肿瘤标志物CA242与CA19-9在大肠癌中的临床意义

目的:评价肿瘤标志物CA242与CA19-9在大肠癌诊断、治疗和预后中的临床意义。方法:应用酶联免疫吸附(ELISA)法检测35例大肠癌和204例非癌患者血清CA242与CA19-9的含量。结果:大肠癌患者血清CA242与CA19-9的含量(99.5±112.41U/mL和46.23±70.82U/mL)明显高于非癌患者(9.63±15.50U/mL和8.40±22.02U/mL)(P<0.01)。血清CA242对大肠癌诊断的敏感性、特异性和准确性分别为60％、96.57％和91.21％,血清CA19-9分别为31.43％、95.59％和86.19％。CA242与CA19-9比较,敏感性二者差异有显著性(P<0.01),特异性和准确性差异无显著性(P>0.05)。联合检测CA242与CA19-9的敏感性为68.57％(24/35),明显高于单独检测CA19-9的敏感性(31.43％)(P<0.01),略高于单独检测CA242的敏感性(P>0.05)。CA242与CA19-9对结肠癌诊断的敏感性为64.71％和41.18％,高于对直肠癌诊断的敏感性55.55％和22.22％(P>0.05)。大肠癌中血清CA242正常的患者治疗有效率为57.14％,CA242升高的有效率为14.29％(P<0.01)。CA19-9正常的患者治疗有效率为33.33％,CA19-9升高的有效率为 27.27％(P>0.05)。随访 3～14个月,CA242和 CA19-9升高与正常的大肠癌患者的生存期均为 2～14个月。中位生存期:CA242正常患者为9个月,CA242升高患者为6.5个月;CA19-9正常患?

Clinical Significance of CA242 and CA19-9 in Colorectal Cancer

Objective:To investigate the clinical value of CA242 and CA19-9(tumor marker) in the diagnosis,treatment and prognosis of colorectal cancer. Methods: Serum levels of CA242 andCA19-9 in 35 cases with colorectal cancer and 204 cases without cancer were examined by enzyme linked immunosorbent assay (ELISA) . Results: Serum levels of CA242 and CA19-9 were significantly higher in the patients with colorectal cancer than that without (99.51±112.41U/mL vs 9.63± 15.50U/mL and 46.23±70.82U/ mL vs 8.42 ± 22.02U/mL) , respectively(P < 0.01) . The diagnostic sensitivity,specificity and accuracy of serum CA242 and CA19-9 were 60%, 96.57% and 91.21% vs 31.43%,95.59% and 86.19% .respectively. CA242 was more sensitive than CA19-9 in the diagnosis of colorectal cancer, but the difference in specificity and accuracy was not marked. The sensitivity of examination of CA242 and CA19-9 jointly was higher than singly (68.57% vs 31.43%). The sensitivity of CA242 and CA19-9 was higher in the diagnosis of colon cancer (64.71% and 41. 18%)than rectal cancer (55.55%and 22.22%). For the patients accompanied by serum CA242 level elevated or not , the therapeutic responses were 14.29% and 57.14% respectively ( P > 0.05),and the median survival was 6.5 months and 9 months. For the patients accompanied by serum CA19-9 level elevated or not, the therapeutic responses were 27.27% and 33.33% respectively (P> 0.05), and the median survival was 6.5 months and 7 months. Conclusion: CA242 and CA19-9 are useful serum tumor markers for the diagnosis of colorectal cancer. Examination of serum CA242 and CA19-9 jointly helps improve the diagnostic sensitivity, evaluate therapeutic effects and prognosis, and follow the patient' s condition of colorectal