单克隆抗CEA抗体对卵巢上皮性囊性肿瘤标记分析

卵巢手术切除标本53例,其中浆液性囊性肿瘤24例,粘液性囊性肿瘤29例。免疫组化PAP法,结果表明:浆液性囊腺瘤CEA阴性,粘液性囊腺瘤CEA阳性率为27％;浆液性囊腺癌阳性率25％,粘液性囊腺癌阳性率92％。浆液性与粘液性两种细胞类型肿瘤之间CEA分布在良性肿瘤差别不显著(P>0.05),在恶性肿瘤有非常显著性差异(P<0.001)。提示:CEA是卵巢粘液性囊腺癌有用的肿瘤标记物。

直肠癌癌周组织ICAM-1、CEA和CD31的表达(英文)

目的:研究直肠肿瘤发生血管转移的机制。方法:选取8例直肠腺癌患者的癌周组织和淋巴结,6例正常人的直肠组织和淋巴结,用免疫组化sp法处理标本。结果:癌周直肠组织及癌周淋巴结中的血管内皮细胞内,均有ICAM1和CEA的强表达。癌周直肠组织中及癌周淋巴结中的血管内皮细胞内,均有CD31的表达;而正常对照组直肠组织和淋巴结中血管内皮细胞亦见CD31的表达,表达的强度相同。结论:研究表明ICAM1和CEA在癌细胞和内皮细胞之间可能起到一定的粘附作用,而CD31在癌细胞和内皮细胞之间作用还不是十分清楚。

Peripheral and mesenteric serum levels of CEA and cytokeratins,staging and histopathological variables in colorectal adenocarcinoma

AIM： To evaluate the differences that exist bet- ween peripheral and mesenteric serum levels of carcinoembryonic antigen （CEA） and cytokeratins in patients with colorectal adenocarcinoma. METHODS： One hundred and thirty-eight patients with colorectal adenocarcinoma who underwent surgery at Hospital Sao Paulo （Discipline of Surgical Gastroenterology of UNIFESP-EPM） between December 1993 and March 2000 were retrospectively analyzed. Differences between CEA and cytokeratin （TPA-M） levels in peripheral blood （P） and in mesenteric blood （M） were studied. Associations were investigated between peripheral and mesenteric levels and the staging and histopathological variables （degree of cell differentiation, macroscopic appearance, tumor dimensions and presence of lymphatic and venous invasion）. RESULTS： Differences were observed in the numerical values of the marker levels： CEA （M） （39.10 mg/1 ± 121.19 mg/L） vs CEA （P） （38.5 mg/L ± 122.55 mg/L）, P 〈 0.05; TPA-M （M） （325.06 U/L ±527.29 U/L） vs TPA-M （P） （279.48 U/L ±455.81 U/L）, P 〈 0.01. The mesenteric CEA levels were higher in more advanced tumors （P 〈 0.01）, in vegetating lesions （34.44 mg/L ± 93.07 mg/L） （P 〈 0.01） and with venous invasion （48.41 mg/L ± 129.86 mg/L） （P 〈 0.05）. Peripheral CEA was higher with more advanced staging （P 〈 0.01）and in lesions with venous invasion （53.23 mg/L ± 258.57 mg/L） （P 〈 0.05）. The patients demonstrated increased mesenteric and peripheral TPA-M levels with more advanced tumors （P 〈 0.01 and P 〈 0.01） and in non-ulcerated lesions [530.45 U/L =1= 997.46 U/L （P 〈 0.05） and 457.95 U/L ± 811.36 U/L （P 〈 0.01）]. CONCLUSION： The mesenteric levels of the tumor markers CEA and cytokeratins were higher than the peripheral levels in these colorectal adenocarcinoma patients, Higher levels of these biologic tumor markers are associated with an advanced state of cancerous dissemination

Significance of serum tumor markers CA50 and CEA in gastric cancer

AIMS The CAS0 and CEA are well-described human tumor-as- sociated antigens most useful clinically in gastrointestinal cancer. In this study we compared these markers in sera from patients with malignant and benign digestive tract diseases. METHODS Using a side-phase radioimmunoassay,CA50 and CEA serum levels were measured in 33 control subjects and 86 patients with gastric cancer(n=34),gastric ulcer(n=27)and chronic atrophic gastritis(n=25).Carcinoma of the stomach was found in the antrum(n=22),in the body(n=3),and the fundus(n=9),and histopathologically,was divided into adeno- carcinoma(n=21),squamous cancer(n=4)and not divided (n=9).Gastric ulcer,when present,appeared in the antrun(18 patients),the body(3)and the fundus(9)and chronic atrophic gastritis was all associated with intestinal metaplasia(IM). RESULTS The normal ranges established for CA50 and CEA in the control group were 16.26+6.14 kU/L and 3.12±1.03/μg/L respectively.In the patients with gastric cancer,serum levels of CA50(112.67±38.36 kU/L)and CEA(10.28±3.76μg/L) were elevated significantly(P<0.01,respectively),the former being>22 kU/L in 18 of 34 patients(53%;range,5-1 550 kU/ L),and the latter>5 μg/L in 19 of 34 patients(55.8%,range, 0.5-17.4 μg/L).A statistically significant correlation was found between the levels of CA50 and GEA(r=0.648,P<0.01). The serum levels of CA50(46.4±25.9 kU/L,P<0.01 )and CEA(6.85±2.43 μg/L,P<0.01)were much lower in patients with gastric ulcer or chronic atrophic gastritis(P>0.05). CONCLUSIONS Based on these results,it is concluded that CA50 and CEA are indicators for advanced gastric cancer,and af- ter surgery,their serum levels may decrease considerably. Overall,there is such a close correlation between them that in clinical practice they might be of great value to the diagnosis of gastric cancer.

CT diagnosis of recurrence after pancreatic cancer:Is there a pattern?

AIM:To investigate predilection sites of recurrence of pancreatic cancer by computed tomography(CT)in follow-up after surgery. METHODS:Seventy seven patients with recurrence after pancreatic cancer surgery were retrospectively identified.The operative technique,R-status,T-stage and development of tumor markers were evaluated. Two radiologists analyzed CT scans with consensus readings.Location of local recurrence,lymph node recurrence and organ metastases were noted.Surgery and progression of findings on follow-up CT were con-sidered as reference standard. RESULTS:The mean follow-up interval was 3.9± 1.8 mo,with a mean relapse-free interval of 12.9± 10.4 mo.The predominant site of recurrence was local (65%),followed by lymph node(17%),liver metastasis (11%)and peritoneal carcinosis(7%).Local recurrence emerged at the superior mesenteric artery(n=28),the hepatic artery(n=8),in an area defined by the surrounding vessels:celiac trunk,portal vein,inferior vena cava(n=22),and in a space limited by the mesenteric artery,portal vein and inferior vena cava(n=17). Lymph node recurrence occurred in the mesenteric root and left lateral to the aorta.Recurrence was confirmed by surgery(n=22)and follow-up CT(n=55).Tumor markers[carbohydrate antigen 19-9(CA19-9),carcinoembryonic antigen(CEA)]increased in accordance with signs of recurrence in most cases(86%CA19-9;79.2% CEA). CONCLUSION:Specific changes of local and lymph node recurrence can be found in the course of the cardinal peripancreatic vessels.The superior mesenteric artery is the leading structure for recurrence.

Intraductal papillary neoplasm of the bile duct in liver cirrhosis with hepatocellular carcinoma

A case of intraductal papillary neoplasm of the bile duct (IPNB) arising in a patient with hepatitis B-related liver cirrhosis with hepatocellular carcinoma (HCC) is reported. A 76-year-old man was admitted to our hospital with recurrent HCC. Laboratory data showed that levels of carcinoembryonic antigen and carbohydrate antigen 19-9 were elevated. He died of progressive hepatic failure. At autopsy,in addition to HCCs,an intraductal papillary proliferation of malignant cholangiocytes with fibrovascular cores was found in the dilated large bile ducts in the left lobe,and this papillary carcinoma was associated with an invasive mucinous carcinoma (invasive IPNB). Interestingly,extensive intraductal spread of the cholangiocarcinoma was found from the reactive bile ductular level to the interlobular bile ducts and septal bile ducts and to the large bile ducts in the left lobe. Neural cell adhesion molecule,a hepatic progenitor cell marker,was detected in IPNB cells. It seems possible in this case that hepatic progenitor cells located in reactive bile ductules in liver cirrhosis may have been responsible for the development of the cholangiocarcinoma and HCC,and that the former could have spread in the intrahepatic bile ducts and eventually formed grossly visible IPNB.