肿瘤标志物CEA、CA19-9、CA242联检在结直肠癌患者诊断中的应用

The value of combined tumor markers of CEA, CA19-9 and CA242 for diagnosis of patients with colorectal cancer

目的 探讨云南省大理州结直肠癌患者血清中肿瘤标志物癌胚抗原（CEA）、糖链蛋白抗原19-9（CA19-9）、糖链蛋白抗原242（CA242）单项或多项联检对结直肠癌的临床诊断价值.方法 应用电化学发光法和放免法检测89例结直肠癌患者和50例正常体检者的CEA、CA19-9和CA242水平.结果 三种肿瘤标志物在结直肠癌患者血清中含量均明显高于健康对照组（t分别为2.97、3.55和7.44,P均＜0.01）;三种肿瘤标志物联检对结直肠癌的临床诊断效果明显优于各单项（CEA、CA19-9、CA242）和两项联检（CA242＋CA19-9和CEA＋CA19-9）,差异有统计学意义（X2分别为30.552、32.076、18.365、7.130和8.862,P均＜0.01）;三项联检可提高结直肠癌诊断的灵敏度（85.39%）和准确率（90.60%）,但特异度下降（88.00%）.结论 CEA、CA19-9和CA242可用于该地区结直肠痛的早期诊断和病情判断,三者联检可提高诊断效率.

Objective To explore the clinical value of serum tumor markers carcinoembryonic antigen （CEA）, carbohydrate antigen 19-9（CA19-9） and carbohydrate antigen 242（CA242） levels in patients with colorectal cancer using single item and multi-items determination. Methods Serum levels of CEA, CA19-9 and CA242 were measured with chemiuminescent immunoassay （CLIA） and radioimmunoassay （RIA） in 89 cases of colorectal cancer patients and 50 cases of normal people. Results The serum levels of this three tumor markers were significantly higher than those in the control group （t=2.97, 3.55 and 7.44, P〈0.01）. Combined determination of those three obviously excels that two items （CA242＋CA19-9 and CEA＋CA19-9） or single item, there was statistical significance （x2=30.552, 32.076, 18.365, 7.130 and 8.862, P〈0.01）. Combined determination of those three could enhance the sensitivity （85.39%） and accuracy（90.60%）, but the specificity was decreased （88.00%）. Conclusion Determination of serum CEA, CA19-9 and CA242 levels are valuable for the diagnosis and evaluation of patients with colorectal cancer, and the diagnosis sensitivity can be enhanced with combined determinations.