CEA、CA19—9、CA50水平与胰腺癌分期和肿瘤大小的关系

目的探讨血清肿瘤标志物CEA、CA19-9、CA50水平与胰腺癌分期和肿瘤大小的关系。方法分别测定35例胰腺癌和36例慢性胰腺炎患者血清CEA、CA19—9与CA50水平。外科手术和（或）病理学判定TNM分期和肿瘤大小．分析两者之间的关系。结果血清CEA、CA19—9、CA50对胰腺癌诊断的敏感性分别为12％、82％、74%。特异性分别为75%、83％、77％。Ⅲ-Ⅳ期的CA19—9和CA50水平明显高于Ⅰ-Ⅱ期患者（P〈0.05）．CEA超过正常值者仅见于Ⅲ期以上胰腺癌患者。TS3-TS1组的CEA、CA19-9、CA50水平比TS1-TS2组明显增高（P〈0．05）。结论胰腺癌血清CEA、CA19—9、CA50水平与胰腺癌分期和肿瘤大小有一定相关性．对手术前判断胰腺癌的可切除性有一定的参考价值。     

胰腺癌患者血清CEA、CA19-9和CA50水平变化及意义

目的观察胰腺癌患者血清癌胚抗原（CEA）、糖类抗原19-9（CA19-9）和CA50水平变化及其对胰腺癌分期和手术可切除性的术前预测价值。方法测定60例胰腺癌患者（胰癌组）血清CEA、CA19-9及CA50,根据手术和病理学检查判定TNM分期。以40例良性胰腺疾病患者作对照（对照组）,分析血清CEA、CA19-9、CA50水平与胰腺癌分期以及手术可切除性之间的关系。结果胰癌组血清CEA、CA19-9、CA50水平均明显高于对照组（P〈0.01）。胰癌组Ⅲ＋Ⅳ期患者的血清CEA、CA19-9、CA50水平明显高于Ⅰ＋Ⅱ期患者（P〈0.01）;姑息性手术患者的血清CEA、CA19-9、CA50水平显著高于根治性手术患者。结论血清CEA、CA19-9、CA50水平与胰腺癌分期有关,可作为判定胰腺癌能否行根治性手术切除的参考指标。     

43例胰腺癌患者血清CA19-9、CA125、CEA水平检测及分析

目的 探讨血清肿瘤标志物CA19-9、CA125及癌胚抗原（CEA）联合检测对胰腺癌诊断及疗效监测的价值.方法 采用全自动电化学发光分析仪测定43例胰腺癌患者（胰腺癌组）及40例健康查体者（对照组）血清CA19-9、CA125及CEA水平,其中胰腺癌组手术前及术后1个月各测定1次;根据试剂厂家提供的参考值计算三种标志物诊断胰腺癌的敏感性、特异性及准确性.结果 胰腺癌组手术前后血清CA19-9、CA125及CEA水平均显著高于对照组（P＜0.01）,尤以术前为著（P＜0.05）;三种肿瘤标志物术后阳性率均显著低于术前（P＜0.05）,联合检测上述三种肿瘤标志物诊断胰腺癌的敏感性、特异性及准确性均显著高于单一标志物检测（P＜0.05）. 结论联合检测血清CA19-9、CA125、CEA水平对胰腺癌的辅助诊断、疗效判定、病情监测等均有重要价值.     

血清和胆汁CEA、CA19-9对肝外胆管癌诊断的对比研究

目的探讨血清与胆汁CEA、CA19-9测定对肝外胆管癌诊断的对比意义。方法采用化学发光法检测34例肝外胆管癌的血清和胆汁CEA、CA19-9值。结果胆汁CEA高于血清CEA（P〈0.05）,血清CA19-9高于胆汁CA19-9（P〈0.05）;血清CEA、CA19-9灵敏度分别为11.8%、79.4%;胆汁CEA、CA19-9灵敏度分别为52.9%、55.9%。血清CA19-9的灵敏度高于其他三者。结论血清CA19-9对胆管癌的诊断价值高于血清与胆汁CEA和胆汁CA19-9。     

CA19-9在胰腺癌中的应用价值及局限性

胰腺癌的诊治是世界性难题,糖类抗原CA19-9对于胰腺癌的诊断、疗效观察及预后判断等方面具有一定的临床价值,与其他肿瘤标志物比较,具有较好的敏感性及特异性,是最常用的胰腺癌的标志物。但其也存在诸多的局限性,尤其是具有较高的假阳性率及在Lewis a阴性基因型患者中的假阴性,极大限制了其作为胰腺癌诊断标准的应用。因此,血清CA19-9水平的升高需结合影像学及组织学证据,才能做出正确判断。     

血清及胆汁CEA、CA19-9、CA24-2在胆道良恶性梗阻性疾病中的诊断价值

目的探讨血清及胆汁CEA、CA19-9、CA24-2检测对胆道良恶性梗阻性疾病的诊断价值。方法选择2015年6月-2016年12月来恩施土家族苗族自治州中心医院诊治的良性和恶性胆道梗阻患者各40例,收集入院时的血清和手术中的胆汁标本进行肿瘤标志物(CEA、CA19-9及CA24-2)检测。2组间比较采用t检验,并对各肿瘤标志物诊断胆道良恶性梗阻性疾病进行受试者工作特征曲线分析。结果胆道恶性梗阻性疾病组血清CA19-9、CA24-2水平均明显高于胆道良性梗阻性疾病组,差异均有统计学意义(t值分别为5.899、3.223,P值均<0.05)。胆道恶性梗阻性疾病组胆汁CEA、CA19-9及CA24-2水平均明显高于胆道良性梗阻性疾病组,差异均有统计学意义(t值分别为3.304、7.615、7.279,P值均<0.05)。胆道恶性梗阻性疾病组胆汁中肿瘤标志物CEA、CA19-9及CA24-2水平均明显高于血清,差异均有统计学意义(t值分别为3.297、4.975、3.993,P值均<0.05);其中胆汁CA24-2的约登指数和受试者工作特征曲线下面积(AUC)最高,分别为0.75和0.946,而胆汁CA19-9和血清CA19-9的约登指数和AUC也较高,分别为0.74和0.937以及0.68和0.898,三者的诊断价值较大。将胆汁CA24-2、血清CA19-9及胆汁CA19-9三者联合检测,其诊断恶性胆道梗阻性疾病的灵敏度为94.75%、阴性预测值为93.50%、约登指数为0.82。结论胆汁肿瘤标志物检测对胆道恶性梗阻性疾病的诊断价值重大,而胆汁CA24-2、血清CA19-9及胆汁CA19-9三者联合检测对胆道良恶性梗阻性疾病的鉴别诊断价值最大。     

胰腺癌肿瘤基因标记物的研究现况

手术切除是胰腺癌惟一治愈手段,然而,85%的胰腺癌患者在就诊时已属晚期或发生远处转移,手术切除率较低,故胰腺癌的早期诊断具有非常重要的意义。胰腺癌患者血清中含有较多的肿瘤标记物,临床应用较多的是CA19-9、CA242及癌胚抗原(CEA)等。然而,现阶段血清学肿瘤标记物由于灵敏度及特异性尚未尽如人意,故临床急需有效的联合检测以提高其早期诊断率,改善整体治疗效果。     

胰腺外分泌功能与胰腺癌分期、肿瘤大小关系的临床研究

目的 研究胰腺外分泌功能与胰腺癌分期、肿瘤大小的关系.方法 采用NBT-PABA试验测定39例胰腺癌、46例CP患者和20名正常人胰腺外分泌功能,分析其与胰腺癌JPS局部进展度(T因子)及肿瘤大小(Ts)的关系.结果 正常人PABA排泄率平均为(78.9±15.9)%;CP患者平均为(58.6±19.3)%,其中轻、中、重度CP的PABA排泄率分别为(75.5±23.6)%、(57.9±21.5)%、(45.5±16.7)%;胰腺癌患者PABA排泄率平均为(47.6±18.3)%.其中,L3+T4期胰腺癌患者PABA排泄率为(42.2±21.7)%,显著低于Tl+T2期患者的(64.8±11.1)%(P<0.05);TS3+TS4患者PABA排泄率为(34.8±17.2)%,显著低于TS1+TS2患者的(55.6±23.5)%(P<0.05);胰头癌PABA排泄率为(42.5±16.4)%,显著低于胰体尾癌的(71.8±9.6)%(P<0.05);33例胰头癌中,主胰管狭窄患者的PABA排泄率为(54.2±14.1)%,显著高于胰管中断患者的(37.6±14.1)%(P<0.05).胰腺癌与中、重度CP的胰腺外分泌功能无显著差异.结论 胰头癌患者的胰腺外分泌功能减低的程度与胰腺癌分期、肿瘤大小及部位有一定相关性,其中胰管中断为影响判定的因素.胰腺外分泌功能不能鉴别胰腺癌与中、重度CP.     

肿瘤标志物CEA、CA19-9、CA242、TPA在胰腺癌中的表达

对目前研究比较集中的胰腺癌肿瘤标志物CEA、CA1 9- 9、CA2 4 2、TPA进行了研究 ,旨在分析其诊断价值 ,并探索较优组合方案 ,以提高胰腺癌的诊断水平。1　资料与方法1 .1　临床资料　本组共 85例 ,选取标准为梗阻性黄疸患者 ;有 1年以上慢性胰腺炎病史 ;持续性复发性右上腹痛并 GGT>40 U/ L;B超疑诊胰腺疾病。其中包括胰腺癌 45例 ,组成 : 期 8例 , 期 1 2例 , 期 2 5例。1 .2　方法　 1选用 Bio- RAD酶标仪、WZ- IA型微量振荡器、微量加样器 (精确至 1 0 0 μl)、实验平板。CEA试剂盒、CA1 9- 9酶标免疫试剂盒、CA2 4 2酶标…     

Elevated levels of CA 19-9 and CEA in pancreatic cancer-associated diabetes

Background  

The relationship between diabetes and pancreatic cancer has been established by more than several decades of research. However, serum levels of CEA and CA 19-9 in diabetic pancreatic cancer has not been shown.     

胰腺癌患者血清中巨噬细胞因子-1、糖链抗原19-9、糖链抗原242及癌胚抗原的检测分析

目的 探讨血清巨噬细胞因子-1（MIC-1）、糖链抗原（CA）19-9 、CA242及癌胚抗原（CEA）在胰腺癌中的应用价值.方法 分析129例胰腺癌患者和120例健康体检者4项肿瘤标志物的检测结果,计算各肿瘤标志物组合方式对提高胰腺癌诊断的作用.结果 胰腺癌患者血清中各项肿瘤标志物的水平与对照组比较差异有统计学意义（P〈0.05）.MIC-1＋CA19-9组合的敏感性与单项检测敏感性最高的MIC-1比较,差异有统计学意义（P〈0.05）;MIC-1＋CA19-9组合的特异性与单项检测特异性最高的CA19-9比较,差异无统计学意义（P〉0.05）.Ⅲ~Ⅳ期胰腺癌患者血清CA19-9、CA242水平与Ⅰ~Ⅱ期比较,差异有统计学意义（P〈0.05）.结论 4项肿瘤标志物的检测对胰腺癌的诊断均有一定的价值,MIC-1＋CA19-9联合检测可提高诊断的敏感性,同时未降低其特异性.CA19-9、CA242对判断胰腺癌的预后有一定价值.     

Comparison of tumor marker CA 242 with CA 19-9 and carcinoembryonic antigen (CEA) in pancreatic cancer

BACKGROUND/AIMS: Although there are a variety of tumor markers used for diagnosis of pancreatic carcinoma, the sensitivity and specificity of those markers have not yet reached an ideal level. The aim of this study was to compare the diagnostic value of CA 242 with CA 19-9 and CEA in the patients with pancreatic cancer. METHODOLOGY: Serum CA 242, CA 19-9 and CEA levels were determined in 135 subjects in the following groups: Pancreatic cancer (n = 40), cholangiocellular carcinoma (n = 15), hepatocellular carcinoma (n = 10), cirrhosis (n = 7), chronic active hepatitis (n = 7), choledochal stone (n = 12), chronic pancreatitis (n = 9), acute pancreatitis (n = 6), and healthy controls (n = 29). RESULTS: An elevated serum CA 242 concentration (> 20 U/mL) was found in 30 out of 40 (70%) (mean; 2163 +/- 838 U/mL) patients with pancreas cancer, in 11 out of 15 patients with cholangiocellular carcinoma (93.3%) (mean 916 +/- 529 U/mL), in none of patients with hepatocellular carcinoma and healthy controls. Slightly elevated CA 242 concentration was found in 6 out of 41 patients with benign hepatobiliary and pancreatic disease (range 0.4-97.8 U/mL) (1 acute pancreatitis, 2 chronic pancreatitis, 1 cirrhosis, 2 choledochal stone). Mean serum CA 242, CA 19-9 and CEA levels of the pancreas cancer group were significantly higher than those of the other groups except the cholangiocellular carcinoma group. There was no significant difference between the stage of pancreas cancer regarding mean serum CA 242, CA 19-9 and CEA level. There was positive correlation between serum CA 242 and CA 19-9 level. In the pancreas cancer, the sensitivity of CA 242, CA 19-9 and CEA was 75%, 80%, 40%, respectively and the specificity of those markers was 85.5%, 67.5% and 73%, respectively. CONCLUSIONS: In conclusion, the advantage of CA 242 compared to CA 19-9 is that its specificity is higher than that of CA 19-9 in the diagnosis of pancreas cancer.     

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。     

The tumor markers CEA, TPA and CA 19-9 in gastric cancer

In gastric cancer the tumor markers CEA, TPA and CA 19-9 display relatively low sensitivity, which in relation to a specificity of 90% lies between 20% and 25%. Compared with the simple ESR method, these sensitivities are not remarkably greater. But a combination of parameters based on discriminant analysis achieves distinctly greater sensitivities.     

Relationship between serum calcium and CA 19-9 levels in colorectal cancer

AIM: To examine the calcium metabolism of colorectal cancer (CRC) in patients with colorectal cancer and control patients. METHODS: Seventy newly diagnosed CRC patients were included. The healthy control group was age and gender matched (n=32). Particular attention was devoted to the relationship between serum calcium of patients, and levels of AFP, CEA, carbohydrate antigen 19-9 (CA 19-9) (that could be considered as prognostic factors). Furthermore, the Ca-sensing receptor (CaSR) gene A986S polymorphism was investigated in these patients, as well as the relationship between different CaSR genotypes and the data stated above. RESULTS: A lower level of ionized calcium (also corrected for albumin) was found in the serum of CRC patients with normal 25(OH) vitamin D levels. The ionized calcium concentration was inversely correlated with the serum level of CA 19-9. There was no difference in the distribution of CaSR genotypes, between CRC patients and general population. The genotypes did not correlate with other data examined. CONCLUSION: Based on these results, lower levels of serum calcium might be a pathogenic and prognostic factor in colorectal cancer.     

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