胃癌组织、胃液、血清癌胚抗原关系的临床研究

用酶联免疫法和免疫酶染色法同时测定52例胃癌患者粘膜CEA含量分布和胃液血清CEA浓度,探讨其关系并以30例胃良性病变作对照。结果表明:①胃液与胃粘膜CEA呈明显正相关(r=0.77)能够较好地反映瘤细胞排泌CEA的情况,因此胃液CEA测定可用于胃癌辅助的诊断、术后监测和胃癌高危险人群的筛选。②免疫酶CEA染色方法简便易行,临床上可用于鉴别常规病理学检查形态类似的胃部肿瘤。③胃癌患者血清CEA阳性率较低,不适于单独应用,但特异性较好,与胃液CEA测定及CEA免疫酶染色联合应用胃癌诊断符合率明显提高。

CEA CONTENT IN TISSUE AND BODY FLUIDS OF PATIENTS WITH GASTRIC CANCERS,RELATIONSHIP BETWEEN TUMOR TISSUE,GASTRIC JUICE AND SERUM LEVELS

In 52 patients with gastric cancer,we observed CEA levels in gastric juice and serum,the concentration and localization of CEA in gastric mucosa and tumor tissue.Their interrelationships were studied as well.33 cases of benign gastric diseases (16 chronic atrophic gast'itis,14 chronic surperficial gastritis and 3 normal persons) were also investigated as control groups.Tire results were as follows.1.The CEA level was significantly higher in cancerous tissue than in noncancerous ones (P<0.001) .well differentiated adenocarcinomas contained more CEA.The concentration of CEA in tumor tissue increased as the tumor invaded more deeply and metas-tases occured.But this was not statiatieally significant.2.Using cold ethanol-fixed.paraffin-embedded tissue specimens with direct immunoper-oxidase staining,we demonstrated CEA in 78.84% of stcmach cancer,in 22.22% of chronic atrophic gastritis and 71.42% of intestinal metaplasia,but not in chronic superficial gastritis and normal stomach.In well differentiated cancers of the stomach CEA was found on the luminal surface of the tumor cells and in the lumina.In all of mucoid cellular carcinomas and a few poorly differentiated adenocarcinomas,CEA was present on tumor cell surface and in the cytoplasm of isolated tumor cells.If CEA concentration in tissue was higher than 5.01ng/mg,CEA could be demonstrated in all of the tumors by immunoperoxidase technique.3.The CEA levels of gastric juice were increased in patients with gastric cancer than those with benign gastric diseases (P<0.001).If 87ng/ml was set as the criterion of demonstration of positive,the pcsitive rate was 86.53% in the group of cancer patients and 16% in noncancerous groud.The CEA concentration in tissues correlated well with that in gastric juice.