结直肠癌手术前后血清P53抗体，CEA及CA19-9的检测意义

Pre-and post-operative sequential changes of serum P53 antibody,carcinoembryonic antigen and carbohydrate antigen 19-9 in patients with colorectal cancer

目的：通过检测结直肠癌患者手术前后血清P53抗体,CEA,CA19-9的变化,评价其临床意义．方法：选择2002-04/2003-01手术治疗的结直肠癌患者132例和36例非肿瘤患者为研究对象．用ELISA法定性检测血清P53抗体,放射免疫分析法(RIA)定量检测CEA,CA19-9．结果：结直肠癌组中53例血清P53抗体阳性,而对照组仅1例阳性(X^2=18．11,P＜0．0001)．CEA和CA19-9在结直肠癌患者中的阳性率分别为18．2％和12．9％．血清P53抗体阳性患者术后1mo有39例(74％)抗体转阴,其中姑息性手术组3例(33％),而根治性切除组36例(82％)(X^2=9．04,P=0．0026)．CEA阳性的24例患者中,术后1 mo有13例(54％)转为阴性,其中姑息性手术组2例(18％),而根治性手术组11例(85％)(X^2=10．60,P=0．0011)．术前CA19-9阳性的17例患者中7例(41％)在术后1mo转为阴性,在姑息性手术组和根治性切除组的转阴率分别为20％(2例)和71％(5例)(X^2=4．50,P= 0．034)．结论：血清P53抗体,CEA,CA19-9的手术前后动态检测有助于临床判定病情,监测疗效．

AIM： To investigate the value of sequential change of pre- and post-operative serum P53 antibodies, carcinoembryonic antigen （CEA） and carbohydrate antigen 19-9 （CA19-9） in patients with colorectal cancer. METHODS： A total of 132 patients with colorectal cancer and 36 ones with benign lesions （as controls） were included in this prospective study. The blood samples were collected 1 h before operation and 30 d postoperatively. The presence of serum P53 antibody was determined by enzyme-linked immunosorbent assay （ELISA）. The levels of serum CEA and CA19-9 were detected using radioimmunoassay （RIA）. RESULTS： The positive tibodies in patients with rate of serum P53 ancolorectal cancer were significantly higher than that in ones with benign disease （Х^2 = 18.11, P 〈 0.0001）. Thirty-nine （74%） of P53 seropositive patients showed negative conversion 1 mo after operation, including 3 cases （33%） in palliative surgery group and 36 cases （82%） in radical operation group （Х^2 = 9.04, P = 0.0026）. Thirteen （54%） of CEA seropositive patients showed negative conversion I mo after operation, including 2 cases （18%） in palliative surgery group and 11 cases （85%） in radical operation group （Х^2 = 10.60, P = 0.0011）. Seven （41%） of CA19-9 seropositive patients showed negative conversion 1 mo after operation, including 2 cases （20%） in palliative surgery group and 5 cases （71%） in radical operation group （Х^2 = 4.50, P = 0.034）. CONCLUSION： Monitoring of sequential changes of pre- and post-operative serum P53 antibodies, CEA and CA19-9 in patients with colorectal cancer can help to evaluate responses to treatment, judge prognosis and guide the comprehensive treatment after operation.