乳腺癌患者血清可溶性肿瘤标志物的临床价值研究 lectin

目的：探讨血清可溶性肿瘤标志物CEA、CA-153、ICAM-1、E-selection单项及联合检测在乳腺癌中的诊断价值。方法：选取不同临床分期乳腺癌患者130例,乳腺良性肿瘤患者30例,正常人群30例,通过酶联免疫吸附法（ELISA）测定各项指标血清浓度并进行比较。结果：乳腺癌CEA、CA-153、ICAM-1、E-selection血清浓度均显著高于良性肿瘤组及正常人群（P〈0.01）,且其血清浓度与肿瘤分期密切相关。在疾病进展的转移性乳腺癌中,各指标出现明显升高（P〈0.01）。CEA、CA-153、ICAM-1、E-selection单项检测对于乳腺癌的诊断敏感性较低,多指标联合检测可不同程度提高检测的敏感性,以含CA-153及E-selection组合最为显著。结论：E-selection、ICAM-1、CEA、CA-153均为乳腺癌重要的血清标志物,在肿瘤的发生、发展及转移过程中发挥重要的作用。对恶性肿瘤患者的多指标联合检测可在不显著降低特异性的基础上提高诊断的敏感性,为判断预后及监测病情提供重要价值。     

CEA、CA-153、ICAM-1、E-selection单项及联合检测对乳腺癌的诊断价值

目的探讨血清可溶性肿瘤标志物CEA、CA-153、ICAM-1、E-selection单项及联合检测对乳腺癌中的诊断价值。方法选取乳腺癌患者40例,将这些患者作为乳腺癌组,另选取同期收治的乳腺良性肿瘤组患者40例作为良性组,另选取同期接收的健康体检人员40例作为正常组,采用ELISA法对三组人员的血清CEA、CA-153、ICAM-1、E-selection进行连续动态检测。结果血清E-selection单项检测对乳腺癌Ⅲ期、Ⅳ期患者的敏感性较高,血清CEA单项检测对乳腺癌组患者的特异性较高;血清CEA+CA-153+ICAM-1+E-selection、CA-153+ICAM-1+E-selection对乳腺癌组患者的敏感性显著高于CEA+CA-153+ICAM-1、CEA+CA-153+E-selection、CEA+CA-153+ICAM-1+E-selection(P<0.05),血清CA-153+E-selection的敏感性显著高于CEA+CA-153、CA-153+ICAM-1(P<0.05)。结论血清可溶性肿瘤标志物CEA、CA-153、ICAM-1、E-selection联合检测在乳腺癌中具有较高的诊断价值。     

12项肿瘤标志物检测乳腺癌的临床意义

[目的]了解12项肿瘤标志物指标在乳腺癌中的表达.[方法]采用蛋白芯片法检测术前乳腺癌75例及正常对照组160例12项肿瘤标志物.[结果]12项指标中乳腺癌组较正常对照组高,且具有统计学意义的指标有:CA125、CA153、CEA、CA199、Ferritin;但敏感性及特异性均不高.[结论]单项指标诊断乳腺癌的准确性均不高,价值有限,CA125、CA153、CEA、CA199是联合诊断乳腺癌可选指标.     

肿瘤标志物联合检测对原发性肝癌的诊断价值

目的:探讨肿瘤标志物（testing multi-tumor,TM）联合检测对原发性肝癌的诊断价值。方法:应用电化学发光法定量测定46例原发性肝癌患者、32例良性肝病患者、40例健康体检者血清中糖类抗原199（CA-199）、神经特异性烯醇酶（NSE）、癌胚抗原（CEA）、糖类抗原242（CA-242）、血清铁蛋白（FERR）、人绒毛膜促性腺激素（HCG）、甲胎蛋白（AFP）、游离前列腺特异性抗原（FPSA）、前列腺特异抗原（TPSA）、糖类抗原125（CA-125）、生长激素（HGH）、糖类抗原153（CA-153）12种TM的浓度。结果:肝癌组CA-199、CEA、CA-242、Ferritin、AFP、CA-153阳性率相对于良性肝病组及健康对照组显著增高（P<0.01）;肝癌组CA-199、CEA、CA-242、Ferritin、AFP、CA-153联合检测相对于健康对照组阳性率及敏感性显著增高（P<0.01）。结论:CA-199、CEA、CA-242、Ferritin、AFP、CA-153联合检测有助于提高原发性肝癌阳性检出率。     

癌胚抗原、糖类抗原15-3和细胞角蛋白片段19检测对乳腺癌临床应用的价值

 目的　研究血清肿瘤标志物癌胚抗原（CEA）、糖类抗原15-3 （CA15-3）、细胞角蛋白片段19 （CYFRA21-1）联合检测对乳腺癌的诊断及复发监测中的意义。方法　采用电化学发光免疫法检测62例乳腺癌患者、57例乳腺良性病患者及50名健康对照组CEA、CA15-3和CYFRA21-1水平,并计算上述指标联合检测在乳腺癌诊断中的敏感度、特异度、准确度和约登指数（YI）。结果　乳腺癌组3种肿瘤标志物水平均明显高于乳腺良性疾病组和健康对照组（P＜0.01）。临床分期越大3种血清肿瘤标志物水平越高;复发病例中3种肿瘤标志物水平均有不同程度升高。单项检测各种肿瘤标志物以CA15-3的敏感性最高（56.5 %）,CYFRA21-1特异性最好（89.7 %）,但CA15-3和CYFRA21-1的准确度及YI值都不高,分别为71.1 %、0.35和70.5 %、0.37。联合检测较单项检测敏感性、准确性和YI明显提高,3项联合检测敏感度高达88.7 %,特异度90.8 % ,准确度89.9 %,YI为0.80。结论　单项检测对乳腺癌的诊断价值有限,3种血清肿瘤标志物联合检测可显著提高乳腺癌的敏感性和准确性,在术后随访和监测复发中可发挥重要作用。     

三项肿瘤标志物联合检测在乳腺癌诊断中的应用

目的:探讨血清CYFRA21-1、CA153、TSGF与乳腺癌病理类型、临床分期的关系及联合检测的意义.方法: 采用电化学发光检测CYFRA21-1、CA153,化学比色法测定TSGF.结果: 乳腺癌患者组织学分型中,CA153在单纯癌中含量最高,CYFRA21-1在髓样癌中略高,TSGF则无明显差别;晚期乳腺癌患者血清CYFRA21-1、CA153、TSGF明显高于早期;三项标志物联合检测的敏感性和诊断准确性均比单项检测高.结论:血清CYFRA21-1、CA153、TSGF与乳腺癌病理类型、临床分期有关,联合检测血清中的CYFRA21-1、CA153、TSGF对乳腺癌的诊断具有重要的临床意义.     

多种肿瘤标志物在检验乳腺癌的临床应用

目的 探讨12项肿瘤标志物指标在乳腺癌中的表达及临床意义.方法 采用蛋白芯片法榆测术前乳腺癌(74例)及正常对照组(158例)中的12项肿瘤标志物.结果 12项指标,乳腺癌组较正常埘照组高,差异具有统计学意义的指标有:CA125、CA153、CEA、CA199、Ferrtin,但敏感性及特异性均不高.结论 单项指标诊断乳腺癌的准确性均不高,CA125、CA153、CEA、CA199联检是诊断乳腺癌较好方法.     

血清CEA、CA153和CA125联合检测对肺癌的诊断价值

目的:探讨血清肿瘤标志物CEA、CA153和CA125单项和联合检测对肺癌的诊断价值.方法:采用化学发光方法分别检测75例肺癌患者、60例良性肺部疾病患者和70例健康对照者血清中CEA、CA153和CA125水平,并分析上述3项指标在肺癌诊断中的敏感度和特异性.结果:肺癌患者3项肿瘤标志物血清水平均高于良性肺部疾病患者和健康对照者,差异具有统计学意义(P＜0.Ol).3项标志物的联合检测诊断肺癌的敏感度高于单项标志物检测,其敏感度高达88％,特异性为76.2％.结论:3项肿瘤标志物联合检测可提高诊断肺癌的敏感度.     

蛋白芯片技术检测肿瘤标志物对乳腺癌的诊断价值

目的探讨应用蛋白芯片技术检测肿瘤标志物对乳腺癌的诊断价值。方法采用多肿瘤标志物蛋白芯片诊断系统,检测90例乳腺癌患者、60例乳腺良性病变者和100名健康体检者12种血清肿瘤标志物,采用SPSS13．0统计软件进行数据分析。结果乳腺癌组CEA、CA125、FER、CA153水平,均显著高于良性病变组和对照组（P〈0．01）：良性捐变组CEA、CA125、FER、CA153水平与对照组比较,差异无显著性意义（P〉0．05）;而CA199、NSE、CA242、HCG、AFP、f-PSA、PSA、HGH在三三组间比较均未见统计学意义（P〉0．05）;乳腺癌组与对照组的logistic回归方程P=1／1＋e^-（-1.29＋2.25×cea＋3.12×CA125＋10.59×CA153）;ROC曲线中,CA125、CA153、CEA、FER联合检测的AUC大于各项肿瘤标志物单项检测的AUC（P=0．000）。结论蛋白芯片技术检测肿瘤标志物对乳腺癌的有较高的临床诊断价值;血清CA125、CA153、CEA、FER是乳腺癌辅助诊断的理想指标,其联合检测有利于提高乳腺癌的诊断率;CA199,NSE,CA242,HCG,AFP,f-PSA,PSA,HGH这些指标对乳腺癌诊断价值较低;作为1种统计手段,logistic回归可改善诊断的灵敏度和特异性。     

CA-125、CA-199、CEA三项肿瘤标志物联合检测对卵巢癌的临床应用价值

目的 探讨血清CA-125、CA-199、CEA联合检测对卵巢癌的临床应用价值.方法 采用全自动免疫发光分析仪技术检测CA-125、CA-199、CEA;检测153例血清中(包括卵巢癌31例,卵巢良性肿块48例,健康妇女54例)CA-125、CA-199、CEA的值,并对卵巢癌患者进行治疗前后的CA-125、CA-199、CEA的值进行监测、随访.结果 卵巢癌患者CA-125、CA-199、CEA值及阳性检出率均高于良性肿瘤及健康妇女值,单独检测时敏感性分别为80.6%、58.1%、41.9%,联合测定CA-125、CA-199、CEA三项则敏感性达96.7%.结论 联合测定CA-125、CA-199、CEA有助于提高卵巢癌诊断的敏感性,同时对观察术后疗效监测有重要价值.     

Serum levels of E-selectin, ICAM-1 and VCAM-1 in colorectal cancer patients: correlations with clinicopathological features, patient survival and tumour surgery

The serum concentrations of the cell adhesion molecules E-selectin, intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) were investigated in 63 patients with colorectal cancer and in 51 controls by an enzyme-linked immunosorbent assay (ELISA). Their relationship to clinicopathological variables and patient survival and changes in their levels after surgery were examined. Colorectal cancer patients showed significantly higher serum levels of E-selectin, ICAM-1 and VCAM-1 compared with healthy controls. There was a significant association between the serum levels of these molecules, disease stage and the presence of both lymph node and distant metastases. Both ICAM-1 and VCAM-1 levels correlated with serum E-selectin and carcinoembryonic antigen (CEA) levels. Serum levels of all three molecules decreased significantly after radical resection of the tumour. Elevated pre-operative E-selectin, ICAM-1 and VCAM-1 levels were significant prognostic factors, although not independent of stage, for patient survival. These findings suggest that serum concentrations of E-selectin, ICAM-1 and VCAM-1 may reflect tumour progression and metastasis. Since these markers are linked to CEA levels, it is uncertain whether their measurement will prove cost-effective in colorectal cancer management.     

NRP-1在乳腺癌患者血清中的表达及临床意义

目的:研究神经纤毛蛋白-1（neuropilin-1,NRP-1）在乳腺癌患者血清中的表达及意义。方法:选取50例乳腺癌患者,25例良性乳腺疾病患者作为研究对象。应用酶联免疫吸附试验检测血清NRP-1的表达水平,采用ROC曲线评价血清NRP-1对于乳腺癌的临床诊断价值,并以癌胚抗原（CEA）、糖类抗原-125（CA-125）、糖类抗原-153（CA-153）做为参照指标,以Youden指数作为临床诊断实验准确度评价指标,预测患者血清中NRP-1的诊断界值。分析血清NRP-1表达与乳腺癌病理学特征的关系,另将收到的乳腺癌组中25例患者的术后短期内的血清与该部分患者术前血清NRP-1比较术前及术后变化情况。结果:乳腺癌患者血清NRP-1水平高于乳腺良性疾病组（P=0.025）,血清NRP-1的表达与TNM分期、肿瘤大小及有无淋巴结转移具有明显相关性（P均<0.05）,而与患者的年龄、病理分子亚型及病理分级无明显相关性（P均>0.05）。术前与术后NRP-1变化无明显统计学意义（P>0.05）。结论:NRP-1有望成为早期乳腺癌的血清学诊断指标。     

血清CA153、CA125、CA199和CEA联合检测在乳腺癌诊断中的价值

目的探讨联合检测血清CA153、CA125、CA199和CEA的含量对乳腺癌的诊断价值。方法运用电化学发光免疫分析方法检测乳腺癌68例、乳腺良性疾病50例及体检健康女性58名血清中CA153、CA125、CA199、CEA的含量,分析各肿瘤标志物诊断的灵敏度、特异度、准确度及联合检测的临床意义。结果单独检测CA153、CA125、CA199、CEA对乳腺癌诊断的阳性率分别为76．4％（52／68）、44．1％（30／68）、35．3％（24／68）、29．4％（20／68）;联合检测4种肿瘤标志物的阳性率为94．1％（64／68）。结论血清CA153、CA125、CA199和CEA联合检测具有提高乳腺癌早期诊断的价值。     

Increased serum CA-15.3 levels in patients with megaloblastic anemia due to vitamin B12 deficiency

OBJECTIVES: To estimate the usefulness of serum tumor markers' monitoring, as predictors of gastric cancer in patients with pernicious anemia. PATIENTS AND METHODS: We investigated serum levels of carcinoembryonic antigen (CEA), alpha-fetal protein, cancer antigen (CA)-19.9, CA-125 and CA-15.3 in 50 patients with pernicious anemia and in 24 healthy controls, matched for age and sex. In 38 patients, the evaluation was repeated 1-6 months after the correction of cobalamin deficiency. RESULTS: All patients and controls had normal serum CEA and alpha-FP, and the levels of these markers as well as those of CA-125 and CA-19.9 did not differ between the two groups. All 50 patients, but only 2 controls exhibited increased serum CA-15.3, and the difference between the two groups was very significant (129.4 +/- 84.9 vs. 19.8 +/- 7.3 IU/ml, p < 0.001), while no difference between males and females was found. A thorough clinical examination of all patients, and mammographic study in 18 females did not reveal any finding suspicious of breast cancer. CA-15.3 levels were positively correlated with serum lactate dehydrogenase, and negatively with B(12) and hemoglobin, but they were substantially decreased after the correction of anemia, in all 38 patients tested, and in 33 of them they were restored to normal. After a median follow-up of 34 months, one patient developed a colon cancer, but none showed any sign suspicious of breast cancer. CONCLUSIONS: Serum CA-15.3 shows an aberrant increase in untreated patients with pernicious anemia, which is reversed after the correction of the anemia. The possible origin seems unrelated to mammary tissue, and may be released by the apoptosing bone marrow megaloblastic erythroblasts.     

Measurement of Serum N-Acetyl ß Glucosaminidase Activity in Patients with Breast Cancer

N-acetyl-β-glucosaminidase (NAG) activity measured in sera from 129 breast cancer patients was elevated (mean 18.2 units/l) compared with that in sera from 28 healthy women (11.6 units/l) (p=0.001). There was a weak correlation between NAG activity and carcinoembryonic antigen (CEA) and CA-153, but no relationship to age, menopausal status, node status, stage, histology of tumour or to steroid receptors. NAG, CEA and CA-153 were measured in periodic follow-up samples taken after surgery (up to 26 months) from 17 patients. NAG activity fluctuated within a narrow range, unlike CEA and CA-153. In 70% of cases the pattern was similar to at least one of the other markers, and was generally maintained at a higher level in patients who suffered relapse compared with those who remained disease-free up to the last follow-up, but was not significantly altered before relapse. The measurement of NAG activity is unlikely to be of value in predicting time or occurrence of relapse or of clinical utility in post-surgical therapy. Increased appearance in serum may aid metastasis by degrading the extracellular matrix and it may be better investigated as a predictor of progression from in situ to invasive and metastatic cancer.     

多肿瘤标记物蛋白芯片系统在乳腺癌诊断及术后复发监测中的应用价值

目的 研究多肿瘤标志物蛋白芯片检测系统在乳腺癌诊断及术后复发监测中的应用价值.方法 采用多肿瘤标记物蛋白质芯片检测系统检测乳腺癌患者共154例(其中术前70例,术后无复发者52例,术后复发者32例)以及76名健康对照血清中12种肿瘤标记物(CA199、NSE、CEA、CA242、Ferritin、β-HCG、AFP、f-PSA、PSA、CA125、CA153及HGH)的水平.结果 ①乳腺癌组与对照组相比,芯片阳性率差异有统计学意义(P<0.05),乳腺癌组CA199、CEA、CA242、Ferritin、CA125和CA153六项肿瘤标记物的检测阳性率和检测结果均显著高于对照组(P<0.05);②复发组与无复发组相比,芯片阳性率差异有统计学意义(P<0.05),复发组中CA199、CEA、Ferritin、CA125和CA153五项肿瘤标记物的检测阳性率和检测结果也均显著高于无复发组(P<0.05);③复发组芯片阳性率显著高于乳腺癌组(P<0.05),复发组中Ferritin检测阳性率和检测结果均高于乳腺癌组.结论 多肿瘤标记物蛋白芯片检测系统对乳腺癌的诊断和术后复发监测具有较高的临床应用价值.CA199、CEA、Ferritin、CA125和CA153联合检测可能是一种既经济又有效的乳腺癌诊断及术后复发监测标记物组合.     

原发性乳腺癌患者术前血清中糖类抗原153癌胚抗原和组织多肽特异性抗原水平与临床病理特征和预后的关系

目的 探讨原发性乳腺癌患者术前血清中糖类抗原153( CA153)、癌胚抗原(CEA)和组织多肽特异性抗原(TPS)水平与患者临床病理特征和预后的关系.方法 对386例Ⅰ～Ⅳ期原发性乳腺癌患者的临床资料进行严格随访,回顾性分析患者术前血清中CA153、CEA和TPS水平与乳腺癌临床病理特征和预后的关系.结果 分别有383、382和324例患者进行了术前CA153、CEA和TPS的检测,平均表达水平分别为(21.46±34.88)U/ml、(1.53±7.95)μg/L和(224.87±436.19) AU/ml,CA153、CEA和TPS的阳性表达率分别为10.7％ (41/383)、7.6％ (29/382)和63.9％ (207/324).原发性乳腺癌患者术前血清CA153的表达水平与患者的年龄和肿瘤大小显著相关(均P＜0.05),CEA的表达水平与肿瘤大小显著相关(P＜0.05),TPS的表达水平与肿瘤大小和淋巴结转移状况显著相关(均P＜0.05).术前血清CA153、CEA和TPS阳性表达患者的总生存率显著低于阴性患者(均P＜0.05).Cox多因素分析表明,ER的表达水平以及术前CA153的表达水平是影响乳腺癌患者预后的独立因素(均P＜0.05),其中术前CA153水平增高是危险因素,而ER阳性表达则是保护因素.结论 术前血清CA153、CEA和TPS的表达水平与乳腺癌患者的临床病理特征和预后有关,CA153是影响乳腺癌患者预后的独立因素,CA153表达水平增高者的预后较差.     

结直肠癌患者血清可溶性E-选择素和细胞内黏附分子-1浓度的临床意义

目的:探讨结直肠癌患者可溶性E选择素(sEselectin)和细胞内黏附分子1(ICAM1)的血清浓度与结直肠癌转移的关系。方法:采用酶联免疫吸附实验方法(ELISA法)测定了64例结直肠癌患者可溶性E选择素和细胞内黏附分子1的血清浓度。同时测定癌胚抗原(CEA)的血清浓度。结果:可溶性E选择素的浓度和可溶性sICAM1的血清浓度显著增高,P=0001和P=0032,伴有远处转移者增高显著,P=0004和P=0015。可溶性E选择素的浓度和可溶性sICAM1的血清浓度与血清癌胚抗原的水平有相关性,P=0025和P=0038。结论:可溶性E选择素的浓度和sICAM1的血清浓度的升高可能与结直肠癌的发展和广泛转移有关。