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目的探讨血清角蛋白19(cytokeratin 19,CK19)、癌胚抗原(carcinoembryonic angigen,CEA)和糖链抗原(carbohydrate antigen,CA)19-9检测对胃肠腺癌复发和疗效评估的临床价值。方法 50例胃肠腺癌术后患者,根据有无复发转移分为转移组和非转移组,采用化学发光免疫分析法动态监测2组化疗前、化疗第1周期后、化疗第2周期前CK19水平,并检测化疗前和足疗程化疗后血清CEA及CA19-9水平。结果化疗前转移组CEA,CA19-9及CK19水平均明显高于非转移组(P<0.05);化疗前转移组CEA,CA19-9,CK19及3种肿瘤标志物联合检测的阳性率分别为37.50%,75.00%,75.00%,100.00%;非转移组分别为3.85%,30.77%,15.38%,42.31%,差异均有统计学意义(P<0.05);转移组与未转移组CK19中位数与总体中位数的总体偏离度(66.01%,33.3%)均明显大于CEA(61.62%,9.21%)和CA19-9(59.92%,28.40%),差异有统计学意义(P<0.05);化疗前CEA或CA19-9高于正常,经足疗程化疗后降至正常范围的肿瘤患者,与首次化疗初期动态监测CK19变化的符合率为66.7%。结论 CK19与CEA和CA19-9联合检测对胃肠腺癌术后化疗患者的预后评价有较高准确性;CK19对胃肠腺癌术后复发预测评价优于CEA和CA19-9;CK19的变化与肿瘤化疗疗效明显相关。
Objective To investigate the clinical value of cytokeratin 19 (CK19), carcinoembryonic angigen (CEA) and carbohydrate antigen (CA) 19-9 in evaluating the recurrence and therapeutic efficacy of gastrointestinal adenocarcinoma. Methods Fifty patients with postoperative gastrointestinal adenocarcinoma were divided into metastasis group and non-metastasis group according to the presence or absence of recurrence and metastasis. Chemiluminescence immunoassay was used to detect the changes of CK19 Level, and before and after chemotherapy to detect serum levels of CEA and CA19-9 after chemotherapy. Results The levels of CEA, CA19-9 and CK19 in patients with metastasis before chemotherapy were significantly higher than those in patients without metastasis (P <0.05). The positive rates of CEA, CA19-9, CK19 and three tumor markers in pretreatment group were 37.50%, 75.00%, 75.00% and 100.00% respectively. There was a significant difference between the two groups (3.85%, 30.77%, 15.38%, 42.31%, P <0.05) The overall deviation of the number from the median (66.01%, 33.3%) was significantly higher than that of CEA (61.62%, 9.21%) and CA19-9 (59.92%, 28.40% ; The tumor patients with CEA or CA19-9 higher than normal before chemotherapy and falling to the normal range after the full course of chemotherapy were consistent with the dynamic monitoring of CK19 in the initial stage of initial chemotherapy. The coincidence rate was 66.7%. Conclusion The combination of CK19 with CEA and CA19-9 has a higher accuracy in predicting the prognosis of patients with gastrointestinal adenocarcinoma after chemotherapy. The predictive value of CK19 in predicting the recurrence of gastrointestinal adenocarcinoma is better than that of CEA and CA19-9. Significantly correlated with the efficacy of tumor chemotherapy.