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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 2 4 2。共测定 2 9例健康成人及 5 8例不同Dukes′分期结直肠癌患者血清 ,并对其中 4 9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 )× 10 3U/L ,CA72 4为 ( 4 .6± 2 .1)× 10 3U/L ,CA2 4 2为 ( 7.5± 5 .5 )× 10 3U/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 .0 5 ) ;其敏感性与病理分期程度相关。术前CEA为 ( 3 4.2± 78.7) μg/L ,CA19 9为 ( 2 0 9± 73 7)×10 3U/L ,CA72 4为 ( 7.2± 4 .8)× 10 3U/L ,CA2 4 2为 ( 111± 179)× 10 3U/L ,术后 4项肿瘤标志检测结果较术前明显下降 (P <0 .0 5 ) ;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 .0 5 )。 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 %?
Objective To investigate the application value of four serum tumor markers in the diagnosis of colorectal cancer, evaluation of surgical outcomes, monitoring of metastases and recurrences, and to select relevant serum tumor markers to improve the sensitivity and effectiveness of clinical detection of colorectal cancer. METHODS: Carcinoembryonic antigen (CEA), cancer-associated carbohydrate antigen (CA) 19 9 were detected by rapid microparticle capture double-antibody sandwich enzyme immunoassay, and CA72 4 and CA 2 4 2 were detected by biotin-streptavidin double-antibody sandwich assay. . A total of 29 healthy adults and 58 patients with different Dukes’ stages of colorectal cancer were examined. Among them, 49 patients were followed up for 3 months to 2 years. Results The CEA in the healthy group was (2.1 ± 1.7) μg/L, the CA19 9 was (9.9 ± 9.0) × 10 3 U/L, and the CA72 4 was (4.6 ± 2.1) × 10 3 U/L. 4 2 is (7.5±5.5)×10 3U/L. Any of the four serum tumor markers in stage II, III, and IV of colorectal cancer were significantly higher than those in the healthy group (P < 0.05), and the sensitivity was related to the degree of pathological stage. The preoperative CEA was (3 4.2±78.7) μg/L, the CA19 9 was (2 0 9± 73 7)×10 3 U/L, and the CA72 4 was (7.2±4.8.)10 3 U/L. CA2 4 2 At (111±179)×10 3U/L, the results of four tumor markers after surgery were significantly lower than before surgery (P < 0.05), and when the metastasis and recurrence were significantly higher, they were significantly different from preoperative differences. No significant significance (P > 0.05). After 4 serum tumor markers were combined, the sensitivity of the second, seventh, 9th, and 11th combinations was 62.1%, 65.5%, and 67.2%, respectively.