肿瘤标记物在FOLFIRI方案治疗晚期结直肠癌疗效评价中的意义

目的探讨血清肿瘤标记物在FOLFIRI方案治疗晚期结直肠癌患者疗效评价中的意义。方法对50例确诊的晚期结直肠癌患者,采用FOLFIRI方案治疗,观察治疗前后患者血清肿瘤标记物TPS、CEA、CA199和CA242的动态变化和近期疗效。结果血清肿瘤标记物CEA、CA242和TPS水平RR组(CR PR)化疗后显著减低(P<0.05),其中TPS降低最早,CEA则在治疗6～8周后才出现变化;4种肿瘤标记物评价与临床疗效评价的总一致性比较差异不显著(P>0.05);临床客观评价病情进展和有效率时(PD RR)符合率比较有显著性差异(P<0.05)。联合检测TPS、CEA和CA2423个指标,则总符合率为85.9%。结论TPS、CEA和CA242联合检测,对采用FOLFIRI方案治疗晚期结直肠癌患者的疗效评价有重要意义。     

部分肿瘤标志物与晚期结直肠癌疗效关系的临床观察

目的擦讨CA19-9、CEA、CA242、CA125和CA153等5种肿瘤标记物水平与晚期结肠癌化疗疗效的关系及其临床意义。方法采用自身对照法，前瞻性监测接受FOLFOX4方案的联合化疗的结直肠癌减瘤术后42例患者的CA19-9、CEA、CA242、CA125和CA153等肿瘤标记物。化疗均为1疗程／月，共6疗程。在第1次化疗前，化疗结束时和化疗结束后6个月监测，共3次。化疗结束时按WHO疗效评估标准评估分组。全部结果由SPSS10．0统计软件分析处理。结果CA19-9、CA242、CA125和CEA在化疗结束时有明显下降（幅度在30％-55％，P〈0．01）；化疗获益组的此4项标记物明显低于化疗未获益组（P〈0．01）；CA19-9、CA242和CEA化疗结束后6个月时又趋明显上升，其中CA19-9、CA242明显高于化疗前的水平（P〈0．01），CEA与化疗前的水平相当，CA125升高并不明显（P〉0．05）；CA153在整个观察期变化不显著，化疗获益组的CA153未显著低于化疗未获益组（均P〉0．05）。结论CA19-9、CEA、CA242、CA125是结直肠癌的诊断和疗效判断有效指标；CEA、CA19-9和CA242可作为结直肠癌的病情监测的有效指标；CA153对结直肠癌的疗效与病情监测价值不大。     

血清肿瘤标志物CEA、CA19-9对结直肠癌的诊断价值

目的 分析血清肿瘤标志物CEA、CA19-9单项或联合检测对结直肠癌患者的临床诊断价值,探讨其在病理分期、淋巴结转移等临床特征方面的意义.方法 酶联免疫法检测160例健康人和158例结直肠癌患者术前两天以及术后两周血清中CEA、CA19-9含量.结果 结直肠癌患者2种血清肿瘤标志物含量明显高于健康人(P<0.01),术前与术后2种血清肿瘤标志物水平比较差异有统计学意义(P<0.05).CEA、CA19-9联合检测敏感度和特异度明显高于各单项检测值.在Dukes A、B、C及D期中,2种肿瘤标志物含量及检测阳性率依次增高,淋巴结转移患者的CA19-9含量高于无淋巴结转移患者(P<0.05).结论 肿瘤标志物CEA、CA19-9联合检测可以提高结直肠癌诊断的敏感度和特异度,并对临床分期、判断淋巴结转移、预测预后及监测复发有一定的指导意义.     

结直肠癌患者血清UGT1 A8、CA19-9、CEA联合检测对早期临床诊断的指导价值

目的:探讨血清CA19-9、CEA、UGT联合检测对消化道肿瘤结肠癌的诊断价值及其临床意义.方法:取患者清晨空腹外周静脉血,分离血清,用化学发光法检测肿瘤标记物CEA,CA19-9酶联免疫法检测UGT1 A8.结果:结l直肠癌患者血清CEA检测值明显升高,与正常对照组相比有显著差异,P＜0.Ol,CA19-9检测值也升高,与正常对照组相比也有明显差异,P＜0.05,而结肠癌患者血清UGT1 A8检测水平却明显降低,P＜0.01.结论:UGTIA8、CEA和CA19-9联合检测可提高肿瘤诊断的准确率.     

血清CA199与CEA检测对结直肠癌的诊断价值

目的:研究肿瘤相关糖类抗原199(CA199)与癌胚抗原(CEA)检测对结直肠癌的诊断价值.方法:采用电化学发光方法检测44例结直肠癌患者与19例正常人血清中CA199与CEA的水平并进行统计学分析.结果:结直肠癌患者血清中CA199和CEA水平明显高于正常对照组良性对照组(P＜0.05);治疗后CA199与CEA含量与治疗前相比显著降低(P＜0.05).结论:CA199与CEA检测结对结直肠癌临床诊断与疗效评价有一定的意义.     

血清CRP、CA72-4水平变化与结直肠癌发生发展的关系

目的 探讨C反应蛋白(CRP)、肿瘤上皮来源相关抗原(CA72-4)水平与结直肠癌发生发展的关系.方法 选取250例结直肠癌患者为结直肠癌组,选取250例结肠息肉患者为结肠息肉组,对两组患者的临床资料进行回顾性分析.观察比较两组患者的血清CRP、CA72-4水平,并对不同临床病理特征结直肠癌患者的CRP、CA72-4水平进行比较,分析影响结直肠癌患者血清CRP、CA72-4水平的因素.结果 结直肠癌组患者的血清血清CRP、CA72-4水平均明显高于结肠息肉组(P﹤0.001);年龄≥65岁、有淋巴结转移、组织学分型为管腺癌、TNM分期为Ⅲ~Ⅳ期、肿瘤直径≥5 cm的结直肠癌患者的血清CRP、CA72-4水平均明显高于年龄﹤65岁、无淋巴结转移、组织学分型为黏液腺癌、TNM分期为Ⅰ~Ⅱ期、肿瘤直径﹤5 cm的患者(P﹤0.001);淋巴结转移、TNM分期是影响结直肠癌患者血清CRP、CA72-4水平的因素.结论 结直肠癌患者的血清CRP、CA72-4水平较高,且与患者的淋巴结转移情况和TNM分期密切相关.     

结直肠癌患者血清肿瘤标志物水平与临床病理学特征的关系

目的探讨结直肠癌患者手术前血清中肿瘤标志物CEA、CA199、CA242与临床生理病理特征的关系.方法EUsA法检测602例结直肠癌患者血清中CEA、CAl99、CA242水平.结果1)结直肠癌患者血清中CEA、CA199、CA242水平与性别、年龄、病理类型之间均无密切关系.2)结肠癌患者血清中CEA水平(23.29±7.64)ug/ml、CA199水平(43.11±6.85)U/ml和CA242水平(40.27±6.13)U/ml明显高于直肠癌患者(11.13±1.99)ug/ml、(34.43±3.36)U/ml、(26.06±2.29)U/ml,均P＜0.001.3)淋巴结转移的结直肠癌患者CAl99水平(47.10±5.04)U/ml和CA242水平(37.70±3.89)U/ml高于无淋巴结转移者(22.38±2.57)U/m1、(18.99±2.15)U/ml均P＜0.001.4)远隔脏器转移的结直肠癌患者CEA水平(30.72±3.61)ug/ml、CAl99水平(92.22±12.20)U/ml、CA242水平(68.08±7.85)U/ml高于无转移者(9.83±1.62)ug/ml、(26.95±2.27)U/ml、(21.80±1.80)U/ml,均P＜0.001.5)Duck's分期不同,结直肠癌患者CEA、CA199、CA242水平也有差异.随着期别的变化,CEA、CAl99、CA242水平也明显升高,P＜0.005～＜0.001.6)浸润程度不同,CEA、CA199、CA242水平存在差异.浸全层达浆膜外的患者CEA、CA199、CA24水平明显高于浸全层、浸深肌层和浸浅肌层的患者,P＜0.05～＜0.005;而三者之间无统计学差异.7)CEA与生长类型无密切相关.只有浸润型的患者,血清中CA199、CA242水平明显高于溃疡型、蕈伞型和缩管型,P＜0.05～＜0.01.8)肿瘤大小与血清中CEA水平无关;随着肿瘤体积的增大,血清中CA199、CA242水平明显升高.P＜0.002～＜0.001.9)结直肠癌患者血清中CEA与CA199、CA242之间存在正相关(分别为r=0.189,r=0.194),P＜0.01;CA199与CA242之间的相关系数r=0.884,P＜0.001.结论1)结直肠患者血清中CEA、CA199、CA242水平与肿瘤的部位和远处转移存在密切相关2)血清中CA199、CA242水平与结直肠癌患者的各种生理及病理特征存在更加密切关系;3)血清中CEA、CA199、CA242存在正相关,是监测结直肠癌患者病情的最佳组合.     

CA125联合 CA19－9、CEA、CA72－4检测在上皮性卵巢癌诊断中的意义

目的：阐明联合检测糖类抗原（CA125、CA19－9、CA72－4）与癌胚抗原（CEA）在上皮性卵巢癌中的诊断意义。方法：对81例上皮性卵巢癌患者,81例良性卵巢肿瘤患者以及作为对照的80例健康体检者血清中的 CA125、CA19－9、CA72－4与 CEA 进行检测。采用 ROC 曲线及 AUC、Logistic 回归分析评估上述血清标记物对上皮性卵巢癌的诊断意义。结果：卵巢癌患者血清肿瘤标记物 CA125、CA19－9、CA72－4的水平与阳性率明显高于良性卵巢肿瘤以及对照组健康体检者（P ＜0．05）。ROC 曲线显示 CA125、CA19－9、CEA 与CA72－4曲线下面积分别为0．904±0．025、0．670±0．042、0．497±0．046 and 0．821±0．033。联合检测上述肿瘤标记物显示最高的敏感性（91．4％）与较好的特异性（83．9％）。与其他单一肿瘤标记物相比,CA125显示最高的敏感性与较好的特异性。结论：联合检测 CA125、CA19－9、CEA 与 CA72－4可以提高上皮性卵巢癌早期诊断的敏感性与准确性。     

血清肿瘤标志物对结直肠癌诊断的评价

癌胚抗原(CEA)、癌相关糖抗原(CA19-9)和(CA-50)血清标志物均为非特异的肿瘤相关抗原。近年来肿瘤相关标志物已广泛应用于肿瘤临床诊断，但各报道结果并非一致，我们对我院部分手术治疗的结、直肠癌患者术前血清CEA、CA19-9、CA-50、甲胎蛋白(AFP)和血清铁蛋白(SF)的联合检测结果进……     

肠镜联合血清肿瘤标志物检测对结直肠癌的诊断价值分析

目的 分析肠镜联合血清肿瘤标志物检测对结直肠癌的诊断价值.方法 将103例结直肠癌患者纳入恶性组,以同期收治的103例结直肠良性病变患者作为良性组,比较两组患者血清肿瘤标志物[糖类抗原72-4(CA72-4)、糖类抗原19-9(CA19-9)、癌胚抗原(CEA)]水平,全部患者均接受肠镜检查;以病理检查结果为金标准,采用受试者工作特征(ROC)曲线分析肠镜、血清肿瘤标志物单独及联合检测对结直肠癌的诊断价值,分析各项检测方法诊断结果与金标准的一致性,计算诊断效能.结果 恶性组患者血清CA19-9、CEA、CA72-4水平均明显高于良性组,差异均有统计学意义(P﹤0.01).肠镜与血清肿瘤标志物联合诊断结直肠癌的各项诊断效能均高于各项单独应用,灵敏度为89.32％,特异度为99.03％,准确度为94.17％;各项诊断结果与金标准的一致性均为良(0.6﹤Kappa值≤0.8,P﹤0.01).肠镜具有中等诊断价值[曲线下面积(AUC)=0.883,P﹤0.01];3项血清肿瘤标志物均具有中等诊断价值,其中CA19-9最高(AUC=0.854,P﹤0.01);肠镜与血清肿瘤标志物联合应用具有较高的诊断价值(AUC=0.942,P﹤0.01).结论 肠镜联合血清肿瘤标志物检测对结直肠癌具有较高的诊断价值.     

Hyperthermia-induced shedding and masking of melanoma-associated antigen

Hyperthermia has been reported to induce a dose-dependent reduction in the expression of melanoma-associated surface antigens. The objective of the present work was to study the mechanisms for the reduction in the expression of the p250 antigen recognized by the monoclonal antibody 9.2.27. Measurements at 37°C showed that antibody binding induced a certain degree of modulation (internalization) of the melanoma-associated antigen. Masking of the antigen due to internalization and/or damage in situ, as well as shedding of the antigen, were measured after hyperthermia, and found to increase in a heat-dose-dependent manner, although for antigen masked this increase was not significant compared with control cells at 37°C. The sum of antigen shed and masked after hyperthermia correlated with the overall reduction in antigen expression measured independently. During hyperthermia, antigen was shed and masked in approximately equal amounts. After the treatment, hyperthermia-induced shedding continued as a function of time and caused a further reduction in antigen expression, but masking did not differ from 37°C controls.     

恶性肿瘤患者血清结肠癌抗原和癌胚抗原的检测

采用酶联免疫双抗体夹心法检测１８６例恶性肿瘤患者血清结肠癌抗原（ＣＣＡ）和癌胚抗原（ＣＥＡ）。结果表明，ＣＣＡ除了在结肠癌有较高阳性检测率外，在其它消化道肿瘤、肺癌、乳癌、鼻咽癌等常见恶性肿瘤也有较高水平表达。将ＣＣＡ与ＣＥＡ联合应用检测恶性肿瘤，可明显提高检出率     

The Significance of PSA Modified Parameters （F/T）/ PSAD for Diagnosing Prostatic Cancer in the Grey Zone of 4-10 ng/ml

OBJECTIVE To investigate the diagnostic value of modified prostate specific antigen(PSA)parameters in the diagnosis of prostate cancer(PCA) when the serum PSAis in a grey zone of 4~10 ng/ml. METHODS The results of serum PSA determinations of the patients receiving a transrectal ultrasound-guided multiphase prostatic biopsy,were retrospectively analyzed.In the 88 patients with a serum PSA value of 4-10 ng/ml,the final diagnosis of PCA was made in 21,and that of benign prostate hyperplasia(BPH)in 67 patients.The percentage of the free-serum PSA([FPSA]/total-serum PSA[TPSA],F/T),PSA density(PSAD)and the sensitivity and specificity of the new PSA modified parameter(F/T)/PSAD in diagnosing PCA,within a set threshold value,was compared. RESULTS In the 88 patients with serum PSA in the grey zone of 4.0-10.0 ng/ml,there was no significant difference in comparing the TPSA between the 21 PCA patients and 67 BPH patients(P>0.05).However, there was a significant difference in the value of modified PSA parameters, such as F/T,PSAD and(F/T)/PSAD,between the PCA and the BPH groups (P<0.001).As the cut off point-value of the F/T,PSAD and(F/T)/PSAD was set at 0.16,0.15 and 0.8,the diagnostic sensitivity for PCA was 66.7%, 76.2%and 85.7%,and the specificity was 41.8%,43.3%and 68.7%,respectively.There was no significant difference in the sensitivity comparing the modified parameters for diagnosing PCA(P>0.05),whereas an overt predominance was present in the specificity of(F/T)/PSAD for PCAdiagnosis (P<0.05). CONCLUSION In the serum PSA grey zone of 4-10 ng/ml,a modified PSA parameter can improve the PCA diagnostic accuracy rate.With a considerably high sensitivity,application of the(F/T)/PSAD may effectively enhance the diagnostic specificity,which is superior to the F/T and PSAD, and can be expected to be one of the new indices derived from the PSA.     

A new case of signet ring cell carcinoma of the prostate

Primary signet ring cell carcinoma of the prostate is a very rare variant of prostate cancer. Herein, we report a new case of primary signet ring cell carcinoma of the prostate in an 85-year-old man with voiding disorder and hematuria. Based on this case, we present the anatomopathologic, clinical, and therapeutic aspects of this rare entity.     

血清糖类抗原及癌胚抗原联合检测在恶性肿瘤诊断中的价值

目的探讨血清糖类抗原及癌胚抗原(CEA)联合检测在恶性肿瘤诊断中的价值,以期为恶性肿瘤的早期诊断提供更可靠的依据。方法选取毕节市中医院2010年3月至2014年3月间收治的恶性肿瘤患者90例,其中直肠癌患者30例,肝癌30例,胰腺癌30例,并选择同期健康体检者40例作为对照,分析癌胚抗原(CEA)以及血清糖类抗原(CA125、CA19-9)在各人群、各类型肿瘤中表达情况。结果在恶性肿瘤患者中,CEA、CA125、CA19-9表达升高的比例显著高于健康体检者,差异有统计学意义(P<0.05);各类型肿瘤中,直肠癌中CEA升高明显高于胰腺癌和肝癌,差异有统计学意义(P<0.05);胰腺癌中CA125、CA19-9升高率明显高于肝癌和直肠癌,差异有统计学意义(P<0.05);CEA、CA125、CA19-9联合检测率直肠癌为96.7%、肝癌为90.0%、胰腺癌为93.3%,明显高于各组的单项检测率,三项联合检测率与单个检查率相比,差异具有统计学意义(P<0.05)。结论联合检测肿瘤标志物CEA、CA125、CA19-9可显著提高胰腺癌、肝癌、直肠癌等恶性肿瘤诊断的敏感性,为临床治疗提供依据。     

f/T-PSA比值和PSA密度对TPSA灰区前列腺癌的诊断意义

目的探讨游离前列腺特异抗原/总前列腺特异抗原(fPSA/TPSA,f/T)比值和TPSA灰区前列腺特异抗原密度(PSAD)(4.0~10.0ng/m l)对诊断前列腺癌的临床意义。方法回顾性分析TPSA在灰区的38例前列腺癌和56例良性前列腺增生症血清PSA相关检测结果,将两组患者f/T比值和PSAD值进行对比分析。结果两组患者TPSA值无显著性差异(P=0.337);f/T比值(P=0.001)和PSAD值(P=0.012)有显著性差异。f/T比值在前列腺癌患者中较低,而PSAD值较高。当f/T比值和PSAD分别以0.15和0.16作为临界值时,其诊断前列腺癌的灵敏度和特异度分别为81.6%和75.0%、65.8%和57.1%。结论f/T比值和PSAD对TPSA灰区的前列腺癌的诊断有重要的临床意义。     

Tumor markers carcinoembryonic antigen, tissue polypeptide antigen, and carbohydrate antigen 19/9 in liver diseases

The tumor markers carcinoembryonic antigen (CEA), tissue polypeptide antigen (TPA), and carbohydrate antigen 19/9 (CA19/9) have been compared with regard to their sensitivity to liver diseases. All three markers have been found to be sensitive to liver diseases, but to a different degree: TPA rises the most; CEA the least. The sensitivities of TPA and CA19/9 are higher in a group of liver diseases than, for comparison, in a group of colorectal carcinomas.     

PSA,PSAD,fPSA在前列腺癌诊断中的应用

目的：测定１６例前列腺癌（ＰＣａ）和３３例前列腺增生（ＢＰＨ）患者血清前列腺特异性抗原（ＰＳＡ）,前列腺特异抗原密度（ＰＳＡＤ）及游离前列腺特异抗原（ｆＰＳＡ）。方法：采用放射免疫法。结果：显示ＰＳＡＤ对ＰＣａ诊断敏感度高而特异阳性预测值低,而ＰＳＡＤ及ｆＰＳＡ／ｔＰＳＡ比值（即参数百分率）是提高ＰＣａ和ＢＰＨ鉴别诊断阳性率的一种较好指标。结论：本实验结果在实际临床应用中有重要意义。