联合检测CEA、CA153、CA199及CA125在胸腔积液鉴别诊断中的应用

目的:探讨联合检测肿瘤标志物CEA、CA153、CA199及CA125在胸腔积液良恶性鉴别诊断中的临床应用价值。方法:将60例胸腔积液患者按其良恶性质分为恶性观察组和良性对照组各30例,采用电化学发光免疫法对其胸水及血清中的肿瘤标志物CEA、CA153、CA199及CA125进行免疫蛋白定量分析。结果:观察组的CEA、CA125、CA15-3及CA19-9水平均显著高于对照组,两组比较有显著性差异(P<0.01)。观察组胸水中的CEA、CA125、CA15-3及CA19-9水平均显著高于血清中的水平,两者比较有显著性差异(P<0.01)。结论:检测胸水及血清中的肿瘤标志物CEA、CA153、CA199及CA125对胸腔积液良恶性质的鉴别诊断具有重要的临床价值。     

CEA、CA125、CA199检测在良恶性胸腔积液鉴别诊断中的应用

目的 探讨胸腔积液癌胚抗原(CEA)、糖类抗原125(CA125)及糖类抗原199(CA199)三项指标联合检测在良恶性胸腔积液鉴别诊断中的应用.方法 采用全自动免疫电化学发光法(ECL)对100例良恶性胸腔积液及对应血清进行肿瘤标志物CEA、CA125和CA199同步检测.结果 胸腔积液、血清CEA、CA125和CA199水平,恶性组均高于炎性组(P＜0.05);恶性胸腔积液肿标含量均高于血清(P＜0.05);胸腔积液、血清肿瘤标志物单项检测诊断恶性胸腔积液的敏感度由高到低依次为CEA、CA125和CA199;特异度由高到低依次为CEA、CA199和CA125.三项指标联合检测的敏感性为90.6%,特异性为70.3%.结论 胸腔积液、血清CEA、CA125、CA199对鉴别良恶性胸腔积液有重要临床价值,三项肿瘤标志物联合检测敏感性更高.     

胸水肿瘤标志物检测在良恶性胸腔积液鉴别诊断中的价值

目的探讨胸水肿瘤标志物的检测在良恶性胸腔积液鉴别诊断中的价值。方法选择28例恶性胸腔积液患者作为实验组及22例良性胸腔积液患者作为对照组,分别检测其血清和胸水中CEA、CA153、CA125、CA199的含量,并进行比较。结果实验组血清和胸水肿瘤标志物均明显高于对照组（P〈0.01）;而实验组中,胸水肿瘤标志物亦明显高于血清肿瘤标志物（P〈0.01）。结论胸水肿瘤标志物检测在良恶性胸腔积液的鉴别诊断中有重要的价值,且优于血清肿瘤标志物检测。     

胸腔镜辅助局部肿瘤切除联合胸膜热烧灼治疗肺癌恶性胸水效果分析

目的 探讨胸腔镜辅助下局部肿瘤切除联合胸膜热烧灼治疗肺癌恶性胸水的新方法.方法 自2005年6月至2008年12月,解放军总医院第一附属医院对37例肺癌伴恶性胸水患者完成了胸腔镜辅助下局部肿瘤切除胸膜热烧灼为主的综合治疗,观察治疗前后血清肺癌标记物浓度变化情况,并与同期25例胸腔化疔患者比较胸水的控制情况和存活时间.结果 手术组患者的胸腔积液控制有效率为100%,对照组的有效率60%,两组比较差异有统计学意义(P=0.005);手术组与对照组1年生存率分别为78.38%、60%,两组比较差异有统计学意义(P=0.003).CEA和CA-125浓度监测结果,手术组术后较术前浓度明显下降(P=0.002);而在对照组中,胸水引流前后和胸腔化疗前后肿瘤标志物浓度变化差异无统计学意义(P=0.797).结论 胸腔镜辅助下局部肿瘤切除联合胸膜热烧灼治疗肺癌恶性胸水可以最大限度减轻瘤负荷,对控制胸水、改善患者生活质量有确切疗效.

Abstract：

Objective To discuss the treatment effect of wedge resection and thermal cantery of pleura for patients with malignant pleural effusion (MPE) caused by lung cancer under VATS.Methods 37patients with MPE underwent wedge resection and thermal cautery of pleura under VATS,from June 2005 to December 2008.Postoperative tumor markers level was contrasted with the preoperative,and the control rate of pleural effusion and survival rate of the patients were compared with control group,including 25 patients undergoing intrapleural chemotherapeutics in the same period.Result In the group,the control rate of pleural effusion was 100%,but 60% in control group(P = 0.005).The 1 -year survival rate of the group and the control group was 78.38% and 60% respectively (P =0.003).CEA and CA-125 were descended obviously in postoperative day 7 in the group(P = 0.002) ;in control group,there were no significant change of CEA and CA 125 after treatment(P= 0.797).Conclusion Wedge resection and thermal cautery of pleura under VATS can reduce tumor burden of patients with MPE to the maximum,and control MPE effectively and improve the quality of life for lung cancer patients with MPE.     

恶性胸腔积液中CEA、CA125、AFP、CA199和CA153的检测对病因诊断的价值

在临床上,引起恶性胸腔积液的疾病主要包括肺结核和恶性肿瘤,因此,探讨引起恶性胸腔积液的病因,对于指导临床治疗和判定预后均具有重要意义[1]。目前,已有学者通过检测胸腔积液中CEA、CA125、AFP、CA199和CA153等肿瘤标志物水平,以区分胸腔积液的良恶性,但尚无用其探究病因的报道[2]。本文通过检测不同癌症患者胸腔积液中CEA、CA125、AFP、CA199和CA153等5种肿瘤标志物水平,旨在评估其在恶性胸腔积液病因诊断中的价值。     

肿瘤标志物检测鉴别良恶性胸腔积液价值评价

目的探讨肿瘤标志物检测鉴别良性胸腔积液(BPE)和恶性胸腔积液(MPE)的诊断价值。方法 MPE患者60例(恶性组),BPE患者60例(良性组),利用化学发光法测定两组胸腔积液肿瘤标志物癌胚抗原(CEA)、糖类抗原(CA)125、CA199和CA153,比较两组上述指标水平及阳性率。结果恶性组CEA、CA125、CA199和CA153水平明显高于良性组(均P<0.05),恶性组CEA、CA125、CA199和CA153阳性率均高于良性组(均P<0.05)。结论胸腔积液CEA、CA125、CA199和CA153水平检测对BPE和MPE的鉴别具有重要的诊断价值。     

胸腔积液患者CEA、CA199、CA125检测结果的临床分析

目的探讨胸腔积液患者血清和胸水CEA、CA125、CA199联合检测在疾病诊断中的价值。方法对94例患者的血清和胸水CEA、CA125、CA199的检测结果进行回顾性分析。结果恶性组胸水与血清的CEA、CA125、CA199均显著高于良性组（P〈0.01）;恶性胸水中CEA水平亦显著高于良性组（P〈0.01）,恶性组胸水/血清比值亦显著高于良性组（P〈0.01）。结论与单纯测定血清和胸水中的CEA、CA125、CA199相比,胸水和血清三者指标联合测定对良恶性胸腔积液鉴别诊断具有更重要的价值。     

癌胚抗原和糖类抗原测定在胸水诊断中的价值

目的:探讨肺癌测定患者外周血清和胸水中糖类抗原(CA153、CA199、CA125)、癌胚抗原(CEA)在鉴别良恶性胸水中的价值.方法:采用IMMULITE酶放大化学发光免疫分析法,测定良恶性胸水患者共100例,其中恶性胸腔积液患者50例,良性胸腔积液患者50例的血清和胸水CA153、CA199、CA125和CEA进行...     

肿瘤标志物在胸腔积液中的诊断价值

目的 探讨胸腔积液中的肿瘤标志物CEA、CA125、CA153、CA199联检，以鉴别良、恶性胸腔积液的意义。方法 抽取病人胸水。用罗氏公司Elecsys2010电化学发光免疫分析仪测定其中CEA、CA125、CA153、CA199的含量。结果良、恶性胸水中CEA、CA199含量差异非常显著（P〈0．001），CA153含量有差异（P〈0．05），CA125含量无差异（P〉0．05）。结论 对胸水进行CEA、CA153、CA199联合测定，有助于提高诊断的正确性。     

血清和胸腔积液肿瘤标志物联合检测的诊断价值

①目的探讨联合检测血清和胸腔积液中肿瘤标志物含量对胸腔积液性质的诊断价值。②方法应用微粒子发光酶免疫分析法分别检测良性胸腔积液35例、恶性胸腔积液29例及其相应血清中的CEA、CA125和CA199含量。③结果恶性组血清及积液3项标志物含量均显著高于良性组（P〈0.01）。CEA和CA199在恶性组血清及积液中阳性率均明显高于良性组（P〈0.01）。CA125在两组血清与积液中的阳性率差异无统计学意义（P〉0.05）。2项或3项指标联合检测对血清和恶性胸腔积液的灵敏度分别为69.0%、96.6%,特异性分别为94.3%、97.1%。④结论联合检测血清和胸腔积液肿瘤标志物对良、恶性积液的鉴别诊断有重要的临床价值。     

癌胚抗原、糖类抗原125、糖类抗原19-9、糖类抗原125联合检测对胃癌的临床诊断价值研究

目的探讨癌胚抗原（CEA）、糖类抗原125（CA125）、糖类抗原50（CA50）、糖类抗原19-9（CA19-9）四种血清肿瘤标记物联合检测对胃癌诊断的临床价值。方法通过放射免疫分析法测定56例胃癌患者（胃癌组）及48例良性胃病组血清CEA、CA50、CA19-9、CA125水平,并与30例正常健康体检者（健康对照组）作比较。结果术前胃癌组的CEA、CA50、CA19-9、CA125明显高于良性胃病组及健康对照组,术后3个月胃癌组患者血清CEA、CA50、CA19-9、CA125水平较术前明显降低,差异有统计学意义（P〈0.05）,良性胃病组与健康对照组比较,差异无统计学意义（P〉0.05）。四项联合检测的灵敏度达87.5%,明显高于其他任一单项检测的灵敏度,差异有统计学意义（P〈0.05）。复发者CEA、CA50、CA19-9、CA125的水平明显高于未复发者,差异有统计学意义（P〈0.05）。结论联合检测血清CEA、CA50、CA19-9、CA125对胃癌的诊断、治疗及预后等方面具有重要的临床价值,有助于提高胃癌诊断的敏感性。     

联合测量肿瘤标志物在鉴别良恶性胸腔积液中的诊断价值

[目的]探讨联合测量胸水及血清中癌胚抗原(CEA),糖链抗原19-9(CA19-9)和糖链抗原125(CA125)在鉴别良恶性胸水中的诊断价值.[方法]用酶联免疫吸附测定法测量179例恶性胸腔积液与167例良性胸腔积液患者的血清和胸水中的CEA,CA19-9和CA125含量,分析其最佳诊断界值,独自及联合诊断的敏感性、...     

CA125 CA19-9 CEA在老年卵巢良恶性肿瘤诊断中的应用价值

目的：探讨肿瘤标志物糖类抗原125（CA125）、糖类抗原19-9（CA19-9）和癌胚抗原（CEA）在老年卵巢良恶性肿瘤诊断中的应用价值。方法：选取我院住院治疗的老年良性卵巢肿瘤患者38例,为A组,恶性肿瘤患者29例,为B组;另选取老年健康体检患者30例,为对照组;分别对三组患者进行CA125、CA19-9和CEA检测。结果：经检测三组患者检测指标阳性率经统计学分析,B组患者各指标检测结果阳性率均明显高于A组、对照组患者;A组患者各指标检测阳性率明显高于对照组;B组患者含量均明显高于A组和对照组,上述指标组间比较差异均具有显著性（P值均〈0.05）。结论：老年卵巢恶性肿瘤患者CA125、CA19-9和CEA指标阳性率明显优于良性肿瘤患者,对老年卵巢肿瘤诊断准确率高,具有较高临床价值。     

胸腔内置管并甘露聚糖肽联合白细胞介素-2注药治疗肺癌致恶性胸腔积液34例

目的 观察胸腔内置管并甘露聚糖肽联合白细胞介素-2注药治疗肺癌致恶性胸腔积液的疗效.方法 将我院收治的恶性胸腔积液患者34例,尽量排尽胸腔积液后胸腔内注入药物,治疗组为甘露聚糖肽60 mg/次、白细胞介素-2 100～200万U/次,每周1～2次,连用4次,无效停止治疗;对照组为甘露聚糖肽60 mg/次,每周1～2次,连用4次无效停用,随访3个月.结果 甘露聚糖肽+白细胞介素-2组有效率为82.35%;甘露聚糖肽组有效率为41.18%,两组有效率比较差异有统计学意义(P＜0.05).结论 中心静脉导管行胸腔闭式引流术操作简单,创伤小,无痛苦,带管活动方便,引流效果满意.甘露聚糖肽和白细胞介素-2联合用于胸膜腔内注射可充分发挥协同作用,迅速促进癌性渗出液的吸收,值得临床上进一步研究和推广. Abstract： Objective To discuss the clinical value of closed drainage of pleural cavity with central venous catheterand to evaluate the effect of mannatide and interleukin-2 in the treatment of the patients with pulmonary neoplasm combined with malignant pleural effusion by thoracic cavity perfusion drainage.Methods Thirty-four patients with pulmonary neoplasm combined with malignant pleural effusion were randomly divided into two groups.In group A, injection of mannatide (60 mg) and interleukin-2(10-20 million U) each time.In group B, injection of mannatide (60 mg)each time.The procedures were performed at an interval of a week for 1-2 times.The course of treatment was 4 weeks and the follow-up period was 3 months.Results The total efficiencies in groups A and B were 82.35% and 41.18%, respectively; the difference was considered significant (P ＜ 0.05).Conclusions The closed drainage of pleural cavity with central venous catheter is easy to manipulate, with minor trauma, no complaints, convenience in patient activity and satisfactory drainage effect.Mannatide and interleukin-2were effective and safe on patients with pulmonary neoplasmcombined with malignant pleural effusion, and they take effect synergetically.This method worth being studied and extended clinically.     

肿瘤标志物联合检测在肺癌诊断中的意义

目的 探讨四种血清肿瘤标志物癌胚抗原(CEA)、糖类抗原125(CA125)、神经元特异性烯醇化酶(NSE)及细胞角蛋白19片段(CYFRA21-1)检测在肺癌患者诊断中的临床应用。方法 选取30例经病理确诊为肺癌患者(肺癌组)和40例同期健康体检者(对照组)为研究对象,采用电化学发光法分别检测血清中CEA、CA125、NSE、CYFRA21-1的水平,比较分析四种血清学肿瘤标志物在肺癌临床诊断中的意义。结果 肺癌组患者血清CEA、CA125、NSE和CYFRA21-1水平均高于对照组,差异有统计学意义(P＜0.05);4项肿瘤标志物联合检测敏感性高于单项检测,差异均有统计学意义(P＜0.05)。结论 血清CEA、CAl25、CYFRA21-1和NSE联合用于肺癌诊断在单项检测高特异性的基础上提高了准确性和敏感性,对肺癌的早期鉴别诊断具有重要意义。     

儿童腺样体扁桃体切除前后血清炎性介质的动态变化

目的 观察阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患儿行腺样体扁桃体切除手术前、后血清中炎性因子的变化,并评估手术的影响.方法 将45例行扁桃体腺样体切除术的OSAHS患儿作为治疗组,另选45例性别和年龄等与治疗组相匹配的健康儿童为对照组.用超敏ELISA法检测血清α-肿瘤坏死因子(TNF-α)和白介素-6(IL-6),用胶乳增强免疫比浊法检测血清中超敏C-反应蛋白(hs-CRP).治疗组手术治疗后6个月复查上述指标.结果 治疗组术前血清TNF-α、IL-6和hs-CRP水平均高于对照组(P<0.01);经手术治疗后1年,上述指标均低于术前水平(P<0.01);TNF-α、IL-6和hs-CRP水平与AHI呈正相关,与LSaO2呈负相关.结论 手术治疗可有效逆转OSAHS患儿血中TNF-α、IL-6和Hs-CRP的水平,可以将其作为手术治疗效果的评价指标. Abstract： Objective To observe the changes of circulating tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6) and high-sensitivity C-reactive protein (hs-CRP) levels in children with obstructive sleep apnea-hypopnea syndrome (OSAHS) before and after operation,and to assess the effect of surgical treatment on the levels of these inflammatory factors. Methods Forty-five children with OSAHS underwent adenoidectomy and tonsillectomy were selected as OSAHS group and matched for age and sex to 45 health children control group. Serum levels of TNF-α and IL-6 were detected by high sensitivity ELISA. The hs-CRP was measured by latex-enhanced turbidometry. The serum levels of these factors in OSAHS group before operation were compared with those of the control group and OSAHS group 6 months after operation. Results Serum levels of TNF-α, IL-6, and hs-CRP in OSAHS group were higher than those in the control group (P<0.01), and the levels in OSAHS group 6 months after operation were significantly lower than those before operation (P<0.01). All the serum parameters were correlated positively with AHI, and negatively with LSaO2. Conclusions Operative treatment can effectively correct circulating serum levels of TNF-α,IL-6 and hs-CRP in children with OSAHS. The changes of TNF-α,IL-6 and hs-CRP levels can be a valuable measure in treatment follow-up.     

肺腺癌患者外周血及肿瘤浸润性淋巴细胞中Fas分子的表达及意义

目的 检测Fas分子在肺腺癌患者肿瘤浸润淋巴细胞(TILs)和外周血淋巴细胞(PBLs)中的表达,探讨Fas/FasL在肿瘤局部与全身免疫反应中的作用及临床意义.方法 用流式细胞术(FCM)对50例肺腺癌患者PBLs及TILs中Fas的表达进行定性定量分析,以48例正常人的PBLs为对照组.结果 Fas分子在肺腺癌患者TILs和PBLs中的表达率分别为16.8%和8.0%,对照组PBLs为12.6%,前者表达率明显高于后两者(P<0.05);而肺腺癌患者PBLs的Fas分子表达率明显低于对照组PBLs(P<0.05).结论 Fas分子在肺腺癌患者PBLs与TILs及其亚群中的表达不同,Fas/FasL在机体肿瘤局部及全身水平的免疫反应中起着重要作用. Abstract： Objective To study the Fas expression in tumor infiltrating lymphocytes (TILs)and peripheral blood lymphocytes(PBLs) from patients with pulmonary adenocarcinoma, and to investigate the clinical significance and the role of the Fas/FasL in local and systemic immune responses. Methods By flow cytometery(FCM),the expression of Fas molecule were detected on TILs and PBLs in 50 cases of lung adenocarcinoma and in 48 cases of normal healthy PBLs. Results Expression rate of Fas molecule on TILs and PBLs of lung adenocarcinoma patients was 16.8% and 8.0% respectively,and on PBL of normal controls was 12.6%. The former was significantly higher than the two latters(P<0.05). Expression rate of Fas molecule on PBLs of lung adenocarcinoma patients was significantly lower than the control group (P<0.05). Conclusions Expression of the Fas molecul on TILs and PBLs of lung adenocarcinoma patients is different. Fas/FasL pathway plays a major role in the fighting between immune system and tumor not only at local tumor site but also at systemic level.     

胸腔积液中肿瘤标志物的联合检测对肺癌的诊断价值

目的探讨胸腔积液和血清中癌胚抗原（CEA）,神经元特异性烯醇化酶（NSE）和细胞角蛋白19片段（CYFRA21—1）联合检测在肺癌诊断中的临床价值。方法将127例胸腔积液患者分为两组,良性组58例,恶性组69例,分别对两组患者胸腔积液和血清中的CEA,NSE和CYFRA21—1进行测定,并对两组的测定结果进行比对分析。结果恶性组患者胸腔积液中的CEA,NSE和CYFRA21—1浓度均明显高于良性组,差异有统计学意义（t=16．3,5．9,8．5,P均〈0．01）;恶性组患者胸腔积液中的CEA,NSE和CYFRA21—1浓度均明显高于血清中的浓度,差异有统计学意义（t=4．91,5．23,6．11,P均〈0．05）;CEA,NSE和CYFRA21—1的联合检测在诊断肺癌的敏感度和特异度均明显高于单独某一项的检测,差异有统计学意义（P〈0．05）。结论胸腔积液和血清中CEA,NSE和CYFRA21-1的检测对肺癌有一定的临床诊断价值,且三项肿瘤标志物联合检测能够明显提高肺癌诊断的特异度和敏感度。