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目的 探讨胆汁癌胚抗原(CEA)的检测对结肠癌肝转移的诊断价值,为早期诊断转移癌提供一新的思路。方法 81例患者分为3组:A组2 6例,为非肿瘤行腹腔手术治疗患者;B组45例,为结肠癌患者;C组10例,为结肠癌合并肝转移患者。所有患者均手术前空腹抽取前臂静脉血,同时术中作胆囊穿刺抽取胆汁,测定CEA值。对B组中的45例患者术后中位随访19个月。结果 (1)A、B和C组血清CEA值分别为(3 .1±0 .6)ng/ml、(10 .9±2 .2 )ng/ml、(14 .5±3 .2 )ng/ml;胆汁CEA值分别为(2 4.7±6.5 )ng/ml、(13 6.5±3 8.0 )ng/ml、(875 .0±2 13 .0 )ng/ml。B .C两组胆汁CEA值相比较差异有显著性(P <0 .0 1)。(2 )B组患者分别在3个月、6个月、9个月、12个月、18个月回院复查,作B超及CT检查,直至发现肝脏转移灶。结果发现胆汁CEA值的变化在术后肝转移出现之前,数值的高低与转移出现时间的早晚有明显的相关性,可提示肝脏病变从微小转移灶向可察见的占位转移发展的动态变化趋势。结论 胆汁CEA的检测对结肠癌肝转移的临床诊断有重要意义,其CEA值能比临床症状提前6～18个月提示肿瘤的复发或转移。检测胆汁CEA对诊断和预测结肠癌肝转移有重要临床价值。
Objective To investigate the diagnostic value of detection of biliary carcinoembryonic antigen (CEA) on liver metastasis of colon cancer and to provide a new idea for the early diagnosis of metastatic cancer. Methods 81 patients were divided into 3 groups: 26 cases in group A were treated by non-tumor abdominal surgery; 45 cases in group B were colon cancer; 10 cases in group C were patients with colon cancer and liver metastasis. All patients were fasting before forearm extraction of venous blood, while intraoperative gallbladder puncture for bile determination of CEA value. The 45 patients in group B were followed up for a median of 19 months. Results The serum CEA values in groups A, B and C were (3. 1 ± 0.6) ng / ml, (10.9 ± 2.2) ng / ml and (14.5 ± 3.2) ng / ml. The bile CEA values were (24.7 ± 6.5) ng / ml, (13.65 ± 3.08) ng / ml and (875.0 ± 2113.0 ng / ml, respectively. There was significant difference in CEA value between B and C groups (P <0.01). (2) Patients in group B were returned to hospital at 3 months, 6 months, 9 months, 12 months and 18 months respectively for B ultrasound and CT examination until they found liver metastases. The results showed that the change of bile CEA value before liver metastasis appeared, the value of the level of metastasis appeared sooner or later, there is a clear correlation between liver metastasis from micrometastases can be prompted to shift the development of visible changes in the development of dynamic changes trend. Conclusion The detection of bile CEA is of great significance in the clinical diagnosis of hepatic metastases of colon cancer. The CEA value of tumors can prompt tumor recurrence or metastasis 6 to 18 months earlier than clinical symptoms. Detection of bile CEA for the diagnosis and prediction of liver metastases of colon has important clinical value.