血清NSE、CYFRA21-1、CEA联合检测对肺癌临床诊断的价值

[目的]探讨血清神经元特异性烯醇化酶(NSE)、细胞角蛋白19片(CYFRA21-1)、癌胚抗原(CEA)水平在各种病理类型肺癌诊断中的价值.[方法]测定68例肺癌(腺癌24例、鳞癌34例、小细胞癌10例)患者NSE、CYFRA21-1、CEA水平,并与16例肺结核、22例肺部感染患者比较.[结果] NSE、CYFRA21-1、CEA分别在小细胞肺癌组(SCLC)、鳞癌组、腺癌组中最高,NSE和CEA与其他组均有显著性差异(P＜0.01);CYFRA21-1在腺癌组其次,鳞癌组与腺癌组之间有差异((P＜0.05),与其他组相比有显著差异(P＜0.01),但腺癌组与其他组无差异(P＞0.05);单项检测中CYFRA21-1、CEA的敏感度及准确度均高于NSE(P＜0.01).三项联合检测敏感度最高,而两两联合、CYFRA21-1与CEA之间均无差异.三项联合和CYFRA21-1 CEA两两联合的准确度高于其他,NSE CYFRA21-1、NSE CEA两两联合、CYFRA21-1和CEA之间均无差异.不论单项还是联合检测特异度均无差异(P＜0.05).[结论]血清NSE、CYFRA21-1、CEA对肺癌诊断有较高的临床参考价值,并有助于肺癌的病理类型评估.三项联合检测可提高检测肺癌的敏感度和准确度,并不降低特异度,特别为临床无法做病理学检查的患者的诊断提供依据.     

CEA、NSE、CYFRA21-1联合检测在肺癌诊断中的价值

[目的]了解血清肿瘤标志物癌胚抗原(CEA)、神经元特异性烯醇化酶(NSE)和细胞角蛋白19片段(CYFRA21-1)在肺癌诊断中的应用价值.[方法]应用电化学发光技术测定58例肺癌患者,34例肺良性疾病患者和31例正常对照者血清CEA、NSE、CYFRA21-1水平.[结果]肺癌组CEA、NSE、CYFRA21-1水平明显高于肺良性疾病组和对照组(P<0.01).CEA、NSE、CYFRA21-1对肺癌的敏感度分别为51.7%、56.9%、55.2%.NSE对小细胞肺癌敏感度为82.6%,CYFRA21-1对肺鳞癌敏感度为83.3%.三者联合检测对肺癌敏感度为93.1%.[结论]血清CEA、NSE、CYFRA21-1联合检测对肺癌的诊断及分型有价值.     

CEA、CA125、pro-GRP及CYFRA21-1联合检测诊断肺癌的临床价值

目的 探讨血清癌胚抗原(CEA)、细胞角蛋白19片段抗原(CYFRA21-1)、胃泌素释放肽前体(pro-GRP)及糖类抗原125(CA125)在肺癌患者中的表达情况及其诊断学价值.方法 选取98例肺癌患者为肺癌组,选取30例肺部良性疾病患者为良性组,选取30例健康体检者为健康组,比较3组研究对象的血清CEA、CYFRA21-1、pro-GRP及CA125水平并进行分析.结果 肺癌组的血清CEA、CYFRA21-1、pro-GRP及CA125水平均明显高于良性组和健康组(P﹤0.01);Ⅰ～Ⅱ期肺癌患者血清中CEA、CYFRA21-1、pro-GRP及CA125阳性表达率均明显低于Ⅲ～Ⅳ期肺癌患者(P﹤0.01);血清CEA、CYFRA21-1、pro-GRP及CA125联合检测诊断肺癌的灵敏度、特异度、漏诊率、误诊率分别为82.65％、95.00％、17.35％、5.00％.结论 血清CEA、CYFRA21-1、pro-GRP及CA125联合检测诊断肺癌具有较高的灵敏度和特异度,可为临床诊断及治疗提供参考.     

肿瘤标志物联检在肺癌诊断中的意义

目的 探讨联合检测血清多项肿瘤标志物在肺癌诊断中的意义.方法 检测96例肺癌,46例良性肺病和58例健康人血清CEA、CA125、NSE和CYFRA21-1的水平.结果 肺癌组血清CEA、CA125、NSE和CYFRA21-1水平显著高于良性肺病组及健康对照组(P<0.01),肺腺癌血清CEA、CA125明显高于肺鳞癌和小细胞肺癌(P<0.05);小细胞肺癌血清NSE明显高于肺腺癌和肺鳞癌(P<0.01);肺鳞癌血清CYFRA21-1明显高于肺腺癌和小细胞肺癌(P<0.05);4项联合检测的灵敏性、准确性均高于单项检测结果.结论 联合检测患者血清CEA、CA1205、NSE和CYFRA21-1有利于肺癌的诊断.     

ECT联合肿瘤标志物检测诊断老年肺癌骨转移的临床观察

目的:探讨ECT(放射性核素骨显像)与肿瘤标志物CEA、NSE和CYFRA21-1联合检测在老年肺癌骨转移诊断中的临床价值。方法:对303例老年肺癌患者进行单光子发射计算机断层仪(SPECT)全身骨显像的同时,采用罗氏电化学发光免疫系统检测其血清CEA、CYFRA21-1、NSE肿瘤标志物水平;分析ECT联合CEA+NSE+CYFRA21-1检测和ECT诊断老年肺癌骨转移的敏感性、特异性、准确性方面的差异性。结果:ECT联合CEA+NSE+CYFRA21-1检测和ECT诊断老年肺癌骨转移的敏感性、特异性、准确性分别为88.9%(175/197)和65.5%(129/197)、97.2%(103/106)和86.8%(92/106)、91.7%(278/303)和72.9%(221/303),ECT联合CEA+NSE+CYFRA21-1检测优于单独ECT检查(P<0.01)。结论:核素骨显像与肿瘤标志物联合检测在老年肺癌骨转移诊断中有较高临床价值,值得临床推广应用。     

CEA、CYFRA21-1、CA125检测在肺癌诊断中的应用

[目的]探讨CEA、CYFRA21-1、CA125联合检测在肺癌诊断中的价值.[方法]采用电化学发光法检测肺部疾病患者血清中CEA、CYFRA21-1、CA125浓度水平.[结果]肺癌组血清CEA、CYFRA21-1、CA125水平均明显高于肺部良性病变组及正常对照组,经统计学分析差异显著.其中CEA、CA125以肺腺癌中最高,阳性率分别78.13％、65.63％;CYFRA21-1以肺鳞癌中最高,阳性率达51.9％.肿瘤患者单独检测以上肿瘤标志物阳性率较低(CEA28.00％,CYFRA21-1 36.80％,CA125 30.40％.而联合检测以上标志物阳性率则大大提高,肺癌的检测阳性率可达70.41％,肺鳞癌达64.56％,腺癌达87.50％,小细胞癌达63.64％.[结论]临床上适当选用多项血清肿瘤标志物联合检测有利于肺癌的早期诊断与鉴别诊断.     

联合检测血清CEA与CYFRA21-1在肺癌诊断中的应用

目的：探讨癌胚抗原（CEA）与细胞角蛋白19片段（CYFRA21-1）联合检测在肺癌诊断中的应用价值。方法：采用电化学发光方法检测116例肺癌患者与10例正常人血清中CEA与CYFRA21-1的水平。结果：肺癌患者血清中CEA与CYFRA21-1水平明显高于健康对照组（P〈0.05）;CEA与CYFRA21-1在肺癌中的检测率分别为41.2%与42.6%,二者联合检测敏感性与准确性均有明显提高;治疗后CEA与CYFRA21-1含量与治疗前相比显著降低（P〈0.05）。结论：CEA与CYFRA21-1联合检测可明显提高肺癌诊断阳性率,对临床诊断与疗效评价有一定的应用价值。     

血清CEA和CYFRA21-1检测与NSCLC临床诊断的相关性研究

目的: 研究血清CEA和CYFRA21-1与NSCLC临床诊断的相关性.方法: 采用电化学发光法对86例NSCLC患者和33例正常人的血清样本进行检测和分析.结果: NSCLC患者的CEA和CYFRA21-1浓度和阳性率高于正常人,二者有显著性差异(P<0.01).肺腺癌的CEA浓度高于肺鳞癌和大细胞肺癌(P<0.01),肺鳞癌的CYFRA21-1浓度高于肺腺癌和大细胞肺癌(P<0.01),CEA和CYFRA21-1联合检测对阳性率均有所提高.CEA和CYFRA21-1浓度随肿瘤分期的增加而升高.结论: 血清CEA和CYFRA21-1与NSCLC临床诊断具有明显相关性,可作为NSCLC患者临床诊断和肿瘤分期的判断指标之一.     

ROC曲线评价CEA、CYFRA21-1对非小细胞肺癌的诊断价值

目的:应用ROC曲线评价CEA、CYFRA21-1对局部晚期非小细胞肺癌(NSCLC)诊断的价值。方法:采用电化学发光法测定局部晚期非小细胞肺癌组、良性肺病组、正常对照组血清CEA、CYFRA21-1表达水平。应用ROC曲线对各指标的诊断效能进行分析和评价。结果:局部晚期非小细胞肺癌患者血清CEA和CYFRA21-1的浓度明显高于良性肺病组和健康体检组(P<0.05);局部晚期非小细胞肺癌患者血清CEA和CYFRA21-1的敏感性均明显高于良性肺病组和健康体检组(P<0.05)。二者联合检测的敏感性为74.11%,明显高于单项检测。CEA、CYFRA21-1的ROC曲线下面积分别为0.848、0.878。结论:CEA、CY-FRA21-1对非小细胞肺癌的诊断有一定的临床价值。二者联合可提高检测的敏感性。     

血清CEA、CYFRA21-1及TSGF在肺癌化疗前后的表达变化及意义

目的 探讨血清癌胚抗原(CEA)、细胞角蛋白19片段(CYFRA21-1)和肿瘤特异性生长因子(TSGF)在肺癌化疗前后的水平变化及疗效评估价值.方法 选取80例接受紫杉醇联合吉西他滨化疗的肺癌患者,应用电化学发光免疫分析技术和生化比色法,检测化疗前及化疗21天后患者血清中CEA、CYFRA 21-1和TSGF水平变化.结果 患者血清中CEA、CYFRA 21-1和TSGF的水平在紫杉醇联合吉西他滨化疗后显著降低,差异具有统计学意义(P<0.05).且患者血清中CEA、CYFRA 21-1和TSGF水平变化与紫杉醇联合吉西他滨的化疗疗效具有明显的统计相关性.结论 肺癌患者应用紫杉醇联合吉西他滨化疗可明显降低血清CEA、CYFRA 21-1和TSGF水平,说明CEA、CYFRA 21-1和TSGF在临床肺癌治疗效果的评估中具有重要的意义.     

Prostate-specific antigen

Prostate specific antigen (PSA) is serine protease produced at high concentrations by normal and malignant prostatic epithelium. It is mainly secreted into seminal fluid, where it digests the gel forming after ejaculation. Only minor amounts of PSA leak out into circulation from the normal prostate, but the release of PSA is increased in prostatic disease. Thus PSA is a sensitive serum marker for prostate cancer but its specificity is limited by a high frequency of falsely elevated values in men with benign prostatic hyperplasia (BPH). Approximately two-thirds of all elevated values (>4 microg/l) in men over 50 years of age are due to BPH. In serum, most of the PSA immunoreactivity consists of a complex between PSA and alpha1-antichymotrypsin (PSA-ACT) whereas approximately 5-40% are free. The proportion of PSA-ACT is larger and the free fraction is smaller in prostate cancer than in benign prostatic hyperplasia (BPH). Determination of the proportion of free PSA has become widely used to improve the cancer specificity of PSA especially in men with PSA values in the 'grey zone' (4-10 microg/l). PSA also occurs in complexes with other protease inhibitors and determination of these and other markers may further improve the diagnostic accuracy for prostate cancer. Interpretation of the results for many different markers is complicated, but this can be simplified by using statistical methods. The diagnostic accuracy can be further improved by using logistic regression or neural networks to estimate the combined impact of marker results and other findings like digital rectal examination (DRE), transrectal ultrasound (TRUS) and heredity.     

Prostate-specific antigen

Prostate-specific antigen (PSA) has revolutionized the diagnosis and management of men with prostate cancer. Significant advances have been made since the early development of immunoassays. While PSA is useful for staging and monitoring of established disease, it has shown the greatest utility in the realm of early detection realm. PSA is the most important tumor marker; its importance in evaluating men for the possibility of prostate cancer is irrefutable. Enhancing specificity is a pressing need. In this regard, the recognition of the molecular forms of free PSA and complex PSA have shown the most promise and undoubtedly will result in fewer false-positive PSA test results. The salient literature is reviewed and commentary made on the current status of PSA with particular emphasis on methods to enhance its specificity in early detection and applications.     

Breast epithelial antigen levels and breast tumor antigen content

The relationship between the primary tumor expression of a breast epithelial antigen, called non-penetrating glycoprotein (NPGP) or breast epithelial mucin, and the same patient's serum level of this antigen at the time of relapse was studied in 23 cases. The expression of NPGP on breast tumors was measured by immunoperoxidase staining using monoclonal antibody Mc5, and quantitated by a histopathological index created for this purpose. Serum levels were measured by a competitive RIA using the same monoclonal antibody. An inverse correlation between these parameters was found, such that tumors having high NPGP levels in serum had a low index, while low NPGP serum levels had a high index. These results show that cellular events in breast tumors could participate in determining NPGP serum levels in breast cancer.     

Immunological heterogeneity of carcinoembryonic antigen: purification from meconium of an antigen related to carcinoembryonic antigen

Two antigens cross-reactive with carcinoembryonic antigen (CEA) and distinct from the nonspecific cross-reacting antigen were identified in meconium by double immunodiffusion with a conventional goat anti-CEA antiserum. These two antigens together competitively inhibited cross-reacting antibodies against them in CEA radioimmunoassay and contributed to the measurement of meconium CEA levels which averaged 6 times higher than that determined with anti-CEA specific antibody. A purification method for one of these antigens, tentatively designated meconium antigen, is described and uses a combination of ethanol fractionation, ion-exchange and molecular sieve chromatography, and adsorption to an immunoadsorbent containing a cross-reactive murine monoclonal antibody to CEA. Preliminary characterization of the purified meconium antigen showed it to be a glycoprotein, migrating as an alpha-globulin and having a molecular size similar to that of CEA (Mr 185,000 versus 200,000). Antigenically, it lacks at least one determinant present on CEA and differs further from CEA by being weakly reactive with concanavalin A and resistant to proteolytic digestion with Pronase E. Although these properties of meconium antigen suggest that it may be nonspecific cross-reacting antigen 2, additional chemical and antigenic studies are required to establish its relationship to CEA and other CEA-related antigens in meconium.     

The prostate stem cell antigen represents a novel glioma-associated antigen

Gliomas of WHO grades III-IV are malignant brain tumors mostly resistant to conventional therapies. Therefore, novel strategies for the treatment of gliomas are warranted. Although immunotherapy is gaining increased attention for the treatment of malignant gliomas and in particular of glioblastoma multiforme (GBM), this approach requires the identification of appropriate antigens. Our aim was to investigate the expression of the prostate stem cell antigen (PSCA), a highly N-glycosylated phosphatidylinositol (GPI)-anchored cell surface protein, in gliomas of different WHO grades in order to evaluate its potential as a diagnostic marker and as a target for immunotherapy. Tumor specimens and controls were assessed by quantitative RT-PCR, Western blotting and immunohistochemistry. The samples investigated in the study consisted of 210 human glial tumors, among which 31 were oligodendrogliomas, 9 ependymomas and 170 were astrocytomas (including 134 glioblastomas). PSCA was absent in normal brain tissue, but was detected in WHO grade III-IV gliomas. Weak PSCA protein expression was also recognized in some WHO grade I and WHO grade II tumors. The difference between WHO grade I-II tumors and WHO grade III-IV tumors was statistically significant (p<0.001). Our results suggest that increased PSCA expression levels are linked to gliomas of WHO grades III and IV, and may represent a suitable additional target for immunotherapy of gliomas.     

Next-generation prostate-specific antigen test: precursor form of prostate-specific antigen

An urgent need exists to develop a more sophisticated screening system in order to improve diagnostic accuracy of clinically significant cancer and also to reduce the drawbacks of prostate-specific antigen (PSA) screening including overdetection and overtreatment. The most promising next-generation PSA test, which can improve the management of prostate cancer, may be proenzyme PSA (proPSA) or precursor PSA (pPSA). proPSA has pro-leader peptide sequences of seven or less amino acids and previous studies demonstrated that [?2]proPSA, which contains only a 2-amino-acid propeptide leader, could be more useful not only to distinguish between men with and without cancer, but also between tumors with aggressive features with performance exceeding other classical PSA-related indices including ratio of free PSA to total PSA (%f-PSA) and PSA density. Recently, it was demonstrated that baseline [?2]proPSA-related indices were independent factors to predict pathological reclassification at one year or several years after entering active surveillance. Furthermore, a retrospective study suggested that [?2]proPSA might be a useful predictive marker for future developing clinically manifested prostate cancer as well as aggressive tumors. ProPSA-related indices may have the potential for developing a more ideal risk classification for men at risk for prostate cancer, with a screening system maintaining the sensitivity of detecting clinically significant prostate cancer while saving cost, individualized treatment strategies, and follow-up procedures of active surveillance or active treatments. At a minimum, proPSA will be one of the most important new markers on the prostate cancer management in the near future.     

A monkey antigen crossreacting with carcinoembryonic antigen, CEA.

Normal monkey tissues were found to contain an antigen which crossreacts immunologically with the carcinoembryonic antigen (CEA) of the human digestive tract. The monkey antigen reacted with complete or partial identity to the normal crossreacting antigen (NCA) in humans when tested in immunodiffusion against anti-CEA or anti-NCA. Extracts of monkey tissues inhibited in radioimmunoassays measuring human NCA. It is possible that monkey foetuses and colonic tumours contain CEA.