡ１２５含量２１８Ｕ／Ｌ±１３０Ｕ／Ｌ，显著高于肝硬变组和正常对照组（分别为１９Ｕ／Ｌ±１１Ｕ／Ｌ，１０Ｕ／Ｌ±８Ｕ／Ｌ，Ｐ＜００１）．肝硬变组高于正常对照（Ｐ＜００５），但显著低于肝癌组（Ｐ＜００１）．以２６Ｕ／Ｌ为界限值，肝癌阳性检出率为６８７％，其中ＡＦＰ阳性（ＡＦＰ＞４００μｇ／Ｌ）的肝癌中血清ＣＡ１２５的阳性检出率为７６０％，ＡＦＰ阴性（ＡＦＰ＜２０μｇ／Ｌ）的肝癌中血清ＣＡ１２５的阳性检出率为４２９％．结论血清ＣＡ１２５是诊断肝癌较好的肿瘤标记物     

消化系统肿瘤患者血清CA50和CA19-9免疫放射分析的比较

目的：比较消化系统肿瘤患者血清ＣＡ５０和ＣＡ１９－９免疫放射分析（ＩＲＭＡ）的诊断价值,探讨ＣＡ５０和ＣＡ１９－９联合检测模式的合理性。方法：ＩＲＭＡ方法检测１４９例消化系统肿瘤患者与对照组血清ＣＡ５０和ＣＡ１９－９,比较分析２项检测结果张临床诊断价值指标。结果：带瘤生存组血清ＣＡ５０和ＣＡ１９－９单独和联合检测的阳 生率显著高主后无 和良性疾病组,其中肝物胰腺肿瘤患者的阳性率最高。ＣＡ５０和ＣＡ     

血清MG-Ag检测在消化系肿瘤诊断中的应用价值

应用鼠抗人胃癌单克隆抗体ＭＧ建立的一步法免疫放射分析法（ＩｍｍｕｎｏｒａｄｉｏｍｅｔｒｉｃＡｓａｙ，ＩＲＭＡ）可检测血清中的胃癌相关抗原ＭＧＡｇ（ＭＧｃｏｒｅｓｐｏｎｄｉｎｇａｎｔｉｇｅｎ）．ＭＧＡｇ是一种新的肿瘤标志物，可用于胃癌、结肠癌、食管...     

胃癌患者血清肿瘤标志CA50和CEA的意义

目的比较胃恶性和良性病变血清人类结肠癌抗原 CA50和 CEA 的变化。方法用放射免疫法测定33例健康对照和86例胃部疾病(胃癌34例,胃溃疡27例和慢性萎缩性胃炎25例)患者血清 CA50和 CEA 含量,胃癌包括窦部27例,体部3例和底部9例,组织学类型包括腺癌21例,上皮癌4例和未分类9例;胃溃疡包括窦部18例,体部3例和底部9例;萎缩性胃炎均伴有肠上皮化生。结果与正常人比较,胃癌血清 CA50(112.67±38.36 kU/L vs 16.26±6.14 kU/L,P<0.01)和 CEA(10.28±3.76μg/L vs 3.12±1.03 μg/L,P<0.01)明显升高;CA50(>22 kU/L)阳性率在胃癌是53.0%(18/34),CEA(>5 μg/L)阳性率是55.8%(19/34);CA50和 CEA 升高呈正相关(r=0.648,P<0.01)。胃癌手术后(n=21),血清 CA50(46.4±25.9 kU/L,P<0.01)和 CEA(6.85±2.43μg/L,P<0.01)有明显下降。胃溃疡和萎缩性胃炎血清 CAS0(P<0.05)轻度升高,而 CEA 无明显变化(P>0.05)。结论血清 CAS0和 CEA 升高可作为诊断晚期胃癌的指标,胃癌手术后血清 CA50和 CEA 明显降低,提示联合测定血清CA50和 CEA 对晚期胃癌的诊治有一定临床意义。     

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。     

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.     

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.     

胆管癌患者血清、胆汁中的CA19-9水平ROC曲线分析及临床参考价值评估

目的 探讨血清、胆汁CA19-9水平对胆管癌的早期诊断和鉴别诊断的价值.方法 对82例胆道恶性病变患者和85例胆道良性疾病者测定血清和胆汁的CA19-9水平,进行对比分析和评价.结果 恶性组患者血清、胆汁CA19-9水平均明显高于良性组患者(P＜0.001);胆汁CA19-9诊断胆管癌的ROC曲线下面积为0.764,诊断价值高于血清的0.701;根据诊断评价指标,胆汁CA19-9灵敏度、特异度、符合率、阳性预测值和阴性预测值(57.90％、95.50％、77.25％、92.30％、70.43％)均高于血液CA19-9(50.90％,89.10％,70.66％,82.35％,65.62％),两项联合检测灵敏度、符合率及阴性预测值均有不同程度提高.结论 选择血清、胆汁CA19-9进行联合检测,在胆管癌的早期筛检中具有重要参考价值.     

血清和胸水中肿瘤标志物检测对老年人胸腔积液的诊断价值

目的　评价老年良、恶性胸腔积液患者血清和胸液中 5种肿瘤标志物单项和联合检测的诊断价值。　方法　采用酶联免疫吸附法同时检测 32例老年肺癌并胸腔积液 (恶性胸腔积液组 )和 30例老年良性胸腔积液患者血清和胸水中细胞角化素蛋白片段 19(CYFRA2 1 1)、神经元特异性烯醇化酶 (NSE)、糖链抗原 15 3(CA15 3)、糖链抗原 19 9(CA19 9)、糖链抗原 12 5 (CA12 5 )水平。　结果　恶性胸腔积液患者血清中上述 5项指标的水平分别为 ( 12 84± 6 4 8) μg/L、( 2 2 0 7± 11 2 5 )μg/L、( 6 5 74± 30 2 6 )kU/L、( 5 6 32± 2 5 6 7)kU/L和 ( 71 86± 31 4 5 )kU/L ,均高于良性胸腔积液患者血清中的水平 (P <0 0 1) ;恶性胸腔积液患者胸水中除NSE外 ,其他 4项指标的水平分别为 ( 18 6 4± 8 15 ) μg/L、( 5 9 31± 2 7 35 )kU/L、( 4 8 2 4± 2 1 5 6 )kU/L和 ( 6 2 16± 2 7 79)kU/L ,均高于良性胸腔积液患者胸水中的水平 (P <0 0 1) ;血清 5种肿瘤标志物平行联合检测可提高诊断的敏感性至90 6 % ,系列联合检测可使特异性提高至 93 3% ;胸液中 4项指标对恶性胸水诊断的敏感性和特异性分别是 :CYFRA2 1 184 4 %和 90 0 % ;CA15 36 2 5 %和 73 3% ;CA19 937 5 %和 6 6 7% ;CA12 55 6 3%和     

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.     

胸腔积液CA15-3、CA19-9和CEA对恶性胸腔积液的诊断价值

目的探讨胸腔积液中CA15-3、CA19-9和CEA在良性和恶性胸腔积液的水平及鉴别诊断价值。方法胸腔积液用化学发光法检测胸腔积液中的含量。结果恶性胸腔积液组的CA15-3、CA19-9、CEA的含量显著高于良性胸腔积液组。联合检测能提高诊断恶性胸腔积液的敏感度和准确度。结论胸腔积液CA15-3、CA19-9和CEA的联合检测对鉴别良恶性胸腔积液有重要价值。     

联合CA19-9、CA125和CEA检测在AFP阴性的ICC鉴别诊断中的应用价值

目的探讨血清癌抗原19-9（CA19-9）、癌抗原125（CA125）和癌胚抗原（CEA）联合检测在甲胎蛋白（AFP）阴性的肝内胆管细胞癌（ICC）患者诊断中的价值。方法2014年6月~2016年6月我院收治的ICC患者60例,根据AFP检测结果,将其分为AFP阴性组和AFP阳性组,每组分别为30例。采用微阵列酶联免疫分析法（Array-ELISA）检测血清CA19-9、CA125和CEA,采用受试者工作特征曲线（ROC）下面积（AUC）分别对各标记物及联合检测诊断的灵敏度、特异度和正确率进行评估。结果30例AFP阴性组血清CA19-9、CA125和CEA水平分别为138.8（85.7~185.1）U/ml、109.6（48.4~201.8）U/ml、11.2（17.5~21.9）ng/ml,均显著高于AFP阳性组的【（38.0（16.9~75.5）U/ml、18.1（9.3~48.1）U/ml、5.5（3.1~8.5）ng/ml）,P<0.01】;两组血清肿瘤标志物诊断ICC的ROC曲线下面积均呈现出CA19-9>CA125>CEA的趋势,在AFP阴性组,各单项诊断的ROC曲线下面积分别为0.85、0.83和0.81,显著高于AFP阳性组的【（0.55、0.45和0.42）,P<0.05】;在单项诊断ICC时,血清CA19-9、CA125和CEA的最佳临床诊断截断点分别为124.89 U/ml、96.04 U/ml和11.97 ng/ml;血清CA19-9、CA125和CEA诊断ICC的灵敏度、特异度和正确率分别为（73.33%、76.67%和71.67%）、（66.67%、70.00%和68.33%）和（60.00%、70.00%和65.00%）,以CA19-9检测诊断的效能最高;两组联合检测诊断的ROC曲线下面积均高于单项指标检测的ROC曲线下面积,且都表现为（CA19-9/CA125/CEA）>（CA19-9/CA125）>（CA19-9/CEA）>（CA125/CEA）,在AFP阴性组,各联合检测诊断的ROC曲线下面积分别为0.94、0.88、0.86和0.85 ,显著高于在AFP阳性组的【（0.74、0.62、0.58和0.52）,P<0.05】;（CA19-9/CA125/CEA）、（CA19-9/CA125）、（CA19-9/CEA）和（CA125/CEA）四种联合检测诊断的灵敏度、特异度和正确率均提高,分别为（90.00%、90.00%和90.00%）、（83.33%、83.33%和81.67%）、（76.67%、83.33%和80.00%）和（70.00%、76.67%和73.33%）,以CA19-9/CA125/CEA联合检测诊断效能最高。结论我们认为,血清CA19-9、CA125和CEA联合检测可提高对AFP阴性ICC患者诊断的正确率,需要临床扩大验证。