血清CEA、CA242、CA50、CA19-9对结直肠癌诊断和生物学特性评估的意义

Significance of Serum CEA,CA242,CA50 and CA19-9 in Diagnosis and Evaluation of Biological Characteristics of Colorectal Cancer

背景：近年来结直肠癌发病率呈逐年升高趋势,早期诊断是提高生存率,改善预后的关键.目的：探讨检测血清CEA、CA242、CA50、CA19-9对结直肠癌诊断和生物学特性评估的意义.方法：选取2009年3月～2013年5月于中国人民武装警察部队湖南省总队医院经病理检查确诊的112例结直肠癌和32例结肠良性疾病患者,选取50例同期健康体检者作为正常对照组.以化学发光法检测血清CEA、CA50、CA19-9水平,以ELISA法检测血清CA242水平.结果：血清CEA、CA242、CA50、CA19-9在结直肠癌组中的表达水平较结肠良性疾病组和正常对照组显著升高（P＜0.05）.四种肿瘤标记物中,血清CA242对结直肠癌的敏感性最高,CA19-9对结直肠癌的特异性最高;四种肿瘤标记物联合检测的敏感性和阳性预测值均显著高于任意三种标记物联合检测（P＜0.05）.肿瘤位于结肠、直径≥5 em、有淋巴结转移、有远处转移的患者与肿瘤位于直肠、直径＜5 cm、无淋巴结转移、无远处转移的患者比较,血清CEA、CA242、CA50、CA19-9阳性率显著升高（P＜0.05）;肿瘤浸及浆膜层的患者与未浸及浆膜层的患者比较,血清CA242、CA50阳性率显著升高（P＜0.05）.四种肿瘤标记物表达水平与结直肠癌Dukes分期呈正相关（P＜0.05）.结论：血清CEA、CA242、CA50、CA19-9对结直肠癌的诊断、临床分期以及生物学特性的评估有较好的临床价值,联合检测可提高诊断率.

Background： The incidence of colorectal cancer has increased obviously in recent years. Early diagnosis is the key to enhance survival rate and improve prognosis. ALms： To investigate the significance of serum CEA, CA242, CAS0 and CA19-9 in diagnosis and evaluation of biological characteristics of colorectal cancer. Methods： A total of 112 patients with colorectal cancer and 32 patients with benign colonic diseases proved by pathology from March 2009 to May 2013 at Hunan Provincial Corps Hospital, Chinese People＇ s Armed Police Force were enrolled. Fifty healthy subjects were served as normal controls. Serum levels of CEA, CAS0 and CA19-9 were detected by chemiluminescence assay Serum level of CA242 was detected by ELISA. Results： The expression levels of serum CEA, CA242, CA50 and CA19-9 were significantly higher in patients with colorectal cancer than in patients with benign colonic diseases and normal controls （ P 〈 0.05 ）. In the four serum tumor markers, CA242 had the highest sensitivity and CA19-9 had the highest specificity to diagnose colorectal cancer. Sensitivity and positive predictive value were significantly higher in combined detection of all the four serum tumor markers than in combined detection of any three of the four serum tumor markers （P 〈 0.05 ）. Positivity rates of serum CEA, CA242, CAS0 and CA19-9 were significantly higher in patients with neoplasm located in colon, diameter ≥5 cm, with lymph node metastasis and with distant metastasis than in patients with neoplasm located in rectum, diameter 〈 5 cm, without lymph node metastasis and without distant metastasis （ P 〈 0. 05 ）. Positivity rates of serum CA242 and CAS0 were significantly higher in patients with neoplasm extended to serosa than in patients with neoplasm not extended to serosa （P 〈 0.05 ）. The expression levels of these four serum tumor markers were positively correlated with Dukes staging of colorectal cancer （P 〈0.05）. Conclusions： Detection of serum CEA, CA242, CAS0 and CA19-9 is valuable for diagnosis, clinical staging and evaluation of biological characteristics of colorectal cancer. Combined detection can increase the diagnostic yield.