血清CEA、CA199联合检测在大肠癌复发诊断中的意义

Clinical Diagnosis Value of Combined Detection of Serum CEA and CA199 in Recurrence Patients of Colorectal Carcinoma

目的探讨癌胚抗原(CEA)和糖抗原199(CA199)联合检测在大肠癌复发患者诊断中的临床意义。方法应用美国Abbott公司AXSYM全自动免疫分析仪测定124例大肠癌术后和(或)化放疗后患者和30例健康对照者血清中的CEA和CA199含量。结果大肠癌复发患者,血清CEA和CA199不论单检、联检,其阳性率均高于对照组(P<0.01);大肠癌复发患者,血清CEA阳性率高于CA199(P<0.05),两者联检阳性率高于单检(P<0.01);结肠癌复发患者,CEA阳性率与CA199比较差异无统计学意义(P>0.05);直肠癌复发患者,CEA阳性率与CA199比较差异有统计学意义(P<0.01);结、直肠癌复发患者,联检与单检相比,差异均有统计学意义(P<0.05);结、直肠癌复发患者,CEA、CA199单独检测的阳性率,结肠癌高于直肠癌(P<0.05)。血清CEA和CA199联合检测具有较好的阳性预测值和阴性预测值。结论血清CEA和CA199联合检测可显著提高大肠癌复发诊断的阳性率。

Objective To evaluate the diagnostic value of combined determination of serum CEA and CA199 in the recurrence patients with colorectal carcinoma. Methods Serum CEA and CA199 was detected with AXSYM auto-immunoanalyzer（ America） in 124 patients with colorectal carcinoma who were post-operation or/and postchemoradiotherapy, and 30 healthy subjects. Results The positive rate of one or two serum markers in the recurrence patients with colorectal carcinoma were significantly higher than those in the controls（ P 〈 0.01 ）. The positive rate of serum CEA in the recurrence patients with colorectal carcinoma were higher than the positive rate of serum CA199（ P 〈 0.05）; the positive rate of serum markers with combined detection were higher than that with single detection（ P 〈 0.01） .The positive result of serum CEA and CA199 in the recurrence patients with rectal carcinoma had not statistical significance（ P 〉 0.05）. The positive rate of serum CEA in the recurrence patients with colo-carcinoma were higher than the positive rate of serum CA199 （ P 〈 0.01 ）. the positive rate of serum markers with combined detection were higher than that with single detection（ P 〈 0.05）in the recurrence patients with rectal or colo- carcinoma. The positive rate of serum CEA or CA199 in the recurrence patients with rectal carcinoma were higher than that in patients with colo-carcinoma（ P 〈 0.05）. Morever, two marks combined detection had nice positive predictive value and negative predictive value. Conclusion Combined detection of serum CEA and CA199 can significant enhance the positive rate of the recurrence patients with colorectal carcinoma,enhancing about 25 % higher than CEA alone.