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1971年到1976年,作者用血清癌胚抗原(CEA)随访300例作一期切除结肠直肠癌患者。22例(7.3%)术后无症状,仅因CEA值升高作再次探查术,两次手术间期为3～6个月,CEA升高到再次手术时间为4.1个月(切除率27%)。1976年到1984年,对124例原发结肠直肠癌作根治术后无症状病人作前瞻性研究,也因CEA值升高行再次探查术。术前测定CEA,首次手术后确立CEA基线值。此后2年中,每4～6周测一次CEA值;其后3年内,每8～10周测定一次。当CEA值超过诺模图中可信限值时,即重复测定,仍见升高者在作一系列检查排除腹部外转移后,作再次探查术。CEA值升高到再次手术时间为2.5个月(切除率60.5%)。目前用多克隆抗体的Abbott酶免疫测定法仅需6小时,换用单克隆抗体后的精确度无变化。据认为,CEA值超过7.5 ng/ml为肿瘤
From 1971 to 1976, the authors followed 300 patients with serum carcinoembryonic antigen (CEA) for one-stage resection of colorectal cancer. Twenty-two patients (7.3%) were asymptomatic after surgery and were only reexplored because of elevated CEA values. The interval between the two operations was 3 to 6 months. CEA was elevated to a reoperation of 4.1 months (resection rate was 27%). ). From 1976 to 1984, a prospective study was performed on 124 asymptomatic patients who underwent radical colorectal cancer after radical surgery, and reexamination was performed due to elevated CEA values. CEA was measured preoperatively and CEA baseline values were established after the first surgery. During the next 2 years, CEA values were measured every 4 to 6 weeks; within 3 years thereafter, they were measured every 8 to 10 weeks. When the CEA value exceeds the confidence limit in the nomogram, it is repeated and the elevating person still undergoes a re-exploration after performing a series of examinations to exclude extra-abdominal metastases. The CEA value was raised to a reoperation time of 2.5 months (resection rate 60.5%). The current Abbott enzyme immunoassay using polyclonal antibodies took only 6 hours, and there was no change in the accuracy of the monoclonal antibodies. It is believed that a CEA value of more than 7.5 ng/ml is a tumor