【摘要】 目的 :观察大肠癌患者血清肿瘤标记物的表达 ,探讨其在大肠癌诊断、手术疗效评价和术后转移复发监测中的临床价值 ,选择适宜的血清肿瘤标记物进行联合检测 ,提高检测的敏感性、特异性。方法 :应用免疫放射分析法测定 88例大肠癌患者和 4 0例大肠良性疾病患者的 AFP、 CEA、 CA5 0、 CA15 - 3、 CA19- 9、 CA 72 - 4、 CA12 5、 CA2 4 2等 8项血清肿瘤标记物 ,并对大肠癌患者进行术后 2年的随访。结果 :8种血清肿瘤标记物中 CEA、 CA5 0、 CA19- 9、 CA12 5和 CA 2 4 2等 5项在大肠癌组水平较对照组明显升高 ,存在非常显著差异 (P <0 .0 1)。 CEA的灵敏度 (6 7.2 % )和特异度 (80 .4 % )最高。采用 5项平行检测法 ,可以提高检测的敏感度 (89.7% )和阴性预测值 (85 .9% ) ;采用系列检测 ,可提高检测的特异度 (91.5 % )和阳性预测值 (74 .1% )。 5项血清肿瘤标记物水平在 、 期病例较 、 期病例明显增高 (P <0 .0 5 ) ;在有淋巴结转移 ,有远处转移或有腹水的病例明显增高 (P <0 .0 5 ) ;血清 CA 5 0和 CA2 4 2的水平与大肠癌肿瘤大小有关 ;CEA和 CA 2 4 2水平在低分化腺癌和未分化癌病例中较高中分化腺癌和黏液腺癌明显增高 (P <0 .0 5 )。复发转移组病例 5种血清肿瘤标记物水平明显升高 (P <0 .0 5 )更多还原

【Abstract】 Objective:To observe the application of serum tumor markers in diagnosis and prognosis of colorectal carcinoma and to use appropriate combination to raise the sensitivity,specificity and validity in diagnosis.Methods:8 kinds of serum tumor markers including AFP,CEP,CA50,CA15 3,CA19 9,CA72 4,CA125 and CA242 were detected in 88 patients with colorectal carcinoma b IRMA and in 40 patients with benign colorectal diseases.And the patients with colorectal cancer were followed up for 2 years.Results:Among 8 kinds of serum tumor markers,CEA,CA50,CA19 9,CA125 and CA242 were valuable in diagnosis of colorectal carcinoma (P=0.01).The most sensitive and specific marker was CEA(67.2%,80.4%) and the rest were CA242,CA50,CA19 9 and CA125.The simultaneously combined assay raised sensitivity (89.7%),and the serial combined assay raised specificity(91.5%).The levels of 5 kinds of tumor markers were higher in cases of phases of Ⅳ and Ⅲ than in those of Ⅰ and Ⅱ;and higher in lymph node metastasised cases,distant metastasis cases and ascites cases(P<0 05).The level of CA50 and CA242 were related to the diameter of the tumors(P<0 05).The level of CEA and CA242 were higher in cases of low differentiated adenocarcinoma and undifferentiated carcinoma than in cases of high differentiated and middle differentiated adenocarcinoma and mucus adenocarcinoma(P<0 05).The levels of 5 kinds of tumor markers were higher in cases of metastasis and recurrence in 2 years of followed operation.Conclusion:The levels of CEA,CA50,CA19 9,CA125 and CA242 are of value in diagnosis,and can also be used to evaluate treatment effect and to monitor recurrence of metastasis in colorectal cancinoma.The combined assay can raise sensitivity,specificity and validity in diagnosis.更多还原