结直肠癌患者血清CEA、CA19-9的检测价值

目的 探讨癌胚抗原（ＣＥＡ）、糖链抗原（ＣＡ１９－９）在结直肠癌的诊断、观察预后、监测复发转移中的应用价值。方法 ＣＥＡ采用ＥＬＩＳＡ法、ＣＡ１９－９采用放免法,对１９例结肠癌、２６例直肠癌、３０例正常人进行了分析,并在术后定期检查。ＣＥＡ、ＣＡ１９－９水平下降,可恢复至正常：术后复发ＣＥＡ、ＣＡ１９－９重又异常升高,伴广泛转移者升高更加显著,并且ＣＥＲＡ、ＣＡ１９－９的升高出现在临床症状和Ｘ线异     

Contents of tissue CEA and CA19-9 in colonic polyp and colorectal cancer,and their clinical significance

In precancerous states or early cancer, the serum levels of tumor markers are almost not detectable. Therefore, the tissue contents of CEA and CA19-9 were measured in 48 colonic polyps, 8 colorectal cancers and 5 normal colonie mucosa. These tissue specimens were obtained by endoscopie polypectomy, surgery or autopsy, and homogenated in normal saline (10 ml/wet g of tissue). After centrifugation, the supernatant was assayed by enzyme or radioimmunoassay. There was no correlation between serum levels and tissue contents of CEA or CA19-9 in colonie adenomas and colorectal cancers. The mean contents of tissue CEA and CA19-9 in colonie polyp and colorectal cancer were significantly higher than normal colonie mucosa, and the highest contents of CEA and CA19-9 were found in colorectal cancer. The contents of tissue CEA and CA19-9 in cancerous regions were markedly increased as compared with noncancerous regions. In adenomas, there was a relationship between the degree of histological dysplasia and the tissue content of CEA. Relationships were also found between macroscopic findings and tissue tumor markers in adenomas. These results suggest the possibility that the measurement of tissue tumor markers may be useful for borderline colonie lesions.     

胃液CEA、CA19-9联检在胃癌预后判断与复发筛查中的价值

目的探讨胃液中癌胚抗原(CEA)、糖链多肽抗原19-9(CA19-9)在胃癌预后判断和复发筛查中的价值. 方法应用免疫放射法检测了62例胃癌患者(术后复发组32例,未复发组30例)手术前后胃液中CEA、CA19-9变化,并进行随访观察.结果复发组CEA为(65.81±43.62)ng/ml,CA19-9为(172.53±159.38)U/ml.两组比较,有非常显著差异(P＜0.01).CEA、CA19-9联检可将敏感性提高至81.25%,并可在胃癌术后亚临床期检出复发.结论胃液CEA、CA19-9联检对胃癌疗效观察、预后判断和复发筛查具有重要意义.     

血清CEA、CA125、CA19-9联合检测对胃癌诊断的临床意义

目的探讨联合检测胃癌患者血清CEA、CA125、CA19-9水平在胃癌诊断中的意义。方法应用免疫荧光法检测160例胃癌血清CEA、CA125、CA19-9水平并进行分析。结果CEA、CA125、CA19-9阳性率分别为24.4%、37.5%、23.1%,三者联合检测阳性率为64.4%;CEA阳性率与性别、肿瘤浸润深度以及是否转移无明显相关,CA19-9阳性率与性别、肿瘤浸润深度无关,CA125女性高于男性,且与肿瘤浸润深度和是否转移密切相关。三者均与肿瘤部位和组织学类型相关。结论CEA、CA125、CA19-9三者联合检测可以提高胃癌的检出率。     

胆汁端粒酶活性联合血清CEA、CA19-9检测在胆道恶性梗阻诊断中的价值

目的 探讨胆汁端粒酶活性联合血清CEA、CA19-9检测对胆道恶性梗阻的诊断价值.方法 应用TRAP-ELISA法检测66例胆道恶性梗阻患者(恶性组)和28例胆管结石引起胆道梗阻患者(良性组)胆汁脱落细胞端粒酶活性,并检测血清CEA、CA19-9水平.结果 恶性组端粒酶活性、CEA、CA19-9阳性率均高于良性组(P均<0.05),端粒酶阳性率与病灶转移无相关性;胆汁端粒酶活性联合血清CEA、CA19-9检测的敏感性、特异性均高于单独检测,但无统计学意义.结论 胆汁端粒酶活性联合血清CEA、CA19-9检测可提高恶性胆道疾病的诊断率.     

胆汁CEA、CA19-9联合检测对肝外胆管癌及壶腹癌的诊断价值

目的探讨胆汁CEA、CA19—9联合检测对肝外胆管癌及壶腹癌诊断价值。方法观察组38例肝外胆管癌及壶腹癌患者在行ERCP检查前检测血清CEA及CA19—9,行ERCP检查时经造影导管抽取胆汁5ml用放免方法检测CEA及CA19—9,同时在导丝引导下自胆管咬取活检行病理检查,并记录影像学特征;同样,对照组30例非恶性病变患者在行ERCP检查时抽取5ml胆汁检测CEA及CA19—9。结果观察两组患者胆汁CA19—9、CEA水平明显高于对照组,有统计学意义（P〈0．05）,与病理结果-致;观察组患者胆汁及血清CA19—9水平比较,有统计学差异（P〈0．05）,而CEA水平无明显差异（P〉0．05）。结论胆汁CEA、CA19—9联合检测对肝外胆管癌及壶腹癌的定性诊断有重要临床价值。     

Immunohistochemical study of colorectal adenocarcinomas and adenomas with antibodies against carcinoembryonic antigen (CEA), CA19-9, keratin, α-tubulin and secretory component (SC)

The immunohistochemical localization of five antibodies against carcinoembryonic antigen (CEA), CA19-9, keratin, α-tubulin and secretory component (SC) was investigated in 14 lesions of adenocarcinoma (AC), 22 of adenoma with high-grade atypia (AH), 50 of adenoma with low-grade atypia (AL), and 15 of non-neoplastic mucosa (NNM) of the large intestine. The positive patterns for each staining were divided into three categories (patterns 1,2, and 3). All neoplastic lesions (AC, AH and AL) were positive for CEA, while 85.7% of AC, 36.4% of AH and 6.0% of AL showed strongly positive staining (pattern 3). 78.6% of AC and 54.5% of AH were positive for CA19-9 in comparison to 20.0% of AL. For keratin, more than 95% ofthe neoplastic lesions were positive, while 78.6% of AC, 27.3% of AHand 22.0% of AL showed strongly positive staining (pattern 3). For a-tubulin, more than 85% of neoplstic lesions were positive, while 50.0% of AC, 36.3% of AH and 26.0% of AL showed strongly positive staining (pattern 3). For SC, in contrast, 42.9% of AC, 27.3% of AH and 8.0% of AL were negative, but 93.3% of NNM were positive. It was concluded that the positive staining rate, especially the rate of pattern 3 for each antibody correlated with the degree of atypia of the colorectal neoplastic lesions (AC, AH and AL).     

胸腔积液CA15-3、CA19-9和CEA对恶性胸腔积液的诊断价值

目的探讨胸腔积液中CA15-3、CA19-9和CEA在良性和恶性胸腔积液的水平及鉴别诊断价值。方法胸腔积液用化学发光法检测胸腔积液中的含量。结果恶性胸腔积液组的CA15-3、CA19-9、CEA的含量显著高于良性胸腔积液组。联合检测能提高诊断恶性胸腔积液的敏感度和准确度。结论胸腔积液CA15-3、CA19-9和CEA的联合检测对鉴别良恶性胸腔积液有重要价值。     

ADA、CRP、CEA和CA19-9对老年结核性、癌性胸腔积液的诊断价值分析

目的分析对于老年结核性、癌性胸腔积液的鉴别诊断,联合应用腺苷脱氨酶(ADA)、C-反应蛋白(CRP)、癌胚抗原(CEA)、糖类抗原19-9(CA19-9)四个指标的临床价值。方法分别选取我院治疗的肺结核和肺癌老年患者各40例,测定患者胸腔积液中ADA、CRP、CEA和CA19-9水平,比较分析四项单独应用以及联合应用对老年结核性和癌性胸腔积液鉴别的敏感度以及特异性等,从而分析其鉴别诊断的价值高低。结果癌性组CEA水平为(67.3±8.7)μg/ml,CA125为(63.6±15.9)μg/ml,而ADA及CRP水平明显低于结核组,差异显著,具有统计学意义。CEA、CA19-9对癌性胸腔积液诊断敏感性、特异性、准确性较高,ADA、CRP对结核性胸腔积液的敏感性、特异性、准确性较高。结论 ADA、CRP、CEA和CA19-9的检测水平在老年结核性、癌性胸腔积液的判别和诊断中有重要作用,可信度高,值得在临床推广。     

Immunohistochemical Study of Colorectal Polyps with Antibodies against CEA,CA19-9, CA125, CA15-3 (DF3), PCNA and p53

Abstract: We analyzed the expression of CEA, CA19-9, CA125, CA15-3 (DF3), PCNA and p53 immunohistochemically in 14 tissue specimens of mucosal cancers in adenoma, seven tubulovillous adenoma specimens, and 16 tubular adenoma specimens. The rates of positive staining for mucosal cancer in adenoma, tubulovillous adenoma and tubular adenoma specimens, respectively, were: for CEA: 100%, 85.7% and 75%; for CA19-9: 71.4%, 71.4% and 56.2%; for CA125:0%, 0% and 0%;for CA15-3 (DF3): 64.3 %, 0% and 0 %; for PCNA: 100%, 88.9% and 56.2%; and for p53: 35.7%, 0% and 0% . The results suggest that the expressions of CEA, CA19-9, CA15-3 (DF3), PCNA and p53 are related to colorectal tumorigenesis. None of the specimens studied showed staining for CA125, suggesting that CA125 is not involved in the early stages of colorectal carcinogenesis. There was no significant difference in the rates of positive staining for CEA and CA19-9 among mucosal cancer in adenoma, tubular adenoma and tubulovillous adenoma specimens. However, the rates of positive staining for PCNA and p53 were significantly higher in mucosal cancer in adenoma specimens than for tubular adenoma specimens (p<0.05), and the rate of CA15-3 (DF3) positive staining was significantly higher for mucosal cancer in adenoma than for tubulovillous adenoma (p<0.01) and tubular adenoma (p< 0.001) specimens. Therefore, the CA15-3 (DF3) antigen is an immunohistochemical marker for colorectal carcinomas. The present results suggest that CA15-3 (DF3), PCNA and p53 play important roles in the genesis of colorectal adenomas.     

术前血清CEA、CA19-9、CA50联合检测在结直肠癌肝转移预测中的应用

目的研究术前血清CEA、CA19-9、CA50联合检测在结直肠癌肝转移预测中的应用价值。 方法选择2015年1月至2017年1月在中国医学科学院肿瘤医院接受手术治疗的结直肠癌患者316例为研究对象,其中结直肠癌伴有肝转移的患者158例作为实验组,并按照性别、年龄等匹配结直肠癌不伴有肝转移的患者158例作为对照组。对所有患者的术前血清癌胚抗原（CEA）、糖类抗原19-9（CA19-9）以及糖类抗原50（CA50）进行检测,采用单因素及多因素分析以上肿瘤标志物单独或联合检测在结直肠癌肝转移中的预测价值。 结果单因素及多因素分析结果表明,术前血清CEA、CA19-9、CA50升高与结直肠癌发生肝转移显著相关（P<0.05）,CEA、CA19-9、CA50单独预测结直肠癌肝转移的敏感度分别为62.7%、57.4%、67.1%;特异度分别为58.2%、53.5%、56.6%。CEA、CA19-9、CA50联合诊断预测直肠癌肝转移的敏感度和特异度分别为74.3%、76.3%。 结论术前血清CEA、CA19-9、CA50升高是结直肠癌肝转移的独立预测因素,但三者单独预测结直肠癌肝转移的敏感度和特异度均较低。三者联合检测对于预测结直肠癌肝转移的敏感度和特异度均较高,可以作为结直肠癌肝转移的预测模型。     

联合检测CEA、CA19-9和CA125对鉴别良恶性腹水的价值

目的探讨检测CEA(癌胚抗原)、CA19-9(糖类抗原19-9)和CA125(糖类抗原125)对鉴别良、恶性腹水的临床价值。方法化学发光法检测120例患者腹水CEA、CA19-9和CA125的含量。结果化学发光法检测恶性腹水中的CEA、CA19-9和CA125分别为(37±16)ng/ml、(236±78)U/ml和(602±211)U/ml,良性腹水分别为(13±2)ng/ml、(34±3)U/ml和(32±3)U/ml,差异均有统计学意义(P<0.05)。同时,3种抗原检测的敏感性和特异性各有特点,需要联合检测。结论联合检测良、恶性腹水中CEA、CA19-9和CA125水平对鉴别诊断有一定临床意义。     

CEA及CA19-9在良、恶性胸腔积液鉴别诊断中的价值

目的:探讨CEA及CA19-9对良、恶性胸腔积液的鉴别诊断价值。方法:回顾分析100例各类胸腔积液患者的临床资料及胸腔积液CEA、CA19-9水平,根据病因将胸腔积液患者分为良性组和恶性组,再根据恶性胸腔积液患者CEA与CA19-9的分泌特性将其进一步分成"分泌型"与"非分泌型",比较良、恶性胸腔积液CEA及CA19-9水平、作ROC曲线并进一步分析CEA与CA19-9对良、恶性胸腔积液的鉴别诊断价值。结果:恶性胸腔积液中CEA及CA19-9水平均显著高于良性组(均P0.01),剔除"非分泌型"恶性胸腔积液病例后,CEA、CA19-9鉴别诊断良、恶性胸腔积液ROC曲线下面积分别为0.930和0.818,最佳诊断切点CEA为4.35μg/L,CA199为20.60U/ml。CEA、CA19-9及CEA联用CA19-9对良、恶性胸腔积液的诊断效率分别为89.36%、92.98%和94.68%。结论:胸水中CEA及CA19-9检测适用于良性与"分泌型"恶性胸腔积液的鉴别诊断,二者联合检测可明显提高诊断的敏感性和特异性。     

胆总管结石对血清CA19-9的影响

目的:探讨胆总管结石对血清CEA、CA19-9的影响.方法:回顾经ERCP或手术证实、治疗的胆总管结石患者68例,分析血清CEA,特别是血清CA19-9与胆总管结石患者总胆红素、直接胆红素的相关性:并对20例血清CA19-9值超过正常上限两倍以上的患者统一时间进行随访,分析治疗前后血清CA19-9变化值与总胆红素、直接胆红素变化值的相关性.结果:血清CA19-9与总胆红素、直接胆红素存在明显相关性(r=0.813,0.786,均P=0.000);血清CEA与总胆红素、直接胆红素不存在相关性;治疗前后血清CA19-9变化值与总胆红素、直接胆红素变化值存在明显相关性(r=0.787,0.806,均P=0.000).结论:胆总管结石合并阻塞性黄疸时,可导致血清CA19-9升高,此时血清CA19-9作为肿瘤标志物的特异性差.     

Postoperative serum CA19-9, CEA and CA125 predicts the response to adjuvant chemoradiotherapy following radical resection in pancreatic adenocarcinoma

Objective

To evaluate the prediction of benefits from adjuvant chemoradiotherapy by postoperative serum CA19-9, CA125 and CEA.

Value of serum levels of carcinoembryonic antigen,CEA, and gastrointestinal cancer antigen,GICA or CA 19-9, for preoperative staging and postoperative monitoring of patients with colorectal carcinoma

Serum levels of gastrointestinal cancer antigen (GICA) and carcinoembryonic antigen (CEA) were determined in 167 patients with colorectal carcinoma. Eighty-eight patients were studied preoperatively, and 79 postoperatively, before, at the time of, and after the diagnosis of relapse. The authors aimed to assess how often the GICA test failed,i.e., was false-negative in patients in whom the CEA test was true-positive and, more importantly, whether it could give diagnostic information in patients in whom the CEA test failed. Before surgery, serum GICA gave similar information to serum CEA in 56 percent of the patients: true-positive in 18 percent and false-negative in 38 percent; less information in 42 percent; and more information in only 2 percent. During the postoperative follow-up, serum GICA gave similar information to serum CEA in 55 percent of the patients: true-positive (i.e., rising persistently from a postoperative nadir) in 27 percent and falsenegative in 28 percent; less information in 44 percent; and more information in only 1 percent. Therefore, this test in its present version, where both the catcher and the tracer antibody are the same, NS 19-9, is redundant. Supported by grants from the Polish National Cancer Program (grants PR-6/0209 and PR-6/0301); by the National Cancer Institute, NIH, DHHS, under the United States-Poland Cancer Program; and by the United Nations Development Program (grant POL-82/003).     

CA19-9 level determines therapeutic modality in pancreatic cancer patients with para-aortic lymph node metastasis

Background: In general, para-aortic lymph node(LN16) metastasis has been considered as a contraindication for pancreatic resection. However, some pancreatic cancer patients with LN16 metastasis have been reported to survive for longer than expected after pancreatectomy. The purpose of this study was to determine whether pancreatic cancer patients with LN16 metastasis might benefit from surgery.Methods: We retrospectively reviewed 201 consecutive patients with invasive pancreatic ductal adenocarcinoma who underwent surgery at Osaka National Hospital between April 2003 and December 2012.These patients included 22 patients with LN16 metastasis who underwent an extended lymphadenectomy and 25 patients who underwent a palliative surgical biliary and gastric bypass. The clinicopathological data and outcomes were evaluated using univariate and multivariate analyses.Results: The overall survival of the patients with LN16 metastasis was poorer than that of the LN16-negative patients(P = 0.0014). An overall survival analysis of the LN16-positive patients stratified according to the preoperative CA19-9 level showed a significant difference between patients with a low preoperative CA19-9 level(≤360 U/mL) and those with a high preoperative CA19-9 level(360 U/mL)(P = 0.0301). No significant difference in overall survival of patients was observed between those with LN16 positivity and those who underwent bypass surgery. However, the overall survival of the LN16-positive patients with a CA19-9 level ≤360 U/mL(n = 11) was significantly higher than that of those who underwent bypass surgery(P = 0.0452).Conclusion: Surgical resection and extended lymphadenectomy remains an option for pancreatic cancer patients with LN16-positivity whose CA19-9 level is ≤360 U/mL.     

An elevated CA 19-9 is associated with invasive cancer and worse survival in IPMN

BackgroundCurrent guidelines for IPMN include an elevated serum carbohydrate antigen (CA) 19-9 among the worrisome features. However, the correlation of CA 19-9 with histological malignant features and survival is unclear. Serum CEA is also currently used for preoperative management of IPMN, although its measurement is not evidence-based. Accordingly, we aimed to assess the role of these tumor markers as predictors of malignancy in IPMN.MethodsIPMN resected between 1998 and 2018 at Massachusetts General Hospital were analyzed. Clinical, pathological and survival data were collected and compared to preoperative levels of CA 19-9 and CEA. Receiver operating characteristic (ROC) and Cox regression analyses were performed considering cut-offs of 37 U/ml (CA 19-9) and 5 μg/l (CEA).ResultsAnalysis of 594 patients showed that preoperative CA 19-9 levels > 37 U/ml (n = 128) were associated with an increased likelihood of invasive carcinoma when compared to normal levels (45.3% vs. 18.0%, P < 0.001), while there was no difference with respect to high-grade dysplasia (32.9% vs 31.9%, P = 0.88). The proportion of concurrent pancreatic cancer was higher in patients with CA 19-9 > 37 U/ml (17.2% vs 4.9%, P < 0.001). An elevated CA 19-9 was also associated with worse overall and disease-free survival (HR = 1.943, P = 0.007 and HR = 2.484, P < 0.001 respectively). CEA levels did not correlate with malignancy.ConclusionIn patients with IPMN, serum CA19-9 > 37 U/ml is associated with invasive IPMN and concurrent pancreatic cancer as well as worse survival, but not with high-grade dysplasia. Serum CEA appears to have minimal utility in the management of these patients.     

The prognostic value of preoperative serum levels of CEA, CAl9-9 and CA72-4 in patients with colorectal cancer

INTRODUCTIONCarcinoembryonic antigen ( CEA) , originally described by Gold and Freedman [1] in 1965, is now an acknowledged member of immunoglobulin superfamily[2],with a role as an intracellular adhesion molecule[3].Carbohydrate antigen 19-9(CA19-9), obtained with a monoclonal antibody produced by immunizing a monoclonal antibody produced by immunizing a mouse with a colonic cancer cell line in 1979[4],is a ligand for E-selectin that plays an important role in the addhesion of cancer cells to endothelial cells [5,6].