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目的评价血清肿瘤标志物(CEA、CA199和CA242)单项或多项联合检测对大肠癌患者的临床诊断价值,探讨其在病理分期、淋巴结转移、侵袭程度及肿瘤大体形态等临床特征方面的意义。方法应用酶联免疫法检测134例大肠癌患者和200名健康人血清中CEA、CA199和CA242含量。结果大肠癌患者血清3种肿瘤标志物含量明显高于健康人(均P<0.01);单项检测中,CEA和CA242的阳性率无差异,但均显著高于CA199;CEA+CA242联合检测和CEA+CA242+CA199联合检测的阳性率显著高于单项和CEA+CA199的联合及CA199+CA242的联合,但特异性低于单项检测。在dukesA、B、C及D期中,3项肿瘤标志物含量及检测的阳性率依次增高,总体水平差异均有统计学意义(P<0.05～0.01);淋巴结转移患者的3项标志物含量及CA199、CA242的阳性率均高于无淋巴结转移的患者;3项标志物含量随肿瘤侵袭程度的加深显著增高,但在组织病理分类和肿瘤大体形态中均无明显的差异。结论CEA、CA199及CA242肿瘤标志物联合检测可以提高大肠癌诊断的敏感度,并对临床分期、判断淋巴结转移、肿瘤侵袭程度、进而进行有效临床治疗,具有一定的指导意义。
Objective To evaluate the clinical diagnostic value of single or multiple combined detection of serum tumor markers (CEA, CA199 and CA242) in patients with colorectal cancer and to explore its significance in clinical features such as pathological stage, lymph node metastasis, invasion degree and tumor general morphology. Methods Serum levels of CEA, CA199 and CA242 in 134 patients with colorectal cancer and 200 healthy persons were detected by enzyme-linked immunosorbent assay. Results The serum levels of three tumor markers in patients with colorectal cancer were significantly higher than those in healthy individuals (all P <0.01). There was no difference in the positive rates of CEA and CA242 between the two groups (all P <0.01), but both were significantly higher than those of CA199 + CA242 + CA199 joint detection was significantly higher than the single and the combination of CEA + CA199 and CA199 + CA242 combination, but the specificity lower than the single test. In dukesA, B, C and D phases, the content of three tumor markers and the positive rate of detection increased in turn, the overall level differences were statistically significant (P <0.05 ~ 0.01); lymph node metastasis in patients with three markers and The positive rates of CA199 and CA242 were higher than those without lymph node metastasis. The content of three markers increased significantly with the degree of tumor invasion, but there was no significant difference in the histopathological classification and tumor general morphology. Conclusion The combined detection of CEA, CA199 and CA242 tumor markers can improve the sensitivity of colorectal cancer diagnosis, and has some guiding significance for clinical staging, lymph node metastasis, tumor invasion and further clinical treatment.