肿瘤标记物CA-50，CA-242和唾液精脒在头颈部肿瘤病人中的测定

Detection of CA-50 CA-242 and saliva spermidine in patients with head and neck cancer

采用三明治式固相免疫放射测定法，对头颈部恶性肿瘤病人９９人，良性疾病４２人血清中肿瘤相关抗原ＣＡ－５０和ＣＡ－２４２进行测定，此外，对上述病人还采用￣［１２５］Ｉ标记的固相放免法测定唾液精眯。发现ＣＡ－５０，ＣＡ－２４２和精脒水平在恶性肿瘤病人中增高百分比分别为２７％（２６／９８），４９％（４２／８６）和６２％（４９／７９）。在良性疾病中增高比率分别为１０％（４／４２），２８％（１１／３９）和４０％（１１／２７）。联合使用三个标记物，可以相对提高恶性组的阳性率，降低良性组的假阳性率。１４名恶性肿瘤病人的标记物作了连续测定，结果术后１０～１５天时的ＣＡ－５０值明显低于术前和术后３～４个月时的ＣＡ－５０值，而ＣＡ－２４２和唾液精脒却没有明显变化。

Abstract Ninety-nine patients with head and neck cancer,42 patients with head and neck benign disease in the cancer hospital,Chinese Academy of Medical Sciences,Bcijing,were investigated for serum concertration of CA-50 and CA-242 by sandwich immunoradiometric assay. The 125I-labelled,olid-phase radioimmunoassay was used to detect saliva spermidine of the same group of patients.The purpose of this study was to evaluate the use of CA 50,CA-242 and spermidine as tumor markers in head and neck cancer in clinical practice. Elevated values of CA-50,CA-242 and spermidine were found in 26/98(27%),42/86(49%)and 49/79(62%)in malignant group,while4/42(10%),11/39(28%)and 11/27(40%)in benign disease respectively.Combining the three markers,a comparably increased proportion of elevated value in the malignant group and decreased proportion of elevated values in the benign group was found.Serial analyses of the markers were performed in 14 malignant patients.The value of CA-50 was lower 10一15 days after operation than that of pre-operation and 3一4 months after operation,In squamous cell carcinoma,no correlation between staging or grading and levels was detected for any of the markers.CA-50 and CA-242 displayed enhanced serum values in 4/9 and 5/7 parotid gland malignancy. There were no correlation between value of the three markere in the squamous cell carcinoma and benign disease groups. In the follow-up, none of the markers tested revealed any prognosis-related information,Althou8h,this study suggests that no singletumor marker could helpto detect the head and neck cancer,further studies on combined use ofthe tumor markers are justified.