医学检验信息网 检验医学 2007-2-26 16:16:51

关键词： 肿瘤标记；生物学；结肠直肠肿瘤；抗原；肿瘤相关；碳水化合物；癌胚抗原 【摘要】目的 探讨4种血清肿瘤标志在结直肠癌诊断、手术效果评价、转移复发监测中的应用价值；选择相关的血清肿瘤标志进行组合，以提高临床检测结直肠癌的敏感性、有效性。方法 应用快速微粒子捕捉双抗夹心酶免疫分析法测定癌胚抗原（CEA）、癌相关糖抗原（CA)19-9、应用生物素-链霉亲和素双抗夹心法测定CA72-4、CA 242。共测定29例健康成人及58例不同Dukes′分期结直肠癌患者血清，并对其中49例患者进行了术后3个月～2年随访检测。结果 健康人组CEA为(2.1±1.7) μg/L，CA19-9为(9.9±9.0)×10³ U/L，CA72-4为(4.6±2.1)×10³ U/L，CA242为(7.5±5.5)×10³ U/L。结直肠癌患者Ⅱ、Ⅲ、Ⅳ期4项血清肿瘤标志中任何一项均较健康人组有明显增高，差异有显著意义(P＜0.05)；其敏感性与病理分期程度相关。术前CEA为(34.2±78.7) μg/L，CA19-9为(209± 737)×10³ U/L，CA72-4为(7.2±4.8)×10³ U/L，CA242为(111±179)×10³U/L，术后4项肿瘤标志检测结果较术前明显下降（P＜0.05）；而当术后转移、复发时，明显增高，与术前差异无显著意义（P＞0.05）。4项血清肿瘤标志经组合后,第2、7、9、11种组合敏感性分别为62.1%、65.5%、67.2%、 69.0%，均显著高于任一单项敏感性（P＜0.05），4组皆包括CEA 和CA72-4；它们两者的联合中加入CA19-9和（或）CA242，可提高联合检测的敏感性及有效性，但差异无显著意义（P＞0.05），且特异性有所降低。结论 4项肿瘤标志对结直肠癌中晚期的诊断、监测术后疗效及是否转移、复发有意义。CEA、CA72-4二者可作为联合检测的结直肠癌首选标志。 Four tumor markers for diagnoing colorectal cancer

SUN Wei, WANG Qiong, LIU Juan, et al.

（Department of Clinical Laboratory Beijing Cancer Hospital, Beijing 100036, China）

【Abstract】Objectives To evaluate the application of four tumor markers in diagnosing colorectal cancer and use their appropriate combination to raise the sensitivity and validity in detecting the cancer.Methods CEA and CA19-9 were detected by microparticle enzyme immunoassay. CA72-4 and CA242 were detected by sandwich assay using streptavidin technology. 29 healthy adults and 58 patients with colorectal cancer (Dukes′ stage) were detected.Results In the healthy group, CEA, CA19-9, CA72-4 and CA242 were (2.1±1.7) μg/L, 9.9±9.0×10³ U/L, (4.6±2.1)×10³ U/L, (7.5±5.5)×10³ U/L, respectively. The level of the four tumor markers in patients with colorectal cancer (Dukes′ Ⅱ, Ⅲ, Ⅳ) was higher in the patients than in the healthy group (P＜0.05). Before operation, CEA, CA19-9, CA72-4, and CA242 were (34.2±78.7) μg/L, (209.5±736.8)×10³ U/L, (7.2±4.8)×10³ U/L, (110.6±179.0)×10³ U/L, respectively. After operation, a marked decrease in these values was observed (P＜0.05). The sensitivity of 2, 7, 9, 11 groups was 62.1%, 65.5%, 67.2%, and 69.0%, respectively. They were higher than those of the single tumor marker (P＜0.05).Conclusion The four tumor markers are of value in detecting colorectal cancer. Combined CEA and CA72-4 is more economic than others. 【Key words】 Colorectal neoplasms;Tumor markers biological;Carcinoembryonic antigen;Antigens,tumor-associated,carbohydrate 对于结直肠癌的辅助诊断和监测，常用的血清肿瘤生物学标志为癌胚抗原（CEA）、癌相关糖抗原（CA）19-9、CA72-4及CA242等。根据抗肿瘤单克隆抗体证实，血清肿瘤标志均为非特异的肿瘤相关抗原^［1］，其检测肿瘤的敏感性及特异性均有限。我们尝试将以上与结直肠癌有关的血清肿瘤标志进行手术前后测定及单项、双项、3项、4项联合测定并进行比较，目的在于对各肿瘤标志在结直肠癌中的应用价值进行评价，并选择较佳的血清肿瘤标志组合，以提高检测结直肠癌的敏感性。 材料和方法

一、检测对象

1.健康人组：29例健康成人，男15例，女14例，平均年龄50岁。

责任编辑: 参与评论