【摘要】 目的 :探讨血清CA2 42检测在结直肠癌中的临床价值。方法 :用酶联免疫方法测定 5 7例结直肠癌、6 4例其他消化道肿瘤、10 8例消化道良性疾病病人及 36例健康对照者血清CA2 42。结果 :结直肠癌病人组血清CA2 42的含量 (4 2 .92± 38.81U·ml- 1 )和阳性率 (5 6 .14%)均显著高于其他消化道恶性肿瘤如胃癌、肝癌、食道癌(P <0 .0 1)、良性消化道疾病 (P <0 .0 0 1)及正常对照组 (P <0 .0 0 1)。且血清CA2 42对结直肠癌诊断的有效率、特异性、准确性、假阳性、假阴性、阳性结果预报价值和阴性结果预报价值分别为 43.6 %、77.9%、73.2 %、2 2 1%、43 8%、41 0 %和 86 6 %。若联合检查B超、ERCP、腹部螺旋CT和 或MRCP ,可排除胰腺、胆系肿瘤。结直肠癌组中DukesC—D期病人血清CA2 42的含量 (5 7.6 3± 48.91U·ml- 1 )和阳性率 (6 4.71%)显著高于DukesA—B期(2 6 16± 2 7 0 3U·ml- 1 ,2 1.73%,P <0 .0 5 )。血清CA2 42阳性和增高程度与结直肠癌Dukes分期呈正比。肿瘤部位、细胞分化程度与血清CA2 42无关。结直肠癌病人经手术治疗 ,血清CA2 42含量随时间推延明显降低 (P <0 .0 5 ) ;一旦复发和 或转移 ,可在腹部CT、钡剂灌肠或纤维肠镜阳性发现前测得血清CA2 42又复增高。结论 :血清CA2 42是一项对结直?更多还原

【Abstract】 Purpose:To evaluate the clinical value of serum CA242 as a marker for the diagnosis and prognosis of colorectal carcinoma. Methods:Serum CA242 level was determined serially by ELISA in 57 patients with colorectal carcinoma, 64 other gastrointestinal carcinomas, 108 benign digestive tract diseases and 36 healthy control group. In the patients with colorectal carcinoma, preoperative examinations include routine ultrasonography, CT-scan of the abdomen, barium enema roentgenography and fiberopic colonscopy, etc. Clinical courses with respect to the pathological data, surgical procedures employed and the prognosis of these patients were followed up and compared. Results:Average serum CA242 level (42.92 38.81 U ml -1 ) and its positive rate (56.14%) in patients with colorectal carcinoma were significantly higher than those in the other carcinomas of the gastrointestinal tract (P<0.01), in benign digestive tract diseases and in healthy control group, respectively. The effective rate, the specificity , the accuracy,false-positive rate,false-negative rate,positive finding predictive value and negative finding predictive value of serum CA242 for the diagnosis of colorectal carcinomas were 43.6%, 77.9%, 73.2%,22.1%,43.8%,41% and 86.6%,respectively. If combined examinations of CA242 with ultrasonography, CT-scan of the abdomen and/or MRCP were conducted; they might be helpful for differentiating from pancreatic carcinoma and bile duct cancer. Average serum CA242 level (57.63 48.91 U ml -1 ) and its positive rate (64.71%) in patients with colorectal carcinoma in Dukes C-D were significantly higher than those in Dukes A-B (26.16 27.03 U ml -1 , 21.73%, (P<0.01).There was significant relation between the serum CA19-9 levels and the staging of colorectal carcinoma, but no significant relations between the serum CA19-9 levels and the location, etc. Serum CA242 level decreased rapidly to the normal range after tumor resection, whereas a secondary elevation of the levels was observed before the loco regional recurrence and distant metastases of the disease after operation. Conclusions:Serum CA242 measurement may be of important value in the diagnosis of colorectal carcinoma, in the assessment of the stage of the disease and the treatment effect, in prediction of the prognosis of the patients after resection and in monitoring the metastases and recurrence of the disease.更多还原