TrFIA检测CA242对结直肠癌的临床价值

目的：观察采用时间分辨荧光免疫分析检测的CA242在恶性肿瘤普查、诊断和预后的应用价值。方法：收集我院2004年10月～2006年3月的住院病例。包括恶性肿瘤组共226例，良性病变组共74例，正常组50例。采集患者静脉血，常规离心分离血清进行检测。CA242采用TrFIA，CA242正常值为〈20U／ml。结果：使用TrFIA检测CA242在恶性肿瘤组表达水平较良性病变组与正常对照组的表达水平及阳性例数明显升高，其差别明显，P〈0．05，有统计学意义。CA242与其他肿瘤标记物比较，以CEA的灵敏度（45．21％）和CA242的特异度（92．86％）最高。当CA242与另外一项肿瘤标志物联用时，采用平行联检CA242-CEA诊断的灵敏度（59．57％）最高，而采用系列联检CA242-CAl99和CA242-CA50的特异度可以达到100％。当CA242与其他其二项肿瘤标志物联用时，CA242-CEA-CA50平行联检灵敏度最高达67．74％。三项联合应用时，系列联检特异度都是100％。当CA242与其他三项指标联合时，平行联检在本文所用方法中灵敏度最高（69．23％），系列联检特异度是100％。结论：采用TrFIA检测糖链抗原CA242对直肠癌等的普查、诊断、预后的判断提供了一定的应用价值。

Clinical Value of Determination of Serum CA242 Contents with TrFIA for Diagnosis of Colo-Rectal Cancer

Objective To study the clinical usefulness of determination of serum CA242 contents with time-resolved fluoroimmunoassay(TrFIA) in the diagnosis of colo-cancer.Methods Serum CA242 contents were determined with TrFIA in 226 patients with colo-rectal cancer,24 patients with benign colo-rectal polypus,and 50 controls.Results There were no false positive cases in the controls.Serum CA242 contents were significantly higher in malignant cases than those in the benign cases(P<0.05).Compared with other tumor markers(CEA,CA199,CA50),CA242 had the highest specificity(92.86%) and CEA had the highest sensitivity(45.21%).For parallel combined determination of 2 markers,CA242 with CEA would yield the highest sensitivity of 59.57%.With serial combined determination of CA242-CA199 or CA242-CA50,the specificity would be 100%.For parallel combined determination with 3 markers,CA242-CEA-CA50 would result in a highest sensitivity of 67.74%.Serial combined determination of 3 markers with any combination would result in 100% specificity.If CA242 was combined parallelly with all the other 3 markers,the sensitivity could be further raised to 69.23%.Conclusion Determination of serum CA242 contents with TrFIA is specific,convenient,reproducible without radio-active contamination and worth popularization.