大肠癌血清CEA，CA19-9和CA242联合检测及其临床应用

 目的 评价CEA，CA19-9及CA242联合检测对大肠癌患者的临床诊断价值。方法 应用酶联免疫法对术前150例，其中术后70例大肠癌患者和200名健康人血清CEA，CA19-9及CA242含量进行测定。结果 大肠癌患者血清3项标志物含量明显高于健康人（均P＜0.01）；单项和联合检测的阳性率及特异性总体比较差异均有统计学意义（均P＜0.01）；其中CEA、CA242 检测的阳性率显著高于CA19-9， CEA+CA242与3项联合检测的阳性率均显著高于单项或其他两项联合检测的阳性率；CEA特异性高于CA242；3项联合检测的特异性明显低于单项检测。3个年龄段大肠癌患者CEA血清水平差异显著，年龄越大CEA水平越高（P＜0.05）。在Dukes 分期中，3项标志物含量及检测的阳性率依次增高（P＜0.05～0.01）。淋巴结转移患者的3项标志物含量及CA19-9，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。Dukes A+B期大肠癌术后3项标志物含量显著降低（P＜0.01），而C+D期改变不明显。结论 3项标志物的检测有助于大肠癌的临床辅助诊断，联合检测可以提高诊断的阳性率；3项标志物检测对大肠癌临床分期、淋巴结转移及肿瘤侵犯程度评估，尤其CA19-9和CA242比用于术前诊断更有意义，对指导临床医师合理手术有一定的帮助；术后检测有助于观察疗效，评价治疗效果。

Detection and clinical application of serum CEA, CA19-9 and CA242 in patients with colorectal can－cer

Objective To evaluate the clinical diagnosis and the clinical application value of serum CEA，CA19-9 and CA242 in patients with colorectal cancer. Methods The serum levels of CEA, CA19-9 and CA 242 were concomitantly determined by ELISA in 150 preoperative patients with colorectal cancer, and 200 healthy people as a control group. Results The levels of CEA, CA19-9 and CA242 in patients were higher significantly than that in controls (P <0.01 respectively); the sensitivity of CEA and CA242 for colorec－tal cancer were higher than that of CA19-9, and the combined sensitivity of CEA and CA242 or the three item were higher than that of single item or the other combined item. Between man and women with colorectal cancer, there was no significantly difference in the 3 serum tumor markers. The older of the colorectal cancer patients, the higher of the CEA levels. In the dukes A, B, C and D, serum levels and sensitivity of the three tumor markers significantly increased in order; in the cases with lymph node metastasis, the levels of the three tumor markers were significantly increased, and in the degree of infiltration, the levels were also signifi－cantly increased in order respectively. In dukes A and B, the levels of the 3 tumor markers were significantly lower after operation than that before operation, and in dukes C and D there were no significantly difference. Conclusion The combined use of the 3 markers can increase the diagnostic sensitivity for colorectal cancer, and it is helpful to evaluate lymph node metastasis, degree of infiltration, dukes staging and treatment effect in making clinical therapy.