结直肠癌患者测定血脂和单克隆抗体肿瘤标志物水平进行诊断的临床研究

Clinical Study on Determining Blood Lipid and Monoclonal Antibody Tumor Marker Levels for Diagnosis in Patients with Colorectal Cancer

目的探讨结直肠癌患者测定血浆血脂和单克隆抗体肿瘤标志物水平进行诊断的临床意义。方法96例结直肠癌患者（包括Ⅰ～Ⅱ期62例和Ⅲ～Ⅳ期34例）和30例良性结直肠瘤患者血脂和单克隆抗体肿瘤标志物CA199、CA724、CA153水平分别由生化法和电化学发光免疫分析法进行测定，并进行了对比性研究。结果Ⅰ～Ⅱ期结直肠癌患者血清TC、HDL．C和HDL-C／TC比值水平较之良性结直肠瘤患者无明显差异（P均〉0．05）；而Ⅲ～Ⅳ期结直肠癌患者较之良性结直肠瘤患者血清TC水平明显增高（P〈0．01），血清HDL-C和HDL-C／TC比值水平明显降低（P均〈0．01）。Ⅰ～Ⅱ期和Ⅲ～Ⅳ期结直肠癌患者血清CA199、CA724和CA153水平较之良性结直肠癌患者均明显增高（P〈0．01）。单克隆抗体肿瘤标记物的阳性率显示：良性结直肠瘤患者的阳性率为3．33％～13．33％，结直肠癌患者血清CA199、CA724和CA153的阳性率为39．58％、37．50％、35．40％，CA199＋CA724的阳性率为58．33％。CA724＋CA153的阳性率为62．50％，CA199＋CA724＋CA153的阳性率为84．44％。结论结直肠癌患者血清TC水平增高和HDL-C、HDL．C／TC比值水平的降低是诊断中、晚期癌症的良好指标，单克隆抗体肿瘤标志物CA199、CA724和CA153水平的联合测定是提高结直肠癌患者阳性率的重要措施。

Objective To explore the clinical study of determining blood lipid and monoclonal antibody tumor marker levels in patients with colorectal cancer.Methods The blood lipid and plasma monoclonal antibody tumor markers（CA 199,CA724 and CA 153） levels were determined in 96 patients with colorectal cancer（including 62 cases Ⅰ ～ Ⅱ stage colorectal cancer and 34 cases Ⅲ ～ Ⅳ stage colorectal cancer） by biochemistry and electrochemiluminescence immunassay respectively.Comparison study was done in 30 patients with benign colorectal tumor.Results The plasma TC,HDL-C and HDL-C/TC levels in 62 cases Ⅰ ～ Ⅱ stage colorectal cancer were no significant difference than those in 30 patients with benign colorertal tumor（P 〉 0.05）,but the TC levels in 34 cases Ⅲ ～ Ⅳ stage colorectal cancer were significantly higher（P 〈 0.05）,the HDL-C and HDL-C/TC ratio were significantly lower （P 〈 0.05）.The plasma CA199,CA724 and CA153 not only 62 cases Ⅰ ～ Ⅱ stage colorectal cancer but also 34 cases Ⅲ ～ Ⅳ stage colorectal cancer were significantly higher than those in 30 patients with benign colorectal tumor（P 〈 0.01）.The positive rate of plasma CA199,CA724 and CA153 in 30 cases benign colorectal tumor were 3.33% - 13.33% respectively,but in 96 patients with colorectal cancer were 39.58%,37.50% and 35.42% respectively, plasma CA199 added CA724 and CA724 added CA153 were 58.33% and 62.50% respectively, plasma CA199 added CA724 and CA153 was 84.44%.Conclusion The plasma TC level was increased as well as plasma HDL-C and HDL-C/TC levels were decreased,this was a good diagnosis index for advanced colorectal cancer.The monoclonal antibody tumor markers plasma CA199 were determined combined with CA724 and CA153 that was an important screening test for increasing diagnosis positive rate on colorectal cancer.