血清CEA、CA199、CA242联检在大肠癌诊断及随访中的临床应用

目的：评价血清CEA、CA19、CA242单项或多项联检对大肠癌患者的临床诊断价值，并探讨其在病理分期、手术前后及跟踪随访中的临床意义。方法：应用电化学发光法检测92例大肠癌患者和36例健康人血清中的CEA、CA199、CA242含量。结果：大肠癌患者血清CEA、CA199、CA242含量明显高于健康对照组（P〈0．01），单项检测中CEA和CA242敏感性无差异，均显著高于CA199、CEA＋CA242联检和CEA＋CA199＋CA242联检，敏感性显著高于单项和CEA＋CA199联检及CA199＋CA242的联检，但特异性低于单项。在DukesA、B、C及D期部，血清CEA、CA199、CA242的含量及检测的敏感性依次增高，总体水平差异均有显著意义（P〈0．01或P〈0．05）。根治术后CEA、CA199、CA242的水平明显降低（P〈0．01）。结论：CEA、CA199、CA242可用于大肠癌的早期诊断、病情判断，联检可提高诊断效率。

Study on the Clinical Application of Combined Measurement of Serum Levels of CEA, CA199 and CA242 for the Diagnosis and Follow-Up of Patients with Cancer of Large Intestine

Objective To investigate the clinical significance(especially the diagnostic value) of determination of serum tumor markers CEA,CA199 and CA242 levels(individually or in combination) in patients with large intestine cancer.Methods Serum levels of CEA,CA199 and CA242 were determined with CLIA in 92 patients with cancer of large intestine and 36 controls.Results The serum levels of CEA,CA199 and CA242 in the patients were significantly higher than those in the controls(P<0.01).The sensitivity of either CEA or CA242 determination for large intestine cancer diagnosis was higher that of CA199 sensitivities of combined determination of CEA CA242 and CEA CA199 CA242 were both higher than those of any single item determination(but with lower speciticity as well as the other two combination forms,namely CEA CA199 and CA199 CA242.Serum levels and diagnostic sensitivitiy of all these three markers were significantly successively increased as the duke pathological grading of the lesion progressed(P<0.01 or P<0.05).After successful surgery,the levels of these markers decreased significantly(P<0.01).Conclusion Determination of serum CEA,CA199 and CA242 levels are valuable for the diagnosis and evaluation of patients with cancer of large intestine,and the diagnostic sensitivity can be enhanced with combined determinations.