三甲医院2年内CEA检出情况分析以及危重症患者CEA水平明显升高的原因研究

The Analysis of CEA Detection in the Third Grade Hospital and the Cause of the Significant Increase of CEA Level In Critically Ⅲ Patients in Around 2 Years Period

目的了解癌胚抗原(CEA)作为一项重要的肿瘤标志物,在临床三甲医院各科室的应用情况。方法回顾分析近2年来我院各临床科室的CEA检测报告,分析各个科室的使用情况及阳性率。结果 2年内临床科室共完成93433份CEA检测报告,院平均阳性率为13%,阳性率低于10%的科室与临床判断上皮细胞来源肿瘤发生率一致;显著高于院平均水平第一位的是肿瘤科(31.54%)、其次是ICU中心(25.49%),但内科ICU的CEA阳性率更高(46.2%),超过肿瘤科和所有内科科室,包括阳性率最高的呼吸科(21.39%)。将内科ICU所有CEA升高的患者根据有无肿瘤病史分为肿瘤组和非肿瘤组,结果发现非肿瘤患者的病死率随CEA水平升高而上升(P=0.0002)。病情危重状态和严重的呼吸系统感染可能是导致这些非肿瘤患者CEA升高的因素之一。结论 CEA不仅是一项较好的肿瘤标志物,在非肿瘤的危重症患者中还可能与病情严重程度有关。

Objective To investigate the application of carcinoembryonic antigen （CEA） as an important tumor marker in clinical departments.Methods We retrospective analyzed the CEA test reports during around 2 years period in our hospital, the positive rates in each department.Results CEA is widely used as a tumor marker, and more than 40 thousand of cases of CEA were detected every year in our hospital.We analyzed 93433 copies of CEA test reports in nearly 2 years of period.The CEA average positive rate was 13% in our hospital.The departments tested CEA with positive rate less than 10% had lower incidence of epithelial cell tumors as well.One of the highest positive rate was from Oncology department（31.54%）, followed by the ICU Center （25.49%）, the medical ICU had even higher CEA positive rate（46.2%）, which was higher than the oncology data and department of respiration （21.39%）.To analyzethe reasons of the highly positive rate, these patients with highly CEA levels were divided into the tumor group and non-tumor group.The results showed that the higher of the CEA levels they had, the worse outcome they had（P=0.0002）.Critical illness and severe respiratory infection may be one of the factors leading to theses significant elevation of CEA in MICU.Conclusion CEA is not only a better tumor marker, but also may be related to the severity of the disease in the non tumor critically ill patients.