消化道恶性肿瘤病人血清CA_(242)水平及临床意义初探

Determination and Clinical Application of CA 242 in Serum of Patients with Gastro intestinal Cancer

作者采用生物素－链亲和素酶联免疫吸附试验方法，对１６４例消化道癌症病人血清ＣＡ２４２水平进行测定。结果，胰腺癌病人血清ＣＡ２４２含量最高（２８６．２±１２５．３Ｕ／ｍｌ），诊断阳性率为７６．９％，特异性为９１．２％；结直肠癌病人为１９３．６±１０６．４Ｕ／ｍｌ，诊断阳性率为６８．９％，特异性为８４．９％；与正常人及其它癌症病人比较，有非常显著性差异（Ｐ＜０．０１）。肝癌组为８６．１±３５．７Ｕ／ｍｌ，胃癌组为３７．６±１６．３Ｕ／ｍｌ，与正常对照组比较亦有显著性差异（Ｐ＜０．０５），但其敏感性仅分别为５８．３％和３２．３％。手术后病情明显缓解的病人，其血清ＣＡ２４２水平明显降低，与病情恶化或复发病人相比，有非常显著性差异（Ｐ＜０．０１）。其它癌症与良性疾病者血清ＣＡ２４２水平无显著性差异（Ｐ＞０．０５）。表明血清ＣＡ２４２水平测定对胰腺癌及结直肠癌的诊断、鉴别诊断、疗效观察和预后评估有一定价值。

CA 242 is a new tumor associated antigen.Serum CA 242 levels are frequently elevated in patients with gastro intestinal cancer.We have measured CA 242 levels in 164 serum samples.The results showed that the mean value of serum CA 242 in 56 normal human beings was 11.8±6.9 U/ml and it was 286.2±125.3 U/ml、193.6±106.4 U/ml、86.1±35.7 U/ml and 37.6±16.3 U/ml in 26 pancreatic cancer、25 colorectic cancer、36 liver cancer and 31 gastric cancer patients respectively. Apparently there were marked elevation of CA 242 in patients with pancreatic and colorectic cancer.The positive rate of diagnosis was 76.9% in pancreatic cancer and 68.9% in colorectic cancer with a specificity rate of 91.2% and 84.8% respectively.The levels in the patients with other cancer were not higher than that in subjects with benign diseases.In conclusion,determination of serum CA 242 is especially helpful in diagnosis of pancreatic and colorectic cancer.Increased CA 242 concentration in serum may strongly indicate progression of pancreatic and colorectic cancer and poor prognosis.