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目的 :观察大肠癌患者血清肿瘤标记物的表达 ,探讨其在大肠癌诊断、手术疗效评价和术后转移复发监测中的临床价值 ,选择适宜的血清肿瘤标记物进行联合检测 ,提高检测的敏感性、特异性。方法 :应用免疫放射分析法测定 88例大肠癌患者和 4 0例大肠良性疾病患者的 AFP、 CEA、 CA5 0、 CA15 - 3、 CA19- 9、 CA 72 - 4、 CA12 5、 CA2 4 2等 8项血清肿瘤标记物 ,并对大肠癌患者进行术后 2年的随访。结果 :8种血清肿瘤标记物中 CEA、 CA5 0、 CA19- 9、 CA12 5和 CA 2 4 2等 5项在大肠癌组水平较对照组明显升高 ,存在非常显著差异 (P <0 .0 1)。 CEA的灵敏度 (6 7.2 % )和特异度 (80 .4 % )最高。采用 5项平行检测法 ,可以提高检测的敏感度 (89.7% )和阴性预测值 (85 .9% ) ;采用系列检测 ,可提高检测的特异度 (91.5 % )和阳性预测值 (74 .1% )。 5项血清肿瘤标记物水平在 、 期病例较 、 期病例明显增高 (P <0 .0 5 ) ;在有淋巴结转移 ,有远处转移或有腹水的病例明显增高 (P <0 .0 5 ) ;血清 CA 5 0和 CA2 4 2的水平与大肠癌肿瘤大小有关 ;CEA和 CA 2 4 2水平在低分化腺癌和未分化癌病例中较高中分化腺癌和黏液腺癌明显增高 (P <0 .0 5 )。复发转移组病例 5种血清肿瘤标记物水平明显升高 (P <0 .0 5 )
OBJECTIVE: To observe the expression of serum tumor markers in patients with colorectal cancer, and to explore its clinical value in the diagnosis of colorectal cancer, the evaluation of surgical efficacy and the monitoring of postoperative metastasis and recurrence, and to select suitable serum tumor markers for joint detection to improve the sensitivity of detection Specificity. Methods: AFP, CEA, CA5 0, CA15 - 3, CA19-9, CA72 - 4, CA12 5, CA2 4 2 and other 8 cases of 88 patients with colorectal cancer and 40 patients with benign colorectal disease were determined by immunoassay. Serum tumor markers, and patients with colorectal cancer after 2 years of follow-up. Results: Among the eight serum tumor markers, the levels of CEA, CA5 0, CA19-9, CA12 5 and CA 2 4 2 in colorectal cancer group were significantly higher than those in control group (P <0. 0 1). The sensitivity (62.2%) and specificity (80.4%) of CEA were the highest. The five parallel tests can improve the sensitivity (89.7%) and negative predictive value (85.9%) of the test, and the serial test can improve the specificity (91.5%) and the positive predictive value (74.1 %). The levels of 5 serum tumor markers were significantly higher in cases with and without disease (P <0.05). The cases with lymph node metastasis, distant metastasis or ascites were significantly higher (P <0.05) ; The serum levels of CA50 and CA242 were related to the size of colorectal cancer; CEA and CA222 levels were significantly higher in poorly differentiated adenocarcinoma and undifferentiated carcinoma than in moderately differentiated adenocarcinoma and mucinous adenocarcinoma (P < 0 .0 5). Five serum tumor markers in patients with recurrent metastasis were significantly higher (P <0.05)