CA19—9有胃肠肿瘤组织中的测定及其意义

采用固相放射免疫分析法在２４例胃癌和１２例结址肠癌患者的肿瘤组织抽提液中测定糖链抗原ＣＡ１９－９含量。结果显示癌组织中ＣＡ１９－９的平均水平显著高于正常组织（Ｐ〈０．０１）；３６例肿瘤患者有３１例（８６％）癌组织中的ＣＡ１９－９含量明显高于对应的正常组织；瘤体较大的癌组织中ＣＡ１９－９水平与瘤体小的相比差别具有统计学意义（Ｐ〈０．０１）；ＣＡ１９－９水平与淋巴结转移状况和组织学类型无相关性，提示胃     

CA19-9在胃肠肿瘤组织中的测定及其意义

采用固相放射免疫分析法在２４例胃癌和１２例结直肠癌患者的肿瘤组织抽提液中测定糖链抗原ＣＡ１９－９含量。结果显示癌组织中ＣＡ１９－９的平均水平显著高于正常组织（Ｐ＜０．０１）；３６例肿瘤患者有３１例（８６％）癌组织中的ＣＡ１９－９含量明显高于对应的正常组织；瘤体较大的癌组织中ＣＡ１９－９水平与瘤体小的相比差别具有统计学意义（Ｐ＜０．０１）；ＣＡ１９－９水平与淋巴结转移状况和组织学类型无相关性，提示胃肠肿瘤细胞合成ＣＡ１９－９增加，该指标对判断胃肠恶性组织可能具有一定的价值。     

联合检测血清CA72-4、CA19-9和CEA对胃癌临床价值的探讨

目的：探讨血清ＣＡ７２－４、ＣＡ１９－９、ＣＥＡ联合检测对胃癌的临床价值。方法：对３２例中晚期胃癌患者和２１例良性胃病患者采用放射免疫法（ＲＩＡ）分析测定ＣＡ７２－４、ＣＡ１９－９和ＣＥＡ,结果：胃癌组中ＣＡ７２－４、ＣＡ１９－９、ＣＥＡ血清测定值水平,阳性率均明显高于良性胃病组（Ｐ〈０．０１）。其中胃癌组的ＣＡ７２－４阳性率（５９．４％）明显高于ＣＡ１９－９和ＣＥＡ（２８．１％）。联合检测时胃癌     

大肠癌患者术前测定血清CEA,CA50和CA242的临床意义

目的；了解大肠癌患者血清ＣＥＡ，ＣＡ５０和ＣＡ２４２的临床意义，方法：采用放射免疫分析测定了１０６例大肠癌患者术前血清中ＣＥＡ，ＣＡ５０和ＣＡ２４２。结果：ＣＥＡ，ＣＡ５０和ＣＡ２４２的阳性表达与患者性别，年龄，肿瘤部位及大小无明显关系（Ｐ〉０．０５）；肿瘤发生淋巴结转移时血清ＣＥＡ明显升高，ＣＡ５０仅在晚期肿瘤出现升高（Ｐ〈０．０５），有淋巴结转移或肿瘤细胞分化较差的（低分化，未分化）血清ＣＡ２     

血清CA19—9测定对肺癌的诊断价值

检测５１例肺癌血清ＣＡ１９－９。结果表明，肺癌组与正常组、肺良性疾病组比较，其检测值有非常显著差异（Ｐ〈０．０１），肺良性疾病组与正常组比较亦差异显著（Ｐ〈０．０５）。血清ＣＡ１９－９检测肺癌的敏感性为５０．９％，特异性为９０．９％，准确性为６９．５％。上述结果说明血清ＣＡ１９－９测定对提高肺癌的阳性检出率有重要的临床价值。     

血清CA125,CA242监测恶性肿瘤病情进展的临床研究

我们对７７例恶性肿瘤病人进行了ＣＡ１２５、ＣＡ２４２测定，测定结果显示，胃癌ＣＡ２４２测定无转移组与转移组比较有显著意义（Ｐ＜０．０５），结肠癌、乳房癌、胃癌病例中ＣＡ１２５、ＣＡ２４２值转移组的均值明显高于无转移组，化疗后ＣＡ１２５均值明显低于化疗前。     

CA_（19－9）和CA_（50）对消化道肿瘤的诊断价值

本文作者分别检测了１０６例消化道良性疾病患者及７８例癌肿患者血清ＣＡ１９－９和ＣＡ５０的含量，分析了肝脏、胰腺、胃及结直肠４组良，恶性疾病患者血清含量的变化及其临床意义。结果１０６例良性疾病ＣＡ１９－９和ＣＡ５０的上限值分别为３４ｕ／ｍｌ和１４ｕ／ｍｌ（ｘ±２Ｓ），其诊断的敏感性和特异性如下：ＣＡ１９－９对原发性肝癌分别为７５．０％和８６．９％，对胰腺癌分别为９１．７％和１００％，对胃癌分别为５５．６％和１００％；ＣＡ５０对原发性肝癌分别为５５．０％和７８．３％，对胰腺癌分别为９１．７％和１００％，对胃癌分别为５５．６％和１００％。ＣＡ１９－９与ＣＡ５０有高中度相关性，肝癌ｒ＝０．６２、胰腺癌ｒ＝０．６７、胃癌ｒ＝０；９０，Ｐ值均＜０．０１。因此认为ＣＡ１９－９和ＣＡ５０对消化道良、恶性疾病的诊断、鉴别有较高的临床价值，并对消化道癌肿有否转移及胃癌根治术是否彻底、术后有否复发的判断均具有一定临床意义。     

血AFP,CEA,CA—50,CA—199联合检测对原发性肝癌的诊断价值

目的 探讨肿瘤标志物ＡＦＰ、ＣＥＡ、ＣＡ－５０、ＣＡ－１９９联合检测对原发性肝癌的诊断价值。方法 选择原发性肝癌３２例，行血清ＡＦＰＲＩＡ、ＣＥＡＲＩＡ、ＣＡ－５００ＩＲＭＡ、ＣＡ－１９９ＩＲＭＡ检测。结果 原发性肝癌３２例血ＡＦＰ、ＣＥＡ、ＣＡ－５０、ＣＡ－１９９四项联合检测阳性符合率１００％，而各单项检测ＡＦＰ为６８．８％（Ｐ〈０．０１），ＣＥＡ１５．６％（Ｐ〈０．００１），ＣＡ－５０７８．１     

测定胃癌术后患者血清CEA,CA50及Cu／Zn比值的临床意义

作者测定了３０例胃癌术后无瘤患者及３４例胃癌术后复发或转移患者血清中的ＣＥＡ、ＣＡ_（５０）及Ｃｕ／Ｚｎ比值，并对２０例术后无癌残留患者进行随访观察。结果：术后复发转移组的ＣＥＡＣＡ_（５０）及Ｃｕ／Ｚｎ比值均显著高于术后无瘤组（Ｐ＜０．０１）；术后复发转移组中ＣＡ_（５０）、ＣＥＡ及ＣＵ／Ｚｎ比值阳性率分别为５８．８％、４７．０％、４７．０％；术后随访组中，三种指标对胃癌术后转移总的阳性预测率为７５．０％（６／８）。揭示ＣＡ_（５０）、ＣＥＡ及Ｃｕ／Ｚｎ比值可用于胃癌术后患者复发及转移的监测。三者比较，ＣＡ_（５０）敏感性最高，而ＣＥＡ特异性最好。联合检测可提高阳性率。     

血清CA_19－9测定对肺癌的诊断价值

检测５１例肺癌血清ＣＡ１９－９结果表明，肺癌组与正常组、肺良性疾病组比较，其检测值有非常显著差异（Ｐ＜０．０１），肺良性疾病组与正常组比较亦差异显著（Ｐ＜０．０５）。血清ＣＡ１９－９检测肺癌的敏感性为５０．９％，特异性为９０．９％，准确性为６９．５％。上述结果说明血清ＣＡ１９－９测定对提高肺癌的阳性检出率有重要的临床价值。     

Evaluation of serum CEA and CA19-9 levels as prognostic factors in patients with gastric cancer

Background. This clinicopathological study evaluated the utility of serum carcinoembryonic antigen (CEA) and carbohydrate antigen (CA) 19-9 as predictors of locoregional recurrence and long-term disease-free survival in patients with gastric cancer. Methods. During the period January 1989 to December 1994, 485 patients with primary gastric cancer were evaluated. Gastrectomies were performed in 434 patients. Prognostic factors were analyzed by the Kaplan-Meier method and multivariate analysis, using Cox regression. Results. Elevated serum CEA and CA19-9 levels were observed in 92 of the 485 patients (19.0%), and in 95 of the 435 patients (21.8%), respectively, and both markers were elevated in 29 of these 435 patients (6.7%). Elevated serum CEA and CA19-9 levels correlated well with lymph node metastasis, lymphatic invasion, vessel invasion, stage grouping, depth of invasion, and curability. Patients with elevated serum CEA levels were at significantly higher risk of having all recurrence factors than were those with normal serum CEA levels. Patients with elevated serum CA19-9 levels were at significantly higher risk of having peritoneal metastases and distant metastases than were those with normal serum CA19-9 levels. A significant difference in the cumulative survival curves of patients was demonstrated between those with elevated and those with normal serum CEA or CA19-9 levels, even for patients at the same disease stage (stage III). Patients with elevated levels of both markers had a significantly worse prognosis than patients in whom the levels of both markers were normal. In patients who underwent gastrectomy, elevated serum CEA levels either preoperatively or within 3 weeks after gastrectomy were associated with significantly worse prognosis than were normal levels. When the cutoff level of serum CEA was increased to 10 ng/ml, serum CEA, age, lymph node metastasis, and surgical stage grouping were selected as independent prognostic factors by multivariate analysis of 14 prognostic factors, using Cox regression. Conclusion. Serum CEA and CA19-9 levels provide additional prognostic information in patients with primary gastric cancer. In particular, an elevated serum CEA level provides additional prognostic information and is a useful indicator of curability in patients who undergo gastrectomy. Serum CEA level is an independent prognostic factor in patients with primary gastric cancer. Received: June 20, 2000 / Accepted: November 14, 2000     

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。     

The prognostic significance of preoperative serum CA 19-9 in patients with resectable gastric carcinoma: comparison with CEA

BACKGROUND AND OBJECTIVES: In this study, the prognostic value of pre-operative serum levels of tumor markers CA 19-9 and carcinoembryonic antigen (CEA) in gastric carcinoma which has been a controversial matter was investigated. METHODS: Preoperative serum CA 19-9 (cut-off value 37 U/ml) and CEA (cut-off value 5 ng/ml) levels were measured in 168 patients with resectable gastric carcinoma. The correlation between tumor marker levels and clinicopathological features and overall survival was studied. RESULTS: CA 19-9 and CEA positivity rates were 31.5 and 17.8% respectively. In CA 19-9 positive patients, the ratio of males, tumors exceeding subserosa and advanced stage tumors (stages III and IV) was significantly higher (P = 0.052, P = 0.0005 and P= 0.029, respectively). A weak correlation was found with CA 19-9 positivity and tumor location; however, no correlation existed between CA 19-9 positivity and age, tumor size, histologic type, lymph node, hepatic and peritoneal metastasis. The proportion of tumors extending beyond subserosa and with lymph node metastasis was significantly higher in CEA positive patients (P = 0.011 and P = 0.045, respectively). No correlation was found between CEA positivity and gender, age, tumor location, tumor size, and hepatic and peritoneal metastasis; however, a weak correlation existed between CEA positivity and histologic type and tumor stage. Overall survival was significantly poorer in CA 19-9 and CEA positive patients (log-rank test, P = 0.014, P = 0.003, respectively). However, the Cox proportional hazards regression analysis did not show independent prognostic value for both tumor markers. CONCLUSIONS: In resectable gastric carcinoma, preoperative serum CA 19-9 and CEA levels may indicate stage of the disease, but neither has an independent prognostic value.     

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。     

大肠癌患者血清肿瘤标志物含量测定与临床研究

目的评价血清肿瘤标志物(CEA、CA199和CA242)单项或多项联合检测对大肠癌患者的临床诊断价值,探讨其在病理分期、淋巴结转移、侵袭程度及肿瘤大体形态等临床特征方面的意义。方法应用酶联免疫法检测134例大肠癌患者和200名健康人血清中CEA、CA199和CA242含量。结果大肠癌患者血清3种肿瘤标志物含量明显高于健康人(均P<0.01);单项检测中,CEA和CA242的阳性率无差异,但均显著高于CA199;CEA+CA242联合检测和CEA+CA242+CA199联合检测的阳性率显著高于单项和CEA+CA199的联合及CA199+CA242的联合,但特异性低于单项检测。在dukesA、B、C及D期中,3项肿瘤标志物含量及检测的阳性率依次增高,总体水平差异均有统计学意义(P<0.05～0.01);淋巴结转移患者的3项标志物含量及CA199、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。结论CEA、CA199及CA242肿瘤标志物联合检测可以提高大肠癌诊断的敏感度,并对临床分期、判断淋巴结转移、肿瘤侵袭程度、进而进行有效临床治疗,具有一定的指导意义。     

胃肠道恶性肿瘤患者血清AFP、CEA和CA19-9的表达特征探讨

目的:探讨血清肿瘤标志物AFP、CEA和CA19-9在胃肠道恶性肿瘤患者中的表达特征。方法:用罗氏全自动电化学发光分析仪测定126例胃肠道恶性肿瘤患者血清AFP、CEA和CA19-9的表达水平,并分析该3项指标与临床病理因素的关系。结果:血清CEA随着肿瘤浸润深度、临床分期增加以及远处转移而表达水平上升,差异有统计学意义(P0.05);血清CA19-9随着临床分期及远处转移表达水平上升,差异有统计学意义(P0.05)。血清AFP表达水平在不同临床病理因素间无统计学差异(P0.05)。结论:胃肠道恶性肿瘤患者血清CEA、CA19-9的表达水平与胃肠道恶性肿瘤患者的病情密切相关。     

Evaluation of CA72-4 as a tumor marker in patients with gastric cancer

The clinical efficacy of CA72-4 for gastric cancer was studied in comparison with CEA and CA19-9. These 3 markers were examined simultaneously, preoperatively in 156 cases of gastric cancer. The positive rate of CA72-4 was higher than of CA19-9 and was equivalent to CEA. There was no significant difference between differentiated and undifferentiated carcinoma in these 3 markers. However, the positive rates of CEA and CA72-4 were significant higher in the cases with lymph node metastasis and curative grade B, C. The combination assay of CEA and CA72-4 was valuable because the tumor markers were considered to be independent of each other. Cases positive for both CEA and CA72-4 simultaneous were significantly more frequent among the cases with lymph node metastasis and in the serosa-invasive cases. In conclusion, CA72-4 is more important than CA19-9 as a tumor marker in gastric cancer patients.     

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.     

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.     

外周血中CEA和CA19-9的表达水平在进展期胃癌中的预后价值

目的 探讨外周血中CEA和CA19-9的表达水平在进展期胃癌中的预后价值及进展期胃癌患者预后的影响因素。方法 选取2010年1月—2010年12月于哈尔滨医科大学附属肿瘤医院胃肠外科行R0根治术的进展期胃癌患者255例,根据CEA和CA19-9的表达水平分为A组(CEA＜2.19ng/mL且CA19-9＜10.78U/mL)、B组(CEA≥2.19ng/mL或CA19-9≥10.78U/mL)和C组(CEA≥2.19ng/mL且CA19-9≥10.78U/mL),比较三组进展期胃癌患者的临床病理资料和生存情况,并分析进展期胃癌患者预后的影响因素。结果 三组进展期胃癌患者间临床N分期、临床TNM分期和病理TNM分期的差异均具有统计学意义(P＜0.05),三组进展期胃癌患者术后中位生存时间差异无统计学意义(P＞0.05);术后1年、3年、5年生存率差异无统计学意义(P＞0.05),但A组1年、3年、5年生存率高于B组和C组。影响胃癌预后的因素包括肿瘤分化程度、病理T分期、病理TNM分期、清扫淋巴结总数、清扫淋巴结阳性数、淋巴结转移情况。结论 CEA和CA19-9联合检测对进展期胃癌患者评估预后有一定的参考价值。