Serum HCG beta,CA 72-4 and CEA are independent prognostic factors in colorectal cancer

In colorectal cancer, stage is considered to be the strongest prognostic factor, but also serum tumour markers have been reported to be of prognostic value. The aim of our study was to investigate the prognostic value of serum carcinoembryonic antigen (CEA), CA 19-9, CA 242, CA 72-4 and free beta subunit of human chorionic gonadotropin (hCG beta) in colorectal cancer. Preoperative serum samples were obtained from 204 colorectal cancer patients, including 31 patients with Dukes' A, 70 with Dukes' B, 49 with Dukes' C and 54 with Dukes' D cancer. The serum levels of CEA, CA 19-9, CA 242 and CA 72-4 were measured with commercial kits with cut-off values of 5 microg/L for CEA, 37 kU/L for CA 19-9, 20 kU/L for CA 242 and 6 kU/L for CA 72-4. The serum hCG beta was quantitated by an immunofluorometric assay (IFMA) with 2 pmol/L as a cut-off value. Survival analyses were performed with Kaplan-Meier life tables, log-rank test and Cox proportional hazards model. The sensitivity was 44% for CEA, 26% for CA 19-9, 36% for CA 242, 27% for CA 72-4 and 16% for hCG beta. The overall 5-year survival was 55%, and in Dukes' A, B, C and D cancers the survival was 89%, 77%, 52% and 3%, respectively. Elevated serum values of all markers correlated with worse survival (p < 0.001). In Cox multivariate analysis, the strongest prognostic factor was Dukes' stage (p < 0.001), followed by tumour location (p = 0.002) and preoperative serum markers hCG beta (p = 0.002), CA 72-4 (p = 0.003) and CEA (p = 0.005). In conclusion, elevated CEA, CA 19-9, CA 242, CA 72-4 and hCG beta relate to poor outcome in colorectal cancer. In multivariate analysis, independent prognostic significance was observed with hCG beta, CA 72-4 and CEA.     

Preoperative hCGbeta and CA 72-4 are prognostic factors in gastric cancer

In gastric cancer, the role of tumour markers in assessment of prognosis is unconfirmed. In our study, we evaluated the prognostic significance of serum tumour markers carcinoembryonic antigen (CEA), CA 19-9, CA 72-4, CA 242 and free beta subunit of human chorionic gonadotropin (hCGbeta) in gastric cancer. Preoperative serum samples were obtained from 146 patients with gastric cancer, including 29 with stage I, 11 with stage II, 42 with stage III and 64 patients with stage IV cancer. Quantitation of CEA, CA 19-9, CA 72-4 and CA 242 in serum was performed with commercial assays. HCGbeta was measured with an in-house immunofluorometric assay based on monoclonal antibodies specific for the free beta-subunit of hCG. Survival analysis was performed with Kaplan-Meier life-tables and log-rank test, and with multivariate Cox regression analysis. Disease-specific cumulative 2-year survival rate was 40%. Serum levels of CEA, CA 72-4, CA 242 and hCGbeta showed significant correlation with stage (p<0.027); for CA 19-9 the association was of borderline significance (p=0.056). Of the studied markers, CA 19-9, CA 72-4, CA 242 and hCGbeta were found to be prognostic factors in univariate analysis (p< 0.022). In multivariate analysis, stage had the statistically most significant association with prognosis followed by hCGbeta, tumour histology according to the Laurén classification and by CA 72-4. In gastric cancer, tumour markers hCGbeta and CA 72-4 are independent prognostic factors in addition to stage and histological type of the tumour.     

Applicative Value of Serum CA19-9, CEA,CA125 and CA242 in Diagnosis and Prognosis for Patients with Pancreatic Cancer Treated by Concurrent Chemoradiotherapy

Objective: To evaluate the application value of serum CA19-9, CEA, CA125 and CA242 in diagnosis andprognosis of pancreatic cancer cases treated with concurrent chemotherapy. Materials and Methods: 52patients with pancreatic cancer, 40 with benign pancreatic diseases and 40 healthy people were selected. Theelectrochemiluminescence immunoassay method was used for detecting levels of CA19-9, CEA and CA125, anda CanAg CA242 enzyme linked immunoassay kit for assessing the level of CA242. The Kaplan-Meier methodwas used for analyzing the prognostic factors of patients with pancreatic cancer. The Cox proportional hazardmodel was applied for analyzing the hazard ratio (HR) and 95% confidential interval (CI) for survival timeof patients with pancreatic cancer. Results: The levels of serum CA19-9, CEA, CA125 and CA242 in patientswith pancreatic cancer were significantly higher than those in patients with benign pancreatic diseases andhealthy people (P<0.001). The sensitivity of CA19-9 was the highest among these, followed by CA242, CA125and CEA. The specificity of CA242 is the highest, followed by CA125, CEA and CA19-9. The sensitivity andspecificity of joint detection of serum CA19-9, CEA, CA125and CA242 were 90.4% and 93.8%, obviouslyhigher than single detection of those markers in diagnosis of pancreatic cancer. The median survival time of52 patients with pancreatic cancer was 10 months (95% CI7.389~12.611).. Patients with the increasing level ofserum CA19-9, CEA, CA125, CA242 had shorter survival times (P=0.047. 0.043, 0.0041, 0.029). COX regressionanalysis showed that CA19-9 was an independent prognostic factor for patients with pancreatic cancer (P=0.001,95%CI 2.591~38.243). Conclusions: The detection of serum tumor markers (CA19.9, CEA, CA125 and CA242)is conducive to the early diagnosis of pancreatic cancer and joint detection of tumor markers helps improve thediagnostic efficiency. Moreover, CA19-9 is an independent prognostic factor for patients with pancreatic cancer.     

Prognostic significance of CEA, CA 19-9 and CA 72-4 preoperative serum levels in gastric carcinoma.

The prognostic value of preoperative serum levels of CEA, CA 19-9 and CA 72-4 tumor markers was investigated in 153 patients resected for gastric cancer. The positivity rates for CEA, CA 19-9 and CA 72-4 were 20.9, 34.6 and 28.1%, respectively. Multiple logistic regression analysis for positive levels of tumor markers indicates that CEA positivity is significantly related to the depth of invasion (p < 0.005) and the presence of distant metastasis (p < 0. 05), CA 19-9 positivity is related to nodal involvement (p < 0.05) and the depth of invasion (p < 0.05), whereas CA 72-4 positivity is influenced by tumor size (p < 0.005) and noncurative surgery (p < 0. 05). Positive levels of each tumor marker were associated with a worse prognosis if compared with negative cases using univariate analysis. Multivariate analysis of curatively resected cases identified depth in gastric wall (p < 0.0001), nodal status (p < 0. 0005), and tumor location in the upper third (p < 0.05) as significant prognostic variables; CEA, CA 19-9 and CA 72-4 serum positivity did not reach statistical significance. However, when the positivity of the three markers was associated, a p value < 0.05 was observed. The analysis of survival curves stratified by tumor stage revealed that marker positivity significantly affects survival in stages I, II and IV (p < 0.05). The combined assay of CEA, CA 19-9 and CA 72-4 preoperative serum levels provides additional prognostic information in patients resected for gastric cancer; patients with preoperative positivity for one of these tumor markers should be considered at high risk of recurrence even in early stages of gastric carcinoma.     

CEA,CA 19-9 and CA 72-4 improve the diagnostic accuracy in gastrointestinal cancers

BACKGROUND: CEA, CA 19-9, CA 242 and CA 72-4 are commonly used tumour markers for gastrointestinal malignancies. The advantage of the concomitant use of these markers is under debate. MATERIALS AND METHODS: Serum concentrations of the markers were measured at the time of diagnosis in 161 patients with benign and 125 with malignant gastrointestinal diseases. Concomitant use of the markers was evaluated in a logistic regression model. RESULTS: CA 19-9, CA 242 or CA 72-4 showed similar sensitivity of 44% for gastric cancer, whereas CEA was elevated in 25% of the cases. In patients with colorectal cancer, CEA was most frequently elevated (54%), followed by CA 242 (46%), CA 19-9 (36%) and CA 72-4 (25%). High CA 19-9 and CA 242 serum levels were frequent in patients with cholangiocarcinoma (86% and 68%, respectively) and pancreatic cancer (80% and 63%, respectively). In the benign disease group, serum CA 19-9 was most frequently elevated, i.e. in 24%, 25% and 38% of patients with pancreatic, biliary and liver disorders, respectively. The overall accuracy of CEA, CA 19-9, CA 242 and CA 72-4 was 66%, 71%, 71% and 66%, respectively (p > 0.18). When combined in a logistic regression model, CA 72-4, CA 19-9 and CEA provided independent diagnostic information, whereas CA 242 contributed with independent diagnostic information only on excluding CA 19-9. The probability of cancer for each patient, calculated with the model, was applied as a diagnostic test and was compared with the single markers by ROC-curve analysis. The AUC value of the probability index was significantly higher than the values of the different tumour markers. CONCLUSION: An algorithm based on the combination of CEA, CA 19-9 and CA 72-4 improved the diagnostic accuracy in gastrointestinal tract malignancies compared with these markers alone.     

Combined Detection of CEA,CA 19-9, CA 242 and CA 50 in the Diagnosis and Prognosis of Resectable Gastric Cancer

Our aim was to investigate the value of combined detection of serum  carcinoembryonic antigen (CEA), carbohydrate antigen (CA) 19-9, CA 242 and CA 50 in diagnosis and assessment of prognosis in consecutive gastric cancer patients. Clinical data including preoperative serum CEA, CA 19-9, CA 242, and CA 50 values and information on clinical pathological factors were collected and analyzed retrospectively. Univariate and multivariate survival analyses were used to explore the relationship between tumor markers and survival. Positive rates of tumor markers CEA, CA 19-9, CA 242 and CA 50 in the diagnosis of gastric cancer were 17.7, 17.1, 20.4 and 13.8%, respectively, and the positive rate for all four markers combined was 36.6%. Patients with elevated preoperative serum concentrations of CEA, CA 19-9, CA 242 and CA 50, had late clinical tumor stageand significantly poorer overall survival. Five-year survival rates in patients with elevated CEA, CA 19-9, CA 242 and CA 50 were 28.1, 25.8, 27.0 and 24.1%, respectively, compared with 55.0, 55.4, 56.4 and 54.5% in patients with these markers at normal levels (p<0.01). In multivariate Cox proportional hazards analyses, an elevated CA 242 level was determined to be an independent prognostic marker in gastric cancer patients. Combined detection of four tumor markers increased the positive rate for gastric cancer diagnosis. CA 242 showed higher diagnostic value and CA 50 showed lower diagnostic value. In resectable gastric carcinoma, preoperative CA 242 level was associated with disease stage, and was found to be a significant independent prognostic marker in gastric cancer patients.     

CEA, CA 242, CA 19-9, CA 72-4 and hCGbeta in the diagnosis of recurrent colorectal cancer.

OBJECTIVE: The purpose of this study was to compare the utility of serum CEA, CA 19-9, CA 242, CA 72-4 and human chorionic gonadotropin (hCG)beta in the follow-up of 102 surgically treated colorectal cancer patients, out of which 40 patients developed clinical recurrence. METHODS: In patients with recurrent disease, serum samples were obtained at the time of clinical recurrence, and in the disease-free group, they were obtained postoperatively. The combined use of the markers was evaluated with logistic regression analysis. The sensitivities of the different tumour markers at various specificity levels were compared by receiver operating characteristic (ROC) curve analysis. RESULTS: When the five tumour markers, Dukes stage and location of the primary tumour were evaluated together in the same model, only CEA provided significant diagnostic information (p < 0.0005) in addition to the location of the primary tumour (p = 0.003). The diagnostic information provided by the other serum tumour markers was insignificant, although CA 72-4 approached borderline significance (p = 0.053). ROC curves were constructed and the difference in the values of the area under the curve (AUC) between the different serum tumour markers was determined at the time of clinical recurrence. Of the individual markers, the highest AUC was observed for CEA (AUC = 0.931). The difference in AUC values between CEA and the other tumour markers was highly significant (p < or = 0.001). CONCLUSIONS: CEA had the highest diagnostic accuracy in detecting recurrent colorectal cancer. Inclusion of CA 19-9, CA 242, CA 72-4 or hCGbeta in the model did not improve the accuracy, although CA 72-4 approached borderline significance (p = 0.053). Thus, CEA seems to retain its position as the surveillance marker of choice for patients surgically treated for colorectal cancer.     

外周血内CA19-9、CA242、CEA检测对不同病理分期胰腺癌的临床诊断价值

目的:分析糖类抗原19-9、糖类抗原242、癌胚抗原(CEA)检测对不同病理分期胰腺癌的临床诊断价值。方法:选取我院2015年7月至2017年1月收治的106例胰腺癌患者,检测血清CA19-9、CA242、CEA表达水平,比较手术治疗前后及不同临床分期胰腺癌患者血清CA19-9、CA242、CEA差异,评价上述指标对胰腺癌临床诊断及判断分期的指导作用。结果:胰腺癌病理分期越高,其血清CA19-9、CA242、CEA水平升高越显著,差异有统计学意义（P＜0.05）。肿瘤直径≥5 cm者、肿瘤位于胰腺体/尾部者,其血清CA19-9、CA242、CEA均显著高于肿瘤直径＜5 cm者及肿瘤位于胰腺头部或全胰腺者,差异有统计学意义（P＜0.05）。 结论:血清CA19-9、CA242、CEA有助于胰腺癌的临床诊断及分期判断,具有较高的临床价值。     

The clinical value of serum CEA, CA19-9, and CA242 in the diagnosis and prognosis of pancreatic cancer.

AIM: Serum tumour markers carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9) and CA242 were investigated to evaluate the values of single and combined test in the diagnosis and prognosis of pancreatic cancer. METHODS: Pre-operative serum CEA, CA19-9 and CA242 were measured in 105 pancreatic cancers, 70 non-pancreatic malignancies and 30 benign pancreatic diseases. RESULTS: The sensitivity of CA19-9 alone was the highest in pancreatic cancer patients (80%), but the specificity was significantly lower than that of CEA and CA242 (P<0.01). The combination of CEA and CA242 could increase the specificity to 92%. In serum CA242 positive patients, the survival time was remarkably shorter than that of patients with negative result (P<0.01). The survival time in patients with more than two markers positive expression of CEA, CA19-9 and CA242 was obviously shorter than that of only one or no marker positive expression (P<0.05). CONCLUSION: The diagnostic rate of CA19-9 in pancreatic cancer is better than that of CEA and CA242. Combined detection of CEA and CA242 can improve the diagnostic specificity obviously. High levels of serum markers are associated with advanced stage of the disease. Patients with two or three markers positive expression of CEA, CA19-9, and CA242 simultaneously had a shorter survival time.     

Prognostic value of carcinoembryonic antigen, CA 19-9 and CA 72-4 in gastric carcinoma.

The prognostic value of preoperative serum levels of carcinoembryonic antigen (CEA), CA 19-9 and CA 72-4 tumor markers was investigated in patients with gastric cancer. Eighty-two patients who underwent surgical resection of gastric cancer were entered in the study. Correlation analyses showed that CA 72-4 was more frequently positive in patients with advanced tumors (p = 0.04), lymph node invasion (p = 0.02), liver metastasis (p = 0.02) and peritoneal involvement (p = 0.03). CA 19-9 was more frequently positive in patients with advanced tumors (p = 0.01) and with serosal (p = 0.04), lymph node (p = 0.008) and peritoneal involvement (p = 0.02). CEA was more frequently positive in patients with liver metastasis (p = 0.03). Low 3-year cumulative survival was significantly associated with elevated serum levels of CA 72-4 (p = 0.004), CA 19-9 (p = 0.001) and CEA (p < 0.001). Age, tumor stage and CA 72-4 provided prognostic information in the multivariate analysis. Patients with elevated serum levels of CA 72-4 showed a 4.2 times higher risk of death than patients with low levels of the marker. Our results suggest that CA 72-4 has prognostic value in gastric cancer, and patients with a high preoperative serum level of CA 72-4 have a greater risk of death due to gastric cancer.     

胃癌患者血清CA72-4、CEA及CA19-9水平及其与临床病理特征的相关性

目的:探讨血清CA72-4、CEA及CA19-9水平与胃癌患者病理特征的相关性。方法:选择2011年6月-2013年3月收治的86例胃癌患者,56例胃良性肿瘤患者,60例普通胃病患者,比较三组患者CA72-4、CA19-9和CEA水平;CA72-4、CA19-9和CEA单项检测及联合检测胃癌患者的阳性率;CA72-4、CA19-9和CEA水平与胃癌病理特征的关系。结果:胃癌组患者血清CA72-4、CA19-9和CEA水平均高于胃良性肿瘤组患者（P＜0.05),胃癌良性组患者均高于对照组（P＜0.05);三种胃癌肿瘤标志物中CA72-4诊断胃癌的阳性率最高,肿瘤3项标志物的阳性检测率要显著高于单项CA72-4、CA19-9、CEA的阳性检出率（P＜0.05）;肿瘤越大、TNM分期越高,CA72-4、CA19-9和CEA水平越高。结论:采用CA72-4、CA19-9和CEA联合检测是诊断胃癌比较理想的组合。CA72-4、CA19-9和CEA水平的变化可以反应胃癌患者的病理特征。     

联合检测术前与术后CEA CA19-9 CA72-4对不同分期胃癌根治术后复发的预测价值

  目的   探讨联合检测术前、术后CEA、CA19-9、CA72-4等肿瘤标志物对不同分期胃癌根治术后复发的预测价值。   方法   回顾性分析北京大学肿瘤医院2002年1月至2007年3月收治的564例胃癌患者的临床资料及血清肿瘤标志物情况。所有患者均未行新辅助治疗,术前、术后均联合检测CEA、CA19-9、CA72-4等肿瘤标志物。分析CEA、CA19-9、CA72-4等肿瘤标志物与胃癌复发的关系。   结果   在Ⅰ、Ⅱ期胃癌患者中,CEA、CA19-9、CA72-4术前阳性的患者术后复发率分别为50.0%、24.1%、22.6%,而术后阳性的患者复发率分别为42.9%、21.7%、14.3%。在Ⅲ期胃癌患者中,CEA、CA19-9、CA72-4术前阳性的患者术后复发率分别为50.0%、55.2%、47.6%,而术后阳性的患者术后复发率分别为75.0%、66.7%、66.7%。多因素分析表明术前CEA增高是Ⅰ、Ⅱ期胃癌复发的独立影响因素,术后CA72-4增高是Ⅲ期胃癌复发的独立影响因素。   结论   对于Ⅰ、Ⅱ期胃癌,术前CEA水平是预测复发较好的因子;对于Ⅲ期胃癌,术后CA72-4水平的预测性较好。      

乳酸脱氢酶及肿瘤标记物对胰腺癌的预后影响

目的:观察胰腺癌患者乳酸脱氢酶(LDH)及肿瘤标记物对预后影响.方法:收集LDH及肿瘤标记物,对病理诊断明确且回访到生存期的胰腺癌患者分析预后.结果:297例胰腺癌患者中位生存期5.0月,1年、2年、3年生存率分别为27.3％,10.1％,2.0％.肿瘤最大径大及分期晚的患者1年、2年、3年生存率降低(P＜0.05).胰体尾癌及全胰腺癌较胰头癌生存期短,分期晚、LDH、CEA、CA19-9、CA125升高的患者生存期短(P＜0.05)；LDH高于300U/L患者较轻度升高者生存期短(P ＜0.05):CA125、CA15-3高于100L/ml患者较轻度升高者生存期短(P＜0.05).多因素Cox比例风险回归分析显示肿瘤分期及CA19-9是独立预后因素.结论:肿瘤原发部位、分期、LDH、CEA、CA19-9、CA125是胰腺癌的独立预后因素.     

CA 242, a new tumour marker for pancreatic cancer: a comparison with CA 19-9, CA 50 and CEA.

The serum expression of a novel tumour marker, CA 242, defined by monoclonal antibody C 242, was studied in 179 patients with pancreatic cancer. The results were compared with CA 19-9, CA 50 and CEA. CA 242 is a carbohydrate closely related, but not identical, to CA 19-9 and CA 50. The overall sensitivity of the CA 242 assay was 74%: 55% in stage I, 83% in stage II-III and 78% in stage IV disease. The specificity calculated from 112 patients with benign diseases was 91%. CA 19-9 had a higher sensitivity of 83%, but the specificity was only 81%. When comparing the markers by receiver operating characteristic analysis, the sensitivities were almost identical at all specificity levels. The CA 242 level was elevated in 7%, 15% and 7% of patients with benign pancreatic, biliary and liver disease respectively. The corresponding figures for CA 19-9 were 19%, 28% and 15% respectively. The sensitivity of CA 242 was higher than that of CA 50 and CEA at all specificity levels. In conclusion, tumour marker CA 242 seems to be a useful diagnostic tool for the diagnosis of pancreatic cancer, and is an alternative to CA 19-9. The advantage of CA 242 over CA 19-9 is its higher specificity when using the recommended cut-off levels of the assays.     

肿瘤标记物CA19-9、CA242对胰腺癌转移和预后预测价值的分析

目的:探讨肿瘤标记物糖类抗原19-9(CA19-9)、糖类抗原242(CA242)对胰腺癌转移和预后的预测价值.方法:选取80例胰腺癌患者和20例健康人群的血清样本,测定血清中CA19-9、CA242水平.探讨两者与胰腺癌临床分期、分型、肿瘤大小、淋巴转移情况和预后的关系.结果:胰腺癌患者血清CA19-9、CA242水平显著高于健康人群(P＜0.01).胰腺癌患者中Ⅲ+ Ⅳ期患者血清CA19-9、CA242水平显著高于Ⅰ+Ⅱ期患者(P＜0.05),淋巴转移患者血清CA19-9、CA242水平显著高于无转移患者(P＜0.05),生存期小于8个月患者血清CA19-9、CA242水平显著高于大于8个月患者(P＜0.05).以CA19-9 37.0U/ml、CA242 20.0U/ml为阳性阈值,以CA19-9阳性且CA242阳性组的正确指数最高.结论:胰腺癌患者血清CA19-9、CA242水平对胰腺癌患者术前诊断和预后分析具有一定参考价值.     

Independent prognostic value of preoperative serum markers CA 242, specific tissue polypeptide antigen and human chorionic gonadotrophin beta, but not of carcinoembryonic antigen or tissue polypeptide antigen in colorectal cancer.

The prognostic value of preoperative serum concentrations of carcinoembryonic antigen (CEA), CA 242, tissue polypeptide antigen (TPA), specific tissue polypeptide antigen (TPS) and human chorionic gonadotrophin beta (hCG beta) in 251 patients with colorectal cancer (39 Dukes'' A, 98 Dukes'' B, 56 Dukes'' C and 58 Dukes'' D) was investigated. When using the cut-off levels recommended for diagnostic purposes, there was a significantly longer overall survival in patients with low tumour marker levels compared with patients with elevated serum levels for all the investigated markers. In Dukes'' stage B, C and D CA 242 emerged as a significant predictor of survival, whereas TPA, TPS and hCG beta showed a value only in Dukes'' D. Unfortunately, no marker provided prognostic information in Dukes'' A. In multivariate analysis, entering the tumour markers as continuous variables, Dukes'' stage was the strongest prognostic factor, followed by CA 242. TPS, hCG beta and localisation of the tumour were also independent prognostic factors, whereas age, gender, CEA and TPA were not.     

血清胆汁CA19-9、CEA、CA242联合检测诊断胆道良恶性肿瘤的可行性分析

目的:探讨血清、胆汁CA19-9、CEA、CA242联合诊断胆道良恶性肿瘤的临床价值。方法:对象为2013年10月-2015年2月来我院诊治的疑似恶性胆道肿瘤的患者202例,均行手术探查。所有患者均通过穿刺的方式取胆汁进行CA19-9、CEA、CA242检测,比较不同疾病类型患者血清、胆汁中的CA19-9、CEA、CA242检测水平,分析血清胆汁联合检测在胆道良恶性肿瘤中的诊断价值。结果:202例手术探查患者中,98例经病理证实为恶性胆道肿瘤患者、22例为良性胆道肿瘤患者,82例为其他胆道疾病。恶性胆道肿瘤与良性胆道肿瘤患者胆汁中CA242、CA19-9和CEA的表达水平要显著性的高于在血清中的表达水平（P＜0.05）;恶性肿瘤组患者的胆汁中CA242、CA19-9和CEA检测水平均显著性高于良性肿瘤患者（P＜0.05);胆汁CA242、CA19-9和CEA联合诊断胆道恶性肿瘤的敏感率为33.66%,准确率为88.98%,特异性为91.16%,阳性率为35.24%。结论:利用胆汁中肿瘤标记物对胆道肿瘤的检测水平要高于血清中的水平,采用CA19-9、CEA、CA242的联合检测是诊断胆道肿瘤比较理想的组合。上述肿瘤标志物的组合能够提高胆道肿瘤良恶性的预判准确度,对于早期胆道良恶性肿瘤的发现、治疗具有十分重要的意义。     

大肠癌血清CEA,CA19-9和CA242联合检测及其临床意义

目的评价CEA，CA19-9及CA242联合检测对大肠癌患者的临床诊断价值。方法应用酶联免疫法对150例术前大肠癌患者及其中70例术后患者和200名健康人血清CEA，CA19-9及CA242含量进行测定。结果大肠癌患者血清3项标志物含量明显高于健康人（均P〈0．01）；单项和联合检测的阳性率及特异性总体比较差异均有统计学意义（均P〈0．01）；其中CEA、CA242检测的阳性率显著高于CA19-9；CEA＋CA242与3项联合检测的阳性率均显著高于单项或其他两项联合检测的阳性率；CEA特异性高于CA242；3项联合检测的特异性明显低于单项检测。3个年龄段大肠癌患者CEA血清水平差异显著，年龄越大CEA水平越高（P〈0．05）。在Dukes分期中，3项标志物含量及检测的阳性率依次增高（P〈0．05～0．01）。淋巴结转移患者的3项标志物含量及CA19-9，CA242的阳性率均高于无淋巴结转移的患者。3项标志物含量随肿瘤侵袭程度的增加显著增高，但在组织病理分类和肿瘤大体形态中均差异无统计学意义。Dukes A＋B期大肠癌术后3项标志物含量显著降低（P〈0．01），而C＋D期改变不明显。结论3项标志物的检测有助于大肠癌的临床辅助诊断，联合检测可以提高诊断的阳性率；3项标志物检测对大肠癌临床分期、淋巴结转移及肿瘤侵犯程度评估，尤其CA19-9和CA242比用于术前诊断更有意义，对指导临床医师合理手术有一定的帮助；术后检测有助于观察疗效，评价治疗效果。     

大肠癌血清CEA，CA19-9和CA242联合检测及其临床应用

 目的 评价CEA，CA19-9及CA242联合检测对大肠癌患者的临床诊断价值。方法 应用酶联免疫法对术前150例，其中术后70例大肠癌患者和200名健康人血清CEA，CA19-9及CA242含量进行测定。结果 大肠癌患者血清3项标志物含量明显高于健康人（均P＜0.01）；单项和联合检测的阳性率及特异性总体比较差异均有统计学意义（均P＜0.01）；其中CEA、CA242 检测的阳性率显著高于CA19-9， CEA+CA242与3项联合检测的阳性率均显著高于单项或其他两项联合检测的阳性率；CEA特异性高于CA242；3项联合检测的特异性明显低于单项检测。3个年龄段大肠癌患者CEA血清水平差异显著，年龄越大CEA水平越高（P＜0.05）。在Dukes 分期中，3项标志物含量及检测的阳性率依次增高（P＜0.05～0.01）。淋巴结转移患者的3项标志物含量及CA19-9，CA242的阳性率均高于无淋巴结转移的患者。3项标志物含量随肿瘤侵袭程度的加深显著增高，但在组织病理分类和肿瘤大体形态中均无明显的差异。Dukes A+B期大肠癌术后3项标志物含量显著降低（P＜0.01），而C+D期改变不明显。结论 3项标志物的检测有助于大肠癌的临床辅助诊断，联合检测可以提高诊断的阳性率；3项标志物检测对大肠癌临床分期、淋巴结转移及肿瘤侵犯程度评估，尤其CA19-9和CA242比用于术前诊断更有意义，对指导临床医师合理手术有一定的帮助；术后检测有助于观察疗效，评价治疗效果。     

血清肿瘤标志物CEA、CA19-9和CA72-4在胃癌术后监测中的意义

目的研究血清肿瘤标志物CEA、CA19—9和CA72—4在胃癌术后复发、转移监测中的意义。方法采用电化学发光法检测228例手术后胃癌患者血清CEA、CA19—9和CA72—4含量;并结合临床及随访资料进行分析。结果胃癌术后复发、转移患者CEA、CA19—9和CA72—4的含量和阳性率均显著高于未发生复发、转移患者。术后复发、转移的胃癌患者血清CEA、CA19—9和CA72—4检测灵敏度和特异度分别为46．2％和94．7％,52．3％和97．4％,47．1％和90．6％。结论血清CEA、CA19—9和CA72-4升高与胃癌复发、转移密切相关,在术后随访过程中检测血清肿瘤标志物有助于早期诊断胃癌复发、转移。