大肠癌患者血清肿瘤标志物含量测定与临床研究

目的评价血清肿瘤标志物(CEA、CA199和CA242)单项或多项联合检测对大肠癌患者的临床诊断价值,探讨其在病理分期、淋巴结转移、侵袭程度及肿瘤大体形态等临床特征方面的意义。方法应用酶联免疫法检测134例大肠癌患者和200名健康人血清中CEA、CA199和CA242含量。结果大肠癌患者血清3种肿瘤标志物含量明显高于健康人(均P<0.01);单项检测中,CEA和CA242的阳性率无差异,但均显著高于CA199;CEA+CA242联合检测和CEA+CA242+CA199联合检测的阳性率显著高于单项和CEA+CA199的联合及CA199+CA242的联合,但特异性低于单项检测。在dukesA、B、C及D期中,3项肿瘤标志物含量及检测的阳性率依次增高,总体水平差异均有统计学意义(P<0.05～0.01);淋巴结转移患者的3项标志物含量及CA199、CA242的阳性率均高于无淋巴结转移的患者;3项标志物含量随肿瘤侵袭程度的加深显著增高,但在组织病理分类和肿瘤大体形态中均无明显的差异。结论CEA、CA199及CA242肿瘤标志物联合检测可以提高大肠癌诊断的敏感度,并对临床分期、判断淋巴结转移、肿瘤侵袭程度、进而进行有效临床治疗,具有一定的指导意义。

Detection and clinical study of serum tumor markers in patients with colorectal cancer

Objective To investigate the diagnostic value and clinical significance of serum tumor markers CEA, CA19-9 and CA242 in patients with colorectal cancer. Methods The serum levels of CEA, CA19-9 and CA242 were determined by ELISA before surgery in 134 patients with colorectal cancer and in 200 healthy people as a control. Results The CEA, CA19-9 and CA242 levels in patients were significantly higher than those in controls (P<0.01, respectively). The sensitivity of CEA and CA242 for colorectal cancer diagnosis was higher than that of CA19-9, and the combined sensitivity of CEA+CA242 and CEA+CA242+CA19-9 were higher than that of single item or the other two combinations (CEA+CA19-9 and CA19-9+CA242). In Dukes stages A, B, C and D, serum levels and sensitivity of the three tumor markers were significantly and successively increased. In the cases with lymph node metastasis,levels of the three tumor markers were significantly increased. The markers levels were also significantly and successively increased along with the extent of cancer infiltration. ConclusionThe results indicate that the combined use of CEA and CA242 or the three markers is an useful adjuvant diagnostic measure for colorectal cancer, and is helpful in the evaluation of lymph node metastasis, degree of invasion and Dukes staging in cancer treatment.