大肠癌肿瘤标志物SCAgs在其血清学诊断中的价值

目前,可用于大肠癌血清学检测的肿瘤标志物有两类:一是由单克隆抗体(MAb)识别的肿瘤相关抗原,如CA19-9和CEA等;另一类是β-HCG(绒毛膜促性腺激素)等激素.研究表明,CA19—9对大肠癌的阳性检出率一般仅30%左右,而CEA和HCG的特异性和相关性均较差.故寻找更为理想的肿瘤标志物用于其诊断仍是当前人们可望解决的研究课题.     

癌胚性肿瘤标志物联检的诊断价值

152例恶性肿瘤患者血清癌胚抗原(CEA)和铁蛋白用ELISA法检测。CEA>4ng/ml和铁蛋白>80ng/ml分别见于54％和44％的食管癌患者;41％和56％胃癌患者,82％和64％的直肠癌患者,66％和72％的肺癌患者。聚丙烯酰胺凝胶电泳法分离血清乳酸脱氢酶(LDH),62％的患者LDH_4和LDH_6升高。34％的患者血清电泳图谱中出现一条异常区带(LDH-x)。此三项指标联合检测,恶性肿瘤的诊断率显著提高。     

肿瘤标志物在肝细胞癌诊断及预后中的应用

肿瘤标志物具有无创性、可重复分析、实时监测等特征,其在肝细胞癌早期诊断及预后监测中具有重要的应用价值。近几年,肝细胞癌肿瘤标志物研究发展迅速,既有传统的血清学肿瘤标志物(如甲胎蛋白、异常凝血酶原、高尔基体糖蛋白73、磷脂酰肌醇蛋白聚糖3等),又有新型的液体活检肿瘤标志物(如循环肿瘤细胞、循环肿瘤DNA等)。进一步研究肿瘤标志物与肝细胞癌之间的相关性,可为肝细胞癌治疗及预后评估提供参考。     

肿瘤标志物对癌性胸腔积液诊断的价值

目的探讨肿瘤标志物在癌性胸腔积液诊断中的价值。方法应用免疫放射分析法对108例癌性胸腔积液和90例良性胸腔积液的CYFRA21-1、CEA、NSE和CA153含量进行检测,并对结果进行比较分析。结果癌性胸腔积液中四种肿瘤标志物指标明显高于良性组(P<0.01),四项联检后的敏感性、特异性及准确性明显升高。结论肿瘤标志物CYFRA21-1、CEA、NSE和CA153四项联检在癌性胸腔积液的诊断中具有明确的意义。     

脐尿管癌1例

1　病案摘要患者男,6 6岁,汉族。因下腹壁肿块伴隐痛不适月余于2 0 0 2年8月2 8日入院,既往无外伤、手术史。查体:脐下腹壁正中可触及约6cm×7cm肿块,轻压痛,质Ⅲ度,表面欠光,固定。B超及CT检查均示,腹壁见约6 8cm×6 0cm×7 5cm不均质低密肿块影,边缘呈分叶状改变。增强扫描不均匀性强化,病灶与双侧腹直肌分界欠清。肿瘤相关抗原检测CA19 982 0 90 (正常0～39μ/ml下同) ,PSA(前列腺特异抗原) 0 74 (0～4 0ng/ml) ,CA5 0 12 4 9(0～2 5 μ/ml) ,CEA 2 2 0 3(0～4 30ng/ml)。临床诊断:脐尿管肿块性质待查。9月3日作脐尿管肿块…     

脐尿管癌12例的诊断与治疗

背景与目的：脐尿管癌是来源于脐尿管残存组织的少见的恶性上皮肿瘤，由于发生部位特殊，早期诊治比较困难。本研究探讨脐尿管癌的诊治方法和远期疗效。方法：同顾性分析12例脐尿管癌患者的临床资料、治疗方案和随访结果，其中粘液腺癌10例，腺癌2例．结果：3例（均为临床Ⅲ期）膀胱全切患者术后1—3年内死于肿瘤。2例（Ⅱ期1例，Ⅲ期1例）膀胱部分切除者术后分别在术后3个月、5个月局部复发．并于1年内死亡。6例行扩大性膀胱部分切除术，患者中1例（Ⅳ期）术后7个月因肺转移死亡，2例（Ⅲ期）术后1年3个月及1年9个月死亡，1例（Ⅱ期）术后5年无瘤生存，2例（Ⅲ期）分别为术后6个月和1年，仍在随访中。结论：脐尿管癌发病位置隐匿．术前诊断较为困难，治疗方法主要是行扩大性膀胱部分切除术；本病的预后很差，临床分期与预后密切相关。     

肿瘤标志物联合检测诊断壶腹部周围癌的研究

[目的]探讨多项肿瘤标志物联合检测对壶腹部周围癌的诊断及鉴别诊断的价值。[方法]对86例壶腹部周围癌进行多项肿瘤标志物检测,并对胰头癌（n=40）及其他壶腹癌周围癌（n=46）进行多项肿瘤标志物综合后比较。[结果]单项检测CA199,CA242在胰头癌,Vater癌及胆总管癌其值升高明显,相比较无显著差异（P＞0.05）,而十二指肠癌中较低,与胰头癌相比有显著差异（P＜0.01）,CEA在胰头癌和十二指肠癌中升高明显,与Vater癌及胆管癌相比有显著差异（P＜0.05）。单项检测CA199、CD242,CEA诊断胰头癌与其他壶腹部周围癌的特异性分别为56.5%,56.5%,76.1%,三种标志物联合检测能明显提高诊断胰头癌的特异性（87％）。[结论]肿瘤标志物联合检测诊断胰头癌及鉴别壶腹部周围癌有一定价值。     

5种肿瘤标志物联合检测在口腔鳞状细胞癌中的诊断价值

目的:通过检测血清肿瘤标志物（SCC-Ag、CYFRA21-1、CEA、CA125、NSE）探讨联合检测对口腔鳞状细胞癌(oral squamous cell carcinoma,OSCC)的临床诊断意义及诊断效能。方法:收集2015年1月至2018年1月就诊于新疆维吾尔自治区人民医院口腔颌面外科的OSCC患者60例,非OSCC恶性肿瘤患者60例,同期健康体检者60例作为正常组,均抽取空腹外周血2 ml,检测SCC-Ag、CYFRA21-1、CEA、CA125、NSE浓度。结果:OSCC患者的5种血清肿瘤标志物水平与非OSCC恶性肿瘤组、正常组比较差异具有统计学意义(P<0.05)。将CEA、CA125、SCC-Ag、CYFRA21-1、NSE联合检测后敏感性、特异性、准确性、阳性预测值均显著提高。结论:SCC-Ag、CYFRA21-1、CEA、CA125、NSE 5种肿瘤标志物在OSCC中联合检测可以显著提高诊断效能;5种肿瘤标志物的血清表达量在OSCC的临床诊断中具有一定的价值。     

脐尿管癌的CT诊断

目的探讨脐尿管癌的CT表现特点。方法回顾性分析经病理证实的18例脐尿管癌及炎性病变患者的临床资料和CT表现。结果脐尿管癌15例，脐尿管炎性病变3例。所有患者的病变部位均在腹中线Retzius间隙脐尿管走行区，其中17例位于脐尿管膀胱交界区的膀胱顶壁或前壁，1例位于脐尿管上端。15例脐尿管癌cT扫描时呈囊实性（11例）或实性（4例）；6例可见病灶中心或周边点状、斑点状或弧形钙化。3例脐尿管炎性病变中，1例为囊肿伴感染，表现为厚壁囊性肿块；2例为慢性炎性肉芽肿，表现为软组织肿块；3例炎性病灶周同脂肪间隙均呈明显炎性反应，可见较多斑片、条索影。结论脐尿管癌的CT表现具有特征性，CT扫描能提供较为准确的定位和定性诊断信息。     

肿瘤标志物在胃癌早期诊断中的应用价值

目的 探讨血清中常见肿瘤标志物在胃癌早期诊断中的应用价值.方法 选择64例胃癌患者(A组),45例胃良性囊肿患者(B组),42例胃黏膜正常的人(C组)作为研究对象.对3组患者血清中CA242、CA724、CA19-9和CEA水平进行比较、癌症各期患者血清中各肿瘤标志物表达水平的检测以及各种肿瘤标志物单测及联合检测对胃癌诊断有效率进行比较.结果 恶性肿瘤组(A组)患者血清中CA242、CA724、CA19-9和CEA水平均显著性高于良性(B组)、对照组(C组)患者,差异有统计学意义(P<0.05);B组患者血清中肿瘤标志物水平显著性的高于C组患者,差异有统计学意义(P<0.05).随着肿瘤分期的不断延长,胃癌患者血清中CA242、CA724、CA19-9和CEA的表达水平均显著增加;各标志物中CA724的灵敏度最高,CEA标志物的特异性最高,CA724标志物的有效诊断率最高,4项标志物联合检测的灵敏度、特异性以及有效诊断率要显著高于单测肿瘤标志物,差异具有统计学意义(P<0.05).结论 采用CA242、CA724、CA19-9和CEA联合检测是诊断胃癌的理想组合,联合检测能够有效提高诊断的特异性、灵敏度以及有效率,对于胃癌早期的诊断、治疗具有十分重要的意义.     

脐尿管癌11例诊治分析

目的探讨脐尿管癌的诊断、治疗及方法。方法回顾性分析11例脐尿管癌患者的临床症状、影像学特点、治疗和随访结果。结果 11例脐尿管癌中黏液腺癌9例,腺癌2例。Ⅱ期1例、Ⅲ期9例、Ⅳ期1例。1例经尿道行膀胱肿瘤电切术,于术后2个月肿瘤复发,复发后7个月死亡;2例膀胱部分切除者分别于术后3、4个月复发和(或)转移,并分别于肿瘤复发后2、11个月后死亡;2例膀胱全切患者术后1.2、2年死于肿瘤复发;6例行扩大性膀胱部分切除术,其中4例术后1.1～2.1年死亡,1例术后5年无瘤生存,1例术后1.4年,仍在随访中。结论脐尿管癌发病位置隐匿,早期诊断较为困难,易误诊。主要治疗方法是扩大性膀胱部分切除术。脐尿管癌预后很差。     

肿瘤标志物对胃癌诊断及预后的评估价值

目的探讨肿瘤标志物水平变化对胃癌诊断及预后评估的价值。方法经手术与病理学确诊的198例胃癌患者作为病例组,同时选择198例于我院体检均为健康者为对照组。采用电化学发光法检测2组患者血清中肿瘤标志物CEA、CA724、CA199的水平,并评价3种肿瘤标志物的灵敏度、特异度。结果病例组3种肿瘤标志物的含量均高于对照组,且差异均有统计学意义。同时术后该3种肿瘤标志物的水平均低于术前,差异均有统计学意义。同时（Ⅲ＋Ⅳ）期患者肿瘤标志物水平明显高于（Ⅰ＋Ⅱ）期,差异均有统计学意义。病例组患者CEA、CA724、CA199的灵敏度分别为50．9％,51．3％,47．8％;特异度分别为92．1％,91．4％,89．5％;三者联合检测的灵敏度和特异度分别达90．1％,73．4％。结论血清CEA、CA724、CA199对于胃癌的诊断有一定的辅助诊断价值,同时三者联合检测可以提高其诊断的敏感度,对于预后胃癌患者的预后有较高的评估价值。     

Clinical Evaluation of Tumor Markers for Diagnosis in Patients with Non-small Cell Lung Cancer in China

Background: To evaluate the value of combined detection of serum carcinoembryonic antigen (CEA),cytokeratin 19 fragment (CYFRA21-1), and carbohydrateantigen 125 (CA125) for the clinical diagnosis of nonsmallcell lung cancer (NSCLC). Materials and Methods: Serum CEA, CYFRA21-1 and CA125 were assessed in140 patients with NSCLC, 90 patients with benign lung disease and 90 normal control subjects, and differencesof expression were compared in each group, and joint effects of these tumor markers in the diagnosis of NSCLCwere analyzed. Results: Serum CEA, CYFRA21-1 and CA125 in patients with NSCLC were significantly higherthan those with benign lung disease and normal controls (P<0.05). The sensitivity of CEA, CYFRA21-1 andCA125 were 49.45%, 59.67%, and 44.87% respectively. As expected, combinations of these tumor markersimproved their sensitivity for NSCLC. The combined detection of CEA + CYFRA21-1 was the most cost-effectivecombination which had higher sensitivity and specificity in NSCLC. Elevation of serum CEA and CYFRA21-1was significantly associated with pathological types (P<0.05) and elevation of serum CEA, CYFRA21-1 andCA125 was significantly associated with TNM staging (P<0.05). Conclusions: Single measurement of CEA,CYFRA21-1 and CA125 is of diagnostic value in the diagnosis of lung cancer, and a joint detection of these threetumor markers, could greatly improve the sensitivity of diagnosis on NSCLC. Combined detection of CEA +CYFRA21-1 proved to be the most economic and practical strategy in diagnosis of NSCLC, which can be usedto screen the high-risk group.     

膀胱脐尿管癌7例临床病理分析

目的：探讨膀胱脐尿管癌临床病理特征及诊断标准。方法：回顾性总结7例膀胱脐尿管癌的临床病理资料，就其病理类型、临床特征等进行研究。结果：7例膀胱脐尿管癌均位于膀胱顶部。病理类型：黏液腺癌4例，高分化乳头状肠型腺癌、高分化鳞状细胞癌、神经内分泌癌各1例；其中4例可见囊形脐尿管残留。临床表现以血尿多见，术式为部分膀胱及脐尿管切开术。结论：膀胱脐尿管癌主要病理类型为黏液腺癌，常伴有脐尿管残留结构。肿瘤的发生和生长部位、组织形态学特征是诊断脐尿管原发癌的关键标准，脐尿管残留结构的存在应作为确诊的重要依据。     

核素骨显像联合肿瘤标记物检测对乳腺癌骨转移的诊断价值

目的：观察核素骨显像联合肿瘤标记物对乳腺癌骨转移的诊断价值。方法选择乳腺癌患者82例,按照核素骨显像结果分为转移组43例及未转移组39例,另选取40例健康体检女性作为对照组。观察核素骨显像以及肿瘤标记物检测结果,并对其诊断价值进行考察。结果转移组血清CA125、CA15-3及CEA表达水平及阳性率显著高于未转移组及对照组,骨转移灶数目≤2患者血清CA125、CA15-3以及CEA表达水平及阳性率均显著低于骨转移灶数目＞2的患者,差异均具有统计学意义（P＜0．05）。且随着骨转移分级程度的升高,患者乳腺癌相关肿瘤标记物CA125、CA15-3及CEA表达水平及阳性率均呈升高趋势,各分级间差异有统计学意义（ P＜0．05）。结论核素骨显像联合肿瘤标记物检测可提高诊断敏感性,对于乳腺癌骨转移的诊断具有重要的参考价值。     

Urachal carcinoma in bladder

Objective: To investigate the clinicopathologic features and diagnostic criteria of urachal carcinoma in the bladder. Methods: Seven cases of urachal carcinoma in the bladder were analyzed retrospectively. Results: All the tumors were found locating in the dome of bladder. Of them, 4 were mucinous adenocarcinoma, one was well differentiated papillary enteric adenocarcinoma, one was well differentiated squamous carcinoma, and one was neuroendocrine carcinoma. Cystomorphous urachal remnants were found in 4 cases. The main complaint was hematuria and all patients underwent partial excision of bladder and urachus. Conclusion: Mucinous adenocarcinoma is the main histo-pathological type, and cystomorphous urachal remnants are often accompanied with urachal carcinoma in the bladder. The key diagnostic criteria of urachal carcinoma in bladder are site and histopathology. And to examine the specimens carefully to fred the urachal remnants is important.     

Tumor Markers for Diagnosis,Monitoring of Recurrence and Prognosis in Patients with Upper Gastrointestinal Tract Cancer

To evaluate the value of combined detection of serum CEA, CA19-9, CA24-2, AFP, CA72-4, SCC, TPA andTPS for the clinical diagnosis of upper gastrointestinal tract (GIT) cancer and to analyze the efficacy of thesetumor markers (TMs) in evaluating curative effects and prognosis. A total of 573 patients with upper GIT cancerbetween January 2004 and December 2007 were enrolled in this study. Serum levels of CEA, CA19-9, CA24-2,AFP, CA72-4, SCC, TPA and TPS were examined preoperatively and every 3 months postoperatively by ELISA.The sensitivity of CEA, CA19-9, CA24-2, AFP, CA72-4, SCC, TPA and TPS were 26.8%, 36.2%, 42.9%, 2.84%,25.4%, 34.6%, 34.2% and 30.9%, respectively. The combined detection of CEA+CA199+CA242+CA724 hadhigher sensitivity and specificity in gastric cancer (GC) and cardiac cancer, while CEA+CA199+CA242+SCCwas the best combination of diagnosis for esophageal cancer (EC). Elevation of preoperative CEA, CA19-9 andCA24-2, SCC and CA72-4 was significantly associated with pathological types (p<0.05) and TNM staging (p<0.05).Correlation analysis showed that CA24-2 was significantly correlated with CA19-9 (r=0.810, p<0.001). The levelsof CEA, CA19-9, CA24-2, CA72-4 and SCC decreased obviously 3 months after operations. When metastasisand recurrence occurred, the levels of TMs significantly increased. On multivariate analysis, high preoperativeCA72-4, CA24-2 and SCC served as prognostic factors for cardiac carcinoma, GC and EC, respectively. combineddetection of CEA+CA199+CA242+SCC proved to be the most economic and practical strategy in diagnosis of EC;CEA+CA199+CA242+CA724 proved to be a better evaluation indicator for cardiac cancer and GC. CEA andCA19-9, CA24-2, CA72-4 and SCC, examined postoperatively during follow-up, were useful to find early tumorrecurrence and metastasis, and evaluate prognosis. AFP, TPA and TPS have no significant value in diagnosis ofpatients with upper GIT cancer.