联合测定血清CEA、TSGF、sIL-2R对结直肠癌术后再发诊断的临床应用

The Value of Dynamic and Combined Assay of CEA,TSGF and sIL-2R in Predicting Recurrence of Colorectal Cancers after Curative Resection

本文目的是探讨CEA、TSGF、sIL 2R动态及联合测定对结直肠癌术后再发诊断的价值。分别用放免法、生化比色法、ELISA法对 73例结直肠癌根治术后患者进行每 3～ 6月的系统监测 ,随方中位数为 2 7个月 (6～ 5 2个月 )。另有 5 8例再发的患者作为联合检测的研究对象。结果 :(1) 73例术后患者在随访期复发者 15例 ,其中CEA6人 ,TSGF 9人 ,sIL 2R 6人在确诊前 1～ 6月已开始增高 ,另分别有 2人 ,2人和 3人于确诊时也增高 ;(2 )上述标志物两项或三项的联合测定则明显提高对肝外再发诊断的敏感性。而系统的动态监测则大大降低由于其他疾病引起偶尔增高的假阳性率 ,提高了诊断的特异性。故CEA、TSGF及sIL 2R动态和联合测定能较早的发现结直肠癌的再发 ,并能提高其敏感性及特异性。

To evaluate the value of dynamic and combined assay of CEA,TSGF and sIL-2R in predicting the recurrence of colorectal cancers following curative resection,the serum levels of CEA,TSGF and sIL-2R were determined by radioimmumoassay,colorimetry and ELISA in 73 post-operative patients every 3～6 months until recurrence,and another 58 patients with recurrence were taken as objects for study in the combined assay. It was found that in these 73 cases,recurrence developed in 15 cased (20.5%),with a medium follow-up times of 27 months (range 6～52 months). In these 15 cases with recurrence,the serum levels of CEA,TSGF and sIL-2R were elevated in 6(40.0%),9(60.0%) and 9(40.0%) cases respectively 1～6 months before diagnosis was made by other means,and another 2(13.3%),2(13.3%) and 3(20.0%) cases showed elevations of these markers during diagnosis. In comparison with CEA alone,the combined assay of CEA with TSGF or sIL-2R,or the combinations of these three markers obviously enhanced the sensitivity to predict recurrence,and the prospective dynamic assay increased its specificity significantly. It concludes that the dynamic and combined assay of CEA,TSGF and sIL-2R might be valuable for the early detection of recurrence in post-operative colorectal cancers.