检测粪便中的癌相关抗原S—Tn,Tn及CEA诊断胃癌：免疫电泳法

以两株单克隆抗体，ＧＳ－２及ＣＬ－３组合，用免疫电泳法检测粪梗提取液中的癌相关抗原Ｓ－Ｔｎ，Ｔｎ及ＣＥＡ，检测的病例为胃癌７５例，直结肠癌６６例，胰腺癌８例，浅表性胃炎７例，萎缩性胃为１５例，胃及十二指肠溃疡病２０例，胆囊结石１０例以及正常人１００例，结果表明：ＧＳ－２检测各组阳性率为：胃癌８０％，结肠癌５８．７％，胰腺癌１２．５％，正常人为９％，非恶性病变组０－１５％。ＣＬ－３检测各组阳性率为：     

酶免疫—醋酸纤维薄膜电泳法诊断大肠癌

以抗结肠癌及胰腺癌的单克隆抗体用酶免疫──醋酸纤维薄膜电泳法，检测大肠癌及非癌疾病患者粪便中的癌相关抗原。其中大肠癌６１例，慢性肠炎２０例，正常人１００例。结果表明，四株单克隆抗体ＣＬ－３、ＣＬ－４、ＰＳ－２、ＰＳ－９对应抗原在大肠癌患者粪便中的平均含量显著高于正常对照组及非癌肠道疾病组，其阳性率分别为７５．４％、５９．４％，７２．５％和５１．３％，如将三株单抗ＣＬ－３、ＣＬ－４、ＰＳ－２组合应用，则大肠癌组阳性率达８６．２％，正常组为１５．２％，肠炎组为１６．６％，６５例大肠癌中，５例早期诊断（ＤｕｋｅｓＡ期）患者均为阳性。本方法可能为早期诊断大肠癌提供简便省时，价廉，便于推广的新方法。     

ABC－ELISA检测胃癌高发区人群血清中糖链抗原

用新近制备的二株抗胃癌单克隆抗体ＢＭＧ２和ＢＭＧ４，建立ＡＢＣ－ＥＬＩＳＡ方法，检测胃癌高发区６５９例受检者血清中的胃癌糖链抗原，其中胃癌患者２７例，内有３例早期胃癌。结果表明：ＢＭＧ２－Ａｇ和ＢＭＧ４－Ａｇ水平在胃癌、胃癌术后、萎缩性胃炎伴异型增生、胃增生性息肉、胃炎伴肠化生组均显著高于对照组（Ｐ＝０．０００～０．０３７），胃癌阳性率分别是４４．９％和４０．７％，特异性分别是８１．６％和８４．５％。将这二个抗原联合应用，则胃癌阳性率为６６．７％，特异性７６．３％，３例早期胃癌阳性。     

ABC—ELISA检测胃癌高发区人群血清中糖链抗原

用新近制备的二株抗胃癌单克体ＢＭＧ２和ＢＭＧ４，建立ＡＢＣ－ＥＬＩＳＡ方法，检测胃癌高发１工６５９例受检者血清中的胃癌糖链抗原，其中胃癌患者２７例，内有５例早期胃癌。结果表明：ＢＭＧ２－Ａｇ和ＢＭＧ４－Ａｇ水平在胃癌、胃癌术后、萎缩性胃炎伴异型增生、胃增生性息肉、胃炎伴肠化生组均显著高于对照组（Ｐ＝０．０００－０．０３７），胃癌阳性率分别为４４．９％和４０．７％，特异性分别是８１．６％和８４．５％     

c－erbB－2和EGFR在胃癌中表达的研究

应用ＡＢＣ和ＬＳＡＢ法对７５例胃癌及癌旁组织进行了ｃ－ｅｒｂＢ－２和ＥＧＦＲ表达的研究。结果：１）７５例胃癌ｃ－ｅｒｂＢ－２表达阳性率为１８．７％，阳性表达只限于癌灶，而癌旁组织均为阴性。ｃｅｒｂＢ－２在高分化胃癌、大体局限型胃癌中的阳性率较高（Ｐ＜０．０５）。２）ＥＧＦＲ表达阳性率为６１．３％，癌旁组织、新生血管有阳性表达。ＥＧＦＲ表达与胃癌的大体类型、生长方式、分化程度、淋巴结受累和远处转移至正相关（Ｐ＜０．０５）。３）ｃ－ｅｒｂＢ－２表达与ＥＧＦＲ表达无明显关系。结果说明：ｃ－ｅｒｂＢ－２表达出现于胃粘膜癌变的后期，是恶性细胞的标志；ＥＧＦＲ表达与胃癌的恶性程度有明显关系；ｃ－ｅｒｂＢ－２和ＥＧＦＲ在胃癌中的表达是互相独立的。     

SF、β_2－MG、CEA对女性生殖器恶性肿瘤的临床意义

应用放射免疫法对６７例女性生殖器恶性肿瘤患者及３０例非恶性疾病患者进行ＳＦ、β２－ＭＧ、ＣＥＡ测定。结果表明：恶性肿瘤组ＳＦ、β２－ＭＧ、ＣＥＡ的阳性率分别为２５．８１％，１３．１％，１５％。其联合测定的综合阳性率为４３．３％，其中ＳＦ阳性率显著高于非恶性疾病患者（Ｐ＜０．０１）。恶性肿瘤患者治疗前后ＳＦ值比较差异有显著性意义（Ｐ＜０．００１）。而β２－ＭＧ、ＣＥＡ测定值无意义（Ｐ＞０．０５）。作者认为，ＳＦ测定对女性生殖器恶性肿瘤的诊断及疗效估价有一定的临床意义。     

c—erbB—2和EGFR在胃癌中表达的研究

应用ＡＢＣ和ＬＳＡＢ法对７５例胃癌及癌旁组织进行了ｃ－ｅｒｂＢ－２和ＥＧＦＲ表达的研究。结果：１）７５例胃癌ｃ－ｅｒｂＢ－２表达阳性率为１８．７％，阳性表达只限于癌灶，而癌旁组织均为阴性。ｃ－ｅｒｂＢ－２在高分化胃癌，大体局限型胃癌中的阳性率较高。２）ＥＧＦＲ表达阳性为６１．３％，癌旁组织，新生血管有阳性表达。ＥＧＦＲ表达与胃癌的大体类型，生长方式，分化程度，淋巴结受累和远外转移呈正相关。     

新肿瘤相关抗原MG—AgS在肺癌中的免疫组化研究

肿瘤相关抗原的发现对于肿瘤的诊断和治疗都具有重要的意义。本文作者运用ＡＢＣ免疫组织化学技术，采用ＭＧ系列单克隆抗体，对一组新的胃癌相关抗原ＭＧ－ＡｇＳ在肺部病变中的表达进行了免疫组织化学研究，在检测的８８例肺癌标本中，ＭＧ－ＡｇＳ的阳性率为７３．９％。其中肺的腺癌阳性率为８７．５％（２８／３２），肺的鳞癌阳性率为７５％（１８／２４），肺的小细胞癌阳性率为６０．８％（１４／２３），肺的大细胞癌阳性率     

人胎盘GST－π抗体的免疫组织化学检测对胆囊癌早期诊断的意义

应用人胎盘型谷胱甘肽Ｓ—转移酶（ＧＳＴ－π）抗体的ＡＢＣ法免疫组织化学技术，检测了１００例胆囊良、恶性病变组织的ＧＳＴ－π活性，结果表明，２２例正常胆囊粘膜对照组ＧＳＴ－π阳性率为９％，１２例胆囊炎和４例胆囊腺瘤ＧＳＴ－π阳性率分别为１６．６７％和２５％，视为癌前病变的异型增生组，ＧＳＴ－π阳性率达１００％，随着异型增生程度加重，ＧＳＴ－π活性增强。３８例胆囊腺癌ＧＳＴ－π阳性率为８７％，其中高分化和中分化型腺癌组织中ＧＳＴ－π阳性率为９５％，低分化型为１００％，未分化型腺癌ＧＳＴ－π阳性率７５％，胆囊腺癌、异型增生组ＧＳＴ－π阳性率及平均强度都显著高于良性病变和正常对照组（Ｐ＜Ｏ．０１）。因此，ＧＳＴ－π的免疫组织化学检测可作为胆囊癌及癌前病变的一项新的早期诊断指标。     

胃癌术前C—erbB—2癌基因研究的临床意义

应用ＰＣＲ技术结合Ｓｏｕｔｈｅｒｎｂｌｏｔ分子杂交及免疫组合ＡＢＣ法检测８７例胃液脱落癌细胞及胃镜活检组织Ｃ－ｅｒｂＢ－２基因扩增及蛋白过度表达。结果显示：１１例（１２．６％）脱落癌细胞及１８例（２０．７％）活检组织Ｃ－ｅｒｂＢ－２基因扩增阳性；１５例（１７．２％）活检组织Ｃ－ｅｒｂＢ－２过度表达阳性；总阳性率为２５．３％（２２／８７），其中１０例（１１．５％）脱落癌细胞及活检组织基因扩增及过度表达均呈阳性反应。Ｃ－ｅｒｂＢ－２基因扩增及过度表达与胃癌进展程度、有无伴淋巴结及肝转移关系密切，结果表明Ｃ－ｅｒｂＢ－２基因检测似可作为胃癌术前估计预后的一项指标，采用上述不同方法可提高检测阳性率。     

Detection of tumor associated antigen, PA8-15, in sera from pancreatic and gastrointestinal carcinoma patients

A sandwich enzyme immunoassay was set up to measure tumor associated antigen (antigen PA8-15) detected by monoclonal antibody PA8-15. The cut-off value was set at 55 U/ml. Tests on 437 sera samples from patients with malignant or benign diseases yielded the following positive percentages: esophageal cancer, 9.1%; gastric cancer, 23.1%; colorectal cancer, 44.8%; hepatoma, 32.6%; biliary tract cancer, 47.5%; pancreatic cancer, 84%; lung cancer, 30.8%; breast cancer, 16%; benign diseases, 13.2%. Positive antigen PA8-15 levels in patients with gastric, colorectal and pancreatic cancers, increased with the progression of clinical stage. When antigen PA8-15 was monitored in 11 various cancer cases before and after surgery, a decrease in PA8-15 value was revealed in all resected patients postoperatively, whereas a more than 100% increase in PA8-15 values was noted in non-resected patients. Compared with CEA and CA19-9, the highest positive PA8-15 rate was seen in pancreatic cancer patients. By combining the rates of positive sera obtained with each tumor marker, the overall percentage increased. These results suggest that measuring serum PA8-15 levels will aid in serological cancer diagnoses, particularly pancreatic cancer.     

CEA mRNA identification in peripheral blood is feasible for colorectal, but not for gastric or pancreatic cancer staging

OBJECTIVE: It has been suggested that the molecular identification of cancer cells in the circulation may be useful in predicting the presence of micrometastasis in several cancer types. The aim of the present study was therefore to assess the feasibility of CEA mRNA identification in blood for diagnosing and staging colorectal, gastric and pancreatic cancer. METHODS: We studied 16 control subjects, 69 patients with colorectal (CRC), 30 with gastric (GC), 27 with pancreatic cancer (PC) and 8 with benign diseases of the pancreatobiliary tree. At diagnosis CEA mRNA was identified in peripheral blood by means of a RT-PCR procedure. RESULTS: The specificity of this test in control subjects was 94%, and its sensitivity in identifying CRC, GC and PC were 34, 37 and 41%, respectively. False-positive findings were recorded in 25% patients with benign diseases. No association was found between CEA mRNA and stage in patients with GC or PC. In CRC patients, positive CEA mRNA findings were correlated with local spread (chi(2) = 14.6, p<0.01), lymph node (chi(2) = 18.95, p<0.001) and distant metastasis (chi(2) = 11.3, p<0.001). In these cases, CEA mRNA, but not CEA, was entered in stepwise discriminant analysis to classify the presence of lymph node metastasis. CONCLUSIONS: The molecular detection of micrometastasis in the blood by means of CEA mRNA identification is feasible for colorectal, but not for gastric or pancreatic cancer staging. Further studies are needed in order to define the clinical utility of this marker also in follow-up protocols.     

纤维蛋白原在消化系统肿瘤中的水平

目的探讨消化系统肿瘤中纤维蛋白原(FIB)的水平及临床意义。方法使用全自动血凝分析仪检测126例食管癌、92例胰腺癌、138例胃癌、157例大肠癌、135例肝癌、50例体检正常人血浆中的FIB,用全自动电化学发光分析仪检测相应的癌胚抗原(CEA)。结果在食管癌、胰腺癌、胃癌、大肠癌、肝癌及正常人血浆中FIB的阳性率分别为14.3%、42.4%、60.1%、62.4%、45.9%、10.0%,CEA在相应肿瘤人群中阳性率分别为12.7%、25.0%、42.8%、38.9%、33.3%。在胰腺癌、胃癌、大肠癌、肝癌患者中FIB阳性率明显高于正常人,差异有统计学意义(P<0.05);而在食管癌患者与正常人间FIB阳性率差异无统计学意义(P>0.05)。在胰腺癌、胃癌、大肠癌、肝癌患者中FIB阳性率明显高于CEA阳性率,差异有统计学意义(P<0.05);而在食管癌患者中FIB与CEA阳性率差异无统计学意义(P>0.05)。结论在胰腺癌、胃癌、大肠癌、肝癌患者血浆中FIB阳性率明显增高,有望成为肿瘤早期诊断的指标;而在食管癌患者血浆中FIB阳性率与CEA阳性率相近,提示FIB增高有器官特异性。     

Immunocytological detection of micrometastatic cells: Comparative evaluation of findings in the peritoneal cavity and the bone marrow of gastric,colorectal and pancreatic cancer patients

The prognosis of digestive cancers is poor mainly due to intraperitoneal relapse by cells which may have already been seeded at the time of surgery. Using immunocytology we investigated the peritoneal cavity and, as a comparison, the bone marrow of 147 patients with gastric, colorectal and pancreatic cancer for micrometastatic cells. Cytological samples from peritoneal cavity lavages and bone marrow aspirates were analyzed using monoclonal antibodies (MAbs) against tumor-associated antigens (TAA) (CEA, CA-19-9, 17-1-A, C-54-0, Ra96) and compared to a MAb staining cytokeratins (KL-I). Patients with benign diseases served as controls. Intraperitoneal micrometastatic cells were detected in 27% of colorectal, 43% of gastric and 58% of pancreatic cancer patients. In the bone marrow, the corresponding data were 29% for colorectal, 25% for gastric and 58% for pancreatic cancer patients. Combined evaluation of both compartments increased the detection rate significantly (colorectal cancer: 40%, gastric cancer: 52%, pancreatic cancer: 72%). No unwarranted reactions were found in the control group. Combining 3 antibodies (CA-19-9, Ra96, C-54-0) enabled good detection for peritoneal cavity samples. In the bone marrow, the use of 2 antibodies (KL-I and CA-19-9) detected 94% of all positive samples, whereas KL-I and CA-19-9 stained approx. 70% of all positive samples in each case. The occurence of stained cells in the peritoneal cavity correlated with classical prognostic factors (TNM classification). © 1994 Wiley-Liss, Inc.     

结直肠癌组织MMP-7、MMP-9表达与腹腔微转移的相关性研究

目的:探讨MMP-7、MMP-9在结直肠癌腹腔微转移中的作用以及相关性。方法:收集98例结直肠癌患者手术中腹腔冲洗液,进行CEA、CK20免疫细胞化学染色确定腹腔微转移。使用组织阵列仪制作组织芯片,进行免疫组化染色(SP),检测MMP-7、MMP-9在结直肠癌组织中的表达情况,分析其与腹腔微转移的关系。结果:CEA、CK20联合检测腹腔微转移率为32.7%(32/98)。MMP-7、MMP-9在伴有腹腔微转移的结直肠癌中阳性表达率分别为93.75%和96.88%,明显高于无腹腔微转移结直肠癌表达率72.73%和68.18%(P<0.05,P<0.01)。结论:MMP-7、MMP-9可能在结直肠癌腹腔微转移的发生过程中起重要作用。     

大肠癌患者外周血中细胞角蛋白19和癌胚抗原的表达及临床意义

目的:应用巢式逆转录聚合酶链反应（nested RT-PCR）技术检测大肠癌患者外周血中CK19 mRNA、CEA mRNA的表达及临床意义,探讨其作为大肠癌微转移检测分子标记物的可能性。方法:应用巢式RT-PCR技术检测20例健康人、20例大肠腺瘤疾病患者和90例大肠癌患者外周血CK19 mRNA和CEA mRNA的表达。结果:大肠癌组CK19 mRNA和CEA mRNA表达的阳性率为58.89%（53/90）和53.33%（48/90）;20例健康人外周血中无CK19 mRNA和CEA mRNA的表达; 20例大肠腺瘤疾病患者有1例CK19 mRNA的表达,阳性率为5.00%（1/20）,无CEA mRNA的表达。大肠癌患者中CK19 mRNA、CEA mRNA的阳性率与肿瘤分期及肿瘤转移有显著相关性（P＜0.05)。结论:CK19 mRNA和CEA mRNA作为检测大肠癌患者外周血微转移的分子标记物具有良好的敏感度和特异性,同时可作为判断大肠癌患者的预后指标。     

The clinical information value of an immunoenzyme study of the tumor markers CA-19-9, CEA and AFP in cancer of the stomach, pancreas, colon and rectum]

Blood levels of CEA, CA 19-9 and AFP were assayed by immunoenzyme technique in 60 cases of gastric cancer, 15 patients with pancreatic cancer and 30 patients with colorectal cancer. CEA and CA 19-9 levels were found to depend upon stage and degree of tumor differentiation. Changes in the antigen levels in the course of treatment reflected the degree of its radicality. In application of the immunoenzyme assay, CA 19-9 level appeared most clinically relevant in gastric, pancreatic and colorectal cancers. CEA concentration can serve as an indicator of liver metastases. CA 19-9 and CEA levels can be used for monitoring and objective evaluation of treatment for gastric, pancreatic and colorectal cancer as well as for predicting response.     

多肿瘤标志物蛋白芯片检测中CA125对恶性肿瘤的诊断价值

  目的  探讨多肿瘤标志物蛋白芯片中糖链抗原CA125对恶性肿瘤的诊断价值。  方法  收集第三军医大学大坪医院可供分析的25 076例多肿瘤蛋白芯片检测结果,分析CA125在不同人群、不同肿瘤中升高情况,以及CA125升高伴随其他检测指标升高在肿瘤中的分布情况。  结果  CA125在恶性肿瘤患者中明显高于良性病变患者及正常体检者,而且卵巢癌最高（51.92%）,其次为胰腺癌（49.25%）和肝癌（42.56%）;同时升高的指标以CEA最为常见,其次为CA199、CA242和Ferritin,CA125/CEA同时升高最常见于结直肠癌（83.87%）,其次为乳腺癌（59.72%）,CA125/CA199同时升高最常见于结直肠癌（90.97%）和胰腺癌（78.63%）,CA125/CA242伴随升高最常见于结直肠癌（92.26%）和胰腺癌（74.81%）,CA125+CEA+CA199及CA125+CEA+CA199+CA242升高均最常见于肺癌。  结论  CA125单项指标升高对卵巢癌、胰腺癌及肝癌的诊断有较高的价值,CA125伴随或联合CEA、CA199、CA242检测有利于提高结直肠癌、胰腺癌、肺癌的诊断阳性率。