Serum tumor markers (carcinoembryonic antigen, carbohydrate antigen 19-9, carbohydrate antigen 72-4, carbohydrate antigen 24-2, ferritin) and gastric cancer prognosis correlation

BACKGROUND Gastric cancer is a kind of malignant tumor which is prevalent all over the world.Although some progress has been made in the treatment of gastric cancer,its prognosis is still not optimistic,so it is of great significance to find reliable prog-nostic indicators to guide the treatment and management of patients with gastric cancer.AIM To explore the relationship between serum levels of five biomarkers[carcinoem-bryonic antigen(CEA),carbohydrate antigen(CA)19-9,CA72-4,CA24-2,and ferritin]and prognosis in patients with gastric cancer.METHODS This study included 200 patients with gastric adenocarcinoma,and conducted an in-depth analysis of their baseline characteristics,relationship between tumor markers and staging,and prognosis.The study found that CA19-9 has a signi-ficant correlation with tumor stage,the average levels of CA24-2,CEA,CA72-4 and ferritin were slightly increased disregarding the stage of tumor.Survival analysis showed that increases in CEA,CA19-9,CA24-2,and ferritin were all associated with shortened overall survival of patients.Further multivariate ana-lysis revealed that elevated serum CA72-4 levels were an inde-pendent adverse prognostic factor.RESULTS This study reveals that there is a significant correlation between the expression levels of serum tumor markers CEA,CA19-9,CA72-4,CA24-2 and ferritin in patients with gastric cancer and prognosis,and can be used as important indicators for prognostic evaluation of gastric cancer.In particular,markers that appear abnormally elevated initially may help identify gastric cancer patients with poor prognosis.CONCLUSION Serum CEA and CA19-9 play an important role in the prognosis assessment of gastric cancer,and are effective tools to guide clinical practice and optimize individualized treatment strategies for gastric cancer patients.

The combined detection of carcinoembryonic antigen,carcinogenic antigen 125,and carcinogenic antigen 19-9 in colorectal cancer patients

BACKGROUND Hepatic metastases are common and difficult to treat after colorectal cancer(CRC)surgery.The predictive value of carcinoembryonic antigen(CEA),cancer antigen(CA)125 and CA19-9 combined tests for liver metastasis is unclear.AIM To evaluate predictive value of combined tests for CEA,CA125,and CA19-9 levels in patients with liver metastases of CRC.METHODS The retrospective study included patients with CRC alone(50 cases)and patients with CRC combined with liver metastases(50 cases)who were hospitalized between January 2021 and January 2023.Serum CEA,CA125 and CA19-9 levels were compared between the two groups,and binary logistic regression was used to analyze the predictive value of the combination of these tumor markers in liver metastasis.In addition,we performed receiver operating characteristic(ROC)curve analysis to assess its diagnostic accuracy.RESULTS The results showed that the serum CEA,CA125 and CA19-9 levels in the CRC with liver metastasis group were significantly higher than those in the CRC alone group.Specifically,the average serum CEA level in the CRC with liver metastasis group was 162.03±810.01 ng/mL,while that in the CRC alone group was 5.71±9.76 ng/mL;the average serum CA125 levels were 43.47±83.52 U/mL respectively.and 13.5±19.68 U/mL;the average serum CA19-9 levels were 184.46±473.13 U/mL and 26.55±43.96 U/mL respectively.In addition,binary logistic regression analysis showed that CA125 was significant in predicting CRC liver metastasis(P<0.05).ROC curve analysis results showed that the areas under the ROC curves of CEA,CA125 and CA19-9 were 0.607,0.692 and 0.586.CONCLUSION These results suggest that combined detection of these tumor markers may help early detection and intervention of CRC liver metastasis,thereby improving patient prognosis.

Prediction and analysis of albumin-bilirubin score combined with liver function index and carcinoembryonic antigen on liver metastasis of colorectal cancer

BACKGROUND Colorectal cancer(CRC)is a common malignant tumor,and liver metastasis is one of the main recurrence and metastasis modes that seriously affect patients’survival rate and quality of life.Indicators such as albumin bilirubin(ALBI)score,liver function index,and carcinoembryonic antigen(CEA)have shown some potential in the prediction of liver metastasis but have not been fully explored.AIM To evaluate its predictive value for liver metastasis of CRC by conducting the combined analysis of ALBI,liver function index,and CEA,and to provide a more accurate liver metastasis risk assessment tool for clinical treatment guidance.METHODS This study retrospectively analyzed the clinical data of patients with CRC who received surgical treatment in our hospital from January 2018 to July 2023 and were followed up for 24 months.According to the follow-up results,the enrolled patients were divided into a liver metastasis group and a nonliver metastasis group and randomly divided into a modeling group and a verification group at a ratio of 2:1.The risk factors for liver metastasis in patients with CRC were analyzed,a prediction model was constructed by least absolute shrinkage and selection operator(LASSO)logistic regression,internal validation was performed by the bootstrap method,the reliability of the prediction model was evaluated by subject-work characteristic curves,calibration curves,and clinical decision curves,and a column graph was drawn to show the prediction results.RESULTS Of 130 patients were enrolled in the modeling group and 65 patients were enrolled in the verification group out of the 195 patients with CRC who fulfilled the inclusion and exclusion criteria.Through LASSO regression variable screening and logistic regression analysis.The ALBI score,alanine aminotransferase(ALT),and CEA were found to be independent predictors of liver metastases in CRC patients[odds ratio(OR)=8.062,95%confidence interval(CI):2.545-25.540],(OR=1.037,95%CI:1.004-1.071)and(OR=1.025,95%CI:1.008-1.043).The area under the receiver operating characteristic curve(AUC)for the combined prediction of CRLM in the modeling group was 0.921,with a sensitivity of 78.0%and a specificity of 95.0%.The H-index was 0.921,and the H-L fit curve hadχ^(2)=0.851,a P value of 0.654,and a slope of the calibration curve approaching 1.This indicates that the model is extremely accurate,and the clinical decision curve demonstrates that it can be applied effectively in the real world.We conducted internal verification of one thousand resamplings of the modeling group data using the bootstrap method.The AUC was 0.913,while the accuracy was 0.869 and the kappa consistency was 0.709.The combination prediction of liver metastasis in patients with CRC in the verification group had an AUC of 0.918,sensitivity of 85.0%,specificity of 95.6%,C-index of 0.918,and an H-L fitting curve withχ^(2)=0.586,P=0.746.CONCLUSION The ALBI score,ALT level,and CEA level have a certain value in predicting liver metastasis in patients with CRC.These three criteria exhibit a high level of efficacy in forecasting liver metastases in patients diagnosed with CRC.The risk prediction model developed in this work shows great potential for practical application.

血清肿瘤标志物CEA、CA-199、CA125及VEGF联合检测对肺癌诊断的价值

目的本研究目的在于探究肺癌患者中CEA、CA-199、CA125以及VEGF的表达情况,并评价它们在肺癌诊断和治疗中的临床应用价值。方法选取2023年1月至2023年10月期间入院接受肺部疾病检查并确诊为肺癌的84例患者作为观察组,另取80名健康人作为对照组。通过t检验比较两组中的血清肿瘤标志物水平,评估其在肺癌风险评估中的应用价值。此外,采用受试者操作特征曲线(ROC)分析各指标在肺癌辅助诊断中的有效性。结果观察组与对照组比较,CEA、CA-199、CA125和VEGF的血清水平差异具有统计学意义(P<0.05)。Logistic回归分析表明,血清CEA、CA-199、CA125和VEGF水平升高与肺癌风险增加相关(P<0.05)。ROC曲线分析显示,CEA、CA-199、CA125联合VEGF在诊断肺癌方面的AUC值为0.855,明显高于单一测定。结论CEA、CA-199、CA125和VEGF的联合检测在肺癌的早期筛查、诊断和随访中具有显著的临床价值,能显著提高肺癌诊断的敏感性和特异性,可能对于肺癌患者的早期诊断和治疗决策提供较为重要参考。

培美曲塞二钠联合顺铂治疗晚期肺腺癌的疗效及对血清CYFRA21-1、CA125、CEA、NSE的影响分析

目的 探讨培美曲塞二钠联合顺铂治疗晚期肺腺癌的疗效,以及对患者血清细胞角质蛋白19片段抗原(Cytokeratin 19 Fragment Antigen 21-1, CYFRA 21-1)、糖类抗原CA125(Carbohydrate Antigen 125, CA125)、癌胚抗原(Carcinoembryonic Antigen, CEA)、神经元特异性烯醇化酶(Neuron Specific Enolase, NSE)的影响。方法 便利选择建湖县人民医院于2019年1月—2023年12月收治的72例晚期肺腺癌患者为研究对象,以随机数字表法分组,对照组(n=36)采用紫杉醇联合顺铂治疗,观察组(n=36)培美曲塞二钠联合顺铂治疗,比较两组的疗效、血清CYFRA21-1、CA125、CEA、NSE水平以及不良反应发生率。结果 观察组的疾病控制率、客观缓解率分别为88.89%和58.33%,均高于对照组的66.67%、33.33%,差异有统计学意义(χ^(2)=5.143、4.532,P均<0.05)。治疗后,观察组的CYFRA21-1、CA125、CEA、NSE水平均低于对照组,差异有统计学意义(P均<0.05)。观察组的不良反应发生率低于对照组,差异有统计学意义(P<0.05)。结论 培美曲塞二钠联合顺铂治疗晚期肺腺癌的疗效可靠,患者肿瘤标志物水平下降明显,且药物不良反应小,安全性高。

联合检测血清胃蛋白酶原、Hp抗体、CEA、CA724在胃癌筛查的临床研究

目的探讨血清胃蛋白酶原Ⅰ(PGⅠ)、胃蛋白酶原Ⅱ(PGⅡ)、PGⅠ/PGⅡ比值、幽门螺杆菌(Hp)抗体、糖类抗原724(CA724)、癌胚抗原(CEA)联合检测在胃癌筛查的临床价值研究。方法选取2021年7月至2023年11月在玉林市第一人民医院就诊的100例胃癌患者为胃癌组、80例萎缩性胃炎患者为萎缩性胃炎组及同期80例非萎缩性胃炎为对照组。检测并比较三组研究对象血清中PGⅠ、PGⅡ、PGⅠ/PGⅡ比值、Hp抗体、CEA、CA724水平,用受试者工作特征(ROC)曲线评估以上指标在胃癌中的诊断价值。结果胃癌组、萎缩性胃炎组的PGⅠ、PGⅠ/PGⅡ比值水平均低于对照组,差异有统计学意义(P<0.05)。胃癌组的PGⅡ及Hp抗体水平均高于对照组,但胃癌组Hp抗体水平低于萎缩性胃炎组,差异有统计学意义(P<0.05)。胃癌组的CEA、CA724水平均高于其余两组,差异有统计学意义(P<0.05)。采用Spearman相关分析,结果显示PGⅠ/PGⅡ比值与PGⅠ呈正相关(r=0.229,P<0.05),与PGⅡ、Hp抗体、CA724呈负相关(r=-0.560,P<0.05;r=-0.236,P<0.05;r=-0.223,P<0.05)。联合检测血清PGⅠ、PGⅡ、Hp抗体、CEA、CA724诊断胃癌的曲线下面积(AUC=0.844)均大于各单项诊断AUC。结论联合检测血清PGⅠ、PGⅡ、PGⅠ/PGⅡ比值、Hp抗体、CEA、CA724可提高胃癌的诊断价值。

Carcinoembryonic antigen,carbohydrate antigen 199 and carbohydrate antigen 724 in gastric cancer and their relationship with clinical prognosis

BACKGROUND Gastric cancer(GC)is a common malignant tumor of the digestive system with a high degree of malignancy.It usually develops insidiously without any specific symptoms in the early stages.As one of the diseases caused by abnormal gene changes,GC has abnormal expression of various oncogenes and products during its development.Tumor markers such as carcinoembryonic antigen(CEA),carbohydrate antigen 199(CA199)and carbohydrate antigen 724(CA724)are not expressed or lowly expressed in normal people,but significantly increased after carcinogenesis.Monitoring the changes in the levels of tumor markers such as CEA,CA199 and CA724 is conducive to early diagnosis and evaluation of the occurrence of some solid tumors.AIM To investigate the expression of CEA,CA199 and CA724 in GC and their correlation with clinical features,hoping to provide more effective markers for the early preventive diagnosis of GC.METHODS Of 87 patients with GC admitted to our hospital from September 2020 to December 2021 were included in the GC group,and another 80 healthy people who came to our hospital for physical examination with normal results during the same period were selected as the control group.The serum CEA,CA199,and CA724 levels were compared between the two groups,and the serum CEA,CA199,and CA724 levels were compared in patients with GC at different TNM stages,and the differences in the positive rates of CEA,CA199,and CA724 alone and in combination in detecting TNM stages of GC and GC were compared.In addition,the relationship between the levels of tumor markers CEA,CA199 and CA724 and the clinicopathological characteristics of GC patients was also analyzed.The relationship between the serum levels of CEA,CA199 and CA724 and the survival period of GC patients was analyzed by Pearson.RESULTS The serum levels of CEA,CA199 and CA724 in GC group were significantly higher than those in control group(P<0.05).With the increase of TNM stage,the serum CEA,CA199 and CA724 expression levels in GC patients increased significantly,and the differences between groups were statistically significant(P<0.05).The positive rate of the CA724 single test was higher than that of CEA and CA199 single test(P<0.05).The positive rate of the three combined tests was 95.40%(83/87),which was higher than that of CEA,CA199 and CA724 single tests.The difference was statistically significant(P<0.05).The combined detection positive rates of CEA,CA199,and CA724 in stages I,II,III,and IV of GC were 89.66%,93.10%,98.85%,and 100.00%respectively,all of which were higher than the individual detection rates of CEA,CA199,and CA724.The differences were statistically significant(P<0.05).There was no significant difference in serum CEA,CA199 and CA724 levels between GC patients with different genders,smoking history and alcohol history(P>0.05).However,the serum CEA,CA199 and CA724 levels were significantly higher in GC patients aged≥45 years,TNM stage III-IV,with lymph node metastasis and tumor diameter≥5 cm than in GC patients aged<45 years,TNM stage I-II,without lymph node metastasis and tumor diameter<5 cm(P<0.05).CONCLUSION The expression levels of serum tumor markers CEA,CA199 and CA724 in patients with GC are high and rise with the increase of TNM stage.The levels of CEA,CA199 and CA724 are related to age,TNM stage,lymph node metastasis and tumor diameter.The combined detection of CEA,CA199 and CA724 is helpful to improve the diagnostic accuracy of GC with high clinical guidance value.

胃功能三项及NLR、CEA联合检测对胃溃疡良恶性的诊断价值分析

目的 分析研究胃功能三项[胃蛋白酶原Ⅰ(PGⅠ)、胃蛋白酶原Ⅱ(PGⅡ)、胃蛋白酶原比值(PGR)]及中性粒细胞/淋巴细胞比值(NLR)、癌胚抗原(CEA)联合检测对胃溃疡良恶性的诊断价值。方法 选取2020年1月至2022年11月淮南朝阳医院收治的胃溃疡患者为研究对象,将其命名为胃溃疡组(n=100),另选同期在本院体检的健康人群为对照组(n=60)。比较两组外周血PGⅠ、PGⅡ、PGR、NLR及CEA水平;根据内镜与病理检查结果,将胃溃疡组患者分为良性组(n=76)与恶性组(n=24)。采用多因素logistics回归分析胃溃疡恶性病变的影响因素;绘制ROC曲线分析外周血PGⅠ、PGⅡ、PGR、NLR、CEA对胃溃疡恶性病变的预测价值。结果 胃溃疡组的PGⅠ、PGR水平均低于对照组,差异均具有统计学意义(t=22.044、35.045,P<0.05);胃溃疡组的PGⅡ、NLR、CEA水平均高于对照组,差异均具有统计学意义(t=17.810、9.481、29.557,P<0.05);多因素logistics回归分析显示,Hp感染阳性(OR=1.865)、过量饮酒(OR=2.046)、PGⅠ降低(OR=2.006)、PGⅡ升高(OR=2.028)、PGR降低(OR=2.098)、NLR升高(OR=1.958)以及CEA水平升高(OR=2.071)均是胃溃疡恶性病变的独立危险因素(P<0.05);ROC曲线分析显示,PGⅠ、PGⅡ、PGR、NLR、CEA及联合检测预测胃溃疡良恶性病变的曲线下面积(AUC)分别为0.822、0.815、0.863、0.786、0.828、0.951,联合检测优于单一检测(P<0.05)。结论 PGⅠ、PGⅡ、PGR及NLR、CEA联合检测对胃溃疡良恶性病变具有一定的诊断价值。

Serum tumor markers expression(CA199,CA242,and CEA)and its clinical implications in type 2 diabetes mellitus

BACKGROUND Glucose and lipid metabolic disorder in patients with type 2 diabetes mellitus(T2DM)is associated with the levels of serum tumor markers of the digestive tract,such as cancer antigen(CA)199.Therefore,tumor markers in T2DM are important.AIM To evaluate the expression of serum tumor markers[CA199,CA242,and carcinoembryonic antigen(CEA)]and the clinical implications of the expression in T2DM.METHODS For this observational study conducted at Hefei BOE Hospital,China,we enrolled 82 patients with first-onset T2DM and 51 controls between April 2019 and December 2020.Levels of fasting blood glucose(FBG),tumor markers(CA199,CEA,and CA242),glycosylated hemoglobin(HbA1c),etc.were measured and group index levels were compared.Moreover,FBG and HbA1c levels were correlated with tumor marker levels.Tumor markers were tested for diagnostic accuracy in patients with>9%HbA1c using the receiver operating curve(ROC)curve.RESULTS The T2DM group had high serum FBG,HbA1c,CA199,and CEA levels(P<0.05).A comparative analysis of the two groups based on HbA1c levels(Group A:HbA1c≤9%;Group B:HbA1c>9%)revealed significant differences in CEA and CA199 levels(P<0.05).The areas under the ROC curve for CEA and CA199 were 0.853 and 0.809,respectively.CA199,CEA,and CA242 levels positively correlated with HbA1c(r=0.308,0.426,and 0.551,respectively)and FBG levels(r=0.236,0.231,and 0.298,respectively).CONCLUSION As compared to controls,serum CEA and CA199 levels were higher in patients with T2DM.HbA1c and FBG levels correlated with CA199,CEA,and CA242 levels.Patients with poorly controlled blood sugar must be screened for tumor markers.

超声弹性成像联合血清CK19、CEA水平在乳腺癌腋窝淋巴结转移中的诊断价值研究

目的研究超声弹性成像联合血清细胞角蛋白19(cytokeratin 19,CK19)、癌胚抗原(carcino-embryonic antigen,CEA)水平在乳腺癌腋窝淋巴结转移中的诊断价值。方法回顾性分析女性乳腺癌患者74例的临床资料。根据术后病理检查结果是否有腋窝淋巴结转移将其分为转移组(32例)与非转移组(42例)。比较2组超声弹性成像评分;分析超声弹性成像诊断乳腺癌腋窝淋巴结转移的价值;比较2组CK19、CEA水平;分析CK19、CEA对乳腺癌腋窝淋巴结转移的诊断价值;以病理诊断结果为金标准,分析超声弹性成像联合CK19、CEA诊断乳腺癌腋窝淋巴结转移的价值。结果转移组中超声弹性成像评分1、2分所占比例明显低于非转移组,3、4分所占比例明显高于非转移组(P<0.05)。超声弹性成像诊断乳腺癌腋窝淋巴结转移的敏感度为0.781,特异度为0.952,准确率为0.878。转移组CK19、CEA水平明显高于非转移组(P<0.05)。CK19、CEA诊断乳腺癌腋窝淋巴结转移的曲线下面积为0.922、0.916,敏感度为0.875、0.844,特异度为0.857、0.929,P<0.05。超声弹性成像联合CK19、CEA诊断乳腺癌腋窝淋巴结转移的敏感度为0.938,特异度为0.905,准确率为0.919。结论超声弹性成像联合CK19、CEA诊断乳腺癌腋窝淋巴结转移的价值高于其单独诊断的价值,临床可对其密切关注。

Significance of carcinoembryonic antigen detection in the early diagnosis of colorectal cancer:A systematic review and metaanalysis

BACKGROUND Colorectal cancer(CRC)is a prevalent malignant tumor involving adenomas that develop into malignant lesions.Carcinoembryonic antigen(CEA)is a non-specific serum biomarker upregulated in CRC.The concentration of CEA is modulated by tumor stage and grade,tumor site in the colon,ploidy status,and patient smoking status.This study aimed to evaluate current evidence regarding the diagnostic power of CEA levels in the early detection of CRC recurrence in adults.AIM To evaluate current evidence regarding the diagnostic power of CEA levels in the early detection of CRC recurrence in adults.METHODS A systematic search was performed using four databases:MEDLINE,Cochrane Trials,EMBASE,and the Web of Science.The inclusion criteria were as follows:Adult patients aged≥18 years who had completed CRC curative treatment and were followed up postoperatively;reporting the number of CRC recurrences as an outcome;and randomized,clinical,cohort,and case-control study designs.Studies that were not published in English and animal studies were excluded.The following data were extracted by three independent reviewers:Study design,index tests,follow-up,patient characteristics,and primary outcomes.All statistical analyses were performed using the RevMan 5.4.1.RESULTS A total of 3232 studies were identified,with 73 remaining following the elimination of duplicates.After screening on predetermined criteria,12 studies were included in the final analysis.At a reference standard of 5 mg/L,CEA detected only approximately half of recurrent CRCs,with a pooled sensitivity of 59%(range,33%–83%)and sensitivity of 89%(range,58%–97%).CONCLUSION CEA is a significant marker for CRC diagnosis.However,it has insufficient sensitivity and specificity to be used as a single biomarker of early CRC recurrence,with an essential proportion of false negatives.

CEA、CA125、CA199评估贝伐单抗靶向治疗联合XELOX辅助化疗方案对晚期结直肠癌的效果

目的探讨癌胚抗原(CEA)、癌抗原125(CA125)、癌抗原199(CA199)联合检测评估贝伐单抗靶向治疗联合奥沙利铂和卡培他滨(XELOX)辅助化疗方案对晚期结直肠癌患者疗效及预后的效果。方法择取2019年3月至2020年3月就诊的晚期结直肠癌患者共计72例作研究对象,依照计算机随机分组模式归纳为对照组(36例,XELOX化疗)与试验组(36例,贝伐单抗+XELOX化疗),对比2组的临床疗效、短期生存率、血清指标水平、不良反应发生率。结果试验组与对照组的临床控制率分别为88.89%与66.67%,差异有统计学意义(P<0.05);试验组1年、2年生存率分别为91.67%与77.78%,均明显高于对照组(P<0.05);治疗前,2组血清CEA、CA125、CA199水平均无明显差异无统计学意义(P>0.05),治疗后,试验组上述指标水平均明显低于对照组(P<0.05);2组不良反应发生率均差异无统计学意义(P>0.05)。结论对晚期结直肠癌患者给予贝伐单抗+XELOX辅助化疗具有明显的临床疗效,帮助患者有效延长生存周期,降低血清指标水平,药效可靠,值得采纳。

Prognostic role of serum carcinoembryonic antigen in patients receiving liver resection for colorectal cancer liver metastasis:A meta-analysis

BACKGROUND Carcinoembryonic antigen(CEA)is a broad-spectrum tumor marker for differential diagnosis,monitoring,and response assessment of a variety of malignancies.AIM To evaluate whether serum CEA could predict the prognosis in patients with colorectal cancer liver metastasis(CRCLM)before and after liver resection(LR).METHODS PubMed,Embase,Cochrane,and Web of Science were systematically searched to retrieve literature,with a search cut-off date of February 27,2023.Articles were strictly screened for inclusion according to pre-specified inclusion and exclusion criteria.Data were pooled and analyzed using Stata 16.0.RESULTS This meta-analysis included 36 studies involving a total of 11143 CRCLM patients.The results showed that a high pre-LR serum CEA level was correlated with poor overall survival(OS)[hazard ratio(HR)=1.61,95%confidence interval(CI):1.49-1.75,P<0.001]and recurrence-free survival(HR=1.27,95%CI:1.11-1.45,P<0.001)in CRCLM patients.A high post-LR serum CEA level predicted poor OS(HR=2.66,95%CI:2.10-3.38,P<0.001).A comparison by treatment modality,analysis modality,patient source,and cutoff-value showed that overall,high preoperative and postoperative serum CEA levels remained correlated with a poor prognosis.CONCLUSION This study concluded that high pre-LR and post-LR serum CEA levels were significantly correlated with a poor prognosis in CRCLM patients.

联合SHOX2、RASSF1A及CEA构建的列线图模型对肺癌发生的预测价值

目的 联合矮小同源盒基因2(Short stature homeobox gene 2,SHOX2)、RAS相关结构域家族1亚型A(RAS association domain family 1,isoform A,RASSF1A)及癌胚抗原(Carcinoembryonic antigen,CEA)构建预测肺癌发生的列线图模型,并确定该模型的预测价值。方法 选择2020年1月至2022年12月在新疆医科大学第一附属医院就诊的88例肺癌患者及肺良性肿瘤患者219名。比较两组患者的人口统计学和临床特征信息以及支气管肺泡灌洗液(Bronchoalveolar lavage fluid,BALF)中SHOX2和RASSF1A基因的甲基化水平。进行单因素分析及多因素Logistic回归分析筛选出影响肺癌发生的变量构建列线图,并评估其预测效能。结果 肺癌患者中SHOX2阳性36例(41.4%),RASSF1A阳性30例(34.5%)。肺癌患者CEA、细胞角蛋白19片段(Cytokeratin 19 fragment,CYFRA21-1)、鳞状上皮细胞癌抗原(Squamous cell carcinoma antigen,SCCA)、胃泌素释放肽前体(Pro-gastrinreleasing peptide,Pro-GRP)水平与肺良性肿瘤患者比较差异有统计学意义(P<0.05)。Logistic回归分析显示,SHOX2、RASSF1A和CEA为肺癌发生的独立危险因素(P<0.05),基于上述独立风险因素所构建的列线图模型显示出良好的区分能力(AUC=0.926),具有较好的一致性且获益良好。结论 联合SHOX2、RASSF1A和CEA构建的列线图模型对肺癌发生具有较高的预测价值,可为肺癌的早期诊断提供依据。

血清CA125、CYFRA21-1、CEA、NSE及ALP联合检测对原发性肺癌患者骨转移的预测价值

目的探究血清糖类抗原125(CA125)、细胞角蛋白19片段抗原21-1(CYFRA21-1)、癌胚抗原(CEA)、神经元特异性烯醇化酶(NSE)及碱性磷酸酶(ALP)联合检测对原发性肺癌患者骨转移的预测价值。方法选取肺癌患者104例为观察组,并根据是否发生骨转移分为骨转移组(50例)和无骨转移组(54例)。同时选取100例肺部良性病变者为对照组。收集肺癌患者临床资料,检测所有受试者血清CA125、CYFRA21-1、CEA、NSE及ALP水平。采用受试者工作特征(ROC)曲线分析血清CA125、CYFRA21-1、CEA、NSE、ALP对肺癌患者骨转移的预测价值。采用多因素Logistic回归分析肺癌患者骨转移的影响因素。结果与对照组相比,观察组血清CA125、CYFRA21-1、CEA、NSE、ALP水平显著升高(P<0.05)。骨转移组中临床分期Ⅲ~Ⅳ期患者占比、有淋巴结转移患者占比及血清CA125、CYFRA21-1、CEA、NSE、ALP水平显著高于无骨转移组(P<0.05)。血清CA125、CYFRA21-1、CEA、NSE、ALP预测肺癌患者发生骨转移的AUC分别为0.818、0.816、0.739、0.770、0.771,5种肿瘤标志物联合检测的AUC为0.955,敏感度、特异度、AUC均显著高于各肿瘤标志物单独检测(P<0.05)。多因素Logistic回归分析显示,CA125、CYFRA21-1、CEA、NSE、ALP是影响肺癌患者发生骨转移的危险因素(P<0.05)。结论血清CA125、CYFRA21-1、CEA、NSE、ALP联合检测对原发性肺癌患者骨转移的预测具有较高的价值,联合诊断效能更高。

CEACAM1在代谢功能障碍相关脂肪性肝病中的作用

癌胚抗原相关细胞黏附分子1(carcinoembryonic antigen⁃related cell adhesion molecule 1,CEACAM1)是一种免疫球蛋白超家族的跨膜蛋白,参与介导细胞黏附、组织转移、免疫反应控制以及机体代谢平衡。研究表明,CEACAM1主要通过促进胰岛素清除以防止脂肪沉积,从而对肝脏发挥保护作用。CEACAM1表达水平下调会导致胰岛素抵抗状态发生恶性循环并加重代谢紊乱。由于CEACAM1在控制代谢功能障碍相关脂肪性肝病(metabolic dysfunction⁃associated steatotic liver disease,MASLD)中的关键地位,刺激其作用途径或调节其表达水平有望成为MASLD的治疗新方法。本文就CEACAM1在MASLD中的有关研究进展作一综述。

细胞学与CA125、CA199以及CEA联合检验诊断恶性胸水的价值

目的 分析采取细胞学与糖类抗原125(CA125)、糖链抗原199(CA199)以及癌胚抗原(CEA)联合检验诊断恶性胸水的价值。方法 回顾性分析我院2020年12月至2022年12月诊断为恶性胸水的患者50例设为观察组,选取同时期在我院诊断为良性胸水的患者50例设为对照组,观察CA125、CA199、CEA水平以及敏感度和特异度,同时开展细胞学联合检查。结果 观察组CA125、CA199、CEA水平均高于对照组,差异有统计学意义(P <0.05)。联合四项的敏感度高于CA125、CA199和CEA,差异有统计学意义(P <0.05),特异度比较无统计学差异(P> 0.05)。结论 恶性胸水采取CA125、CA199以及CEA和细胞学联合检验具有较高诊断价值。

CEA、CA724、CA19-9、CA125联合检测在胃癌患者中的运用价值

目的观察血清癌胚抗原(CEA)、糖类抗原724(CA724)、糖类抗原19-9(CA19-9)、糖类抗原125(CA125)联合检测对胃癌患者的临床价值。方法选取我院2020年5月至2023年5月收治的176例胃癌患者作为恶性组,按照2∶1配对原则选取同期、同年段88名健康对照作为对照组。比较两组血清CEA、CA724、CA19-9、CA125水平,分析胃癌患者血清各指标与临床病理特征的关系,ROC曲线评估血清各指标联合对胃癌的诊断价值。结果恶性组血清CEA、CA724、CA19-9、CA125水平高于对照组(P<0.05);胃癌患者分化程度、TNM分期、淋巴结转移、远处转移血清CEA、CA724、CA19-9、CA125水平比较,差异有统计学意义(P<0.05);血清CEA、CA724、CA19-9、CA125与分化程度、TNM分期、淋巴结转移、远处转移呈正相关(P<0.05);血清CEA、CA724、CA19-9、CA125联合诊断胃癌的AUC大于各指标单独诊断(P<0.05)。结论胃癌患者血清CEA、CA724、CA19-9、CA125表达较高,与患者分化程度、TNM分期、淋巴结转移、远处转移有关,且联合检测胃癌具有较高参考价值。

经阴道超声联合CEA、CA125、CA153鉴别诊断子宫腔占位性病变良恶性

目的:探讨经阴道超声联合CEA、CA125、CA153鉴别子宫腔占位性病变良恶性的价值.方法:收集2021年2月-2023年5月本院疑似子宫腔占位性病变患者117例临床资料,根据刮宫或术后病理检查结果分为恶性组及良性组,其中恶性组56例,为子宫内膜癌;良性组61例,为子宫内膜良性息肉.比较两组经阴道超声及血清指标差异,受试者工作特征曲线(ROC)分析各指标鉴别诊断子宫腔占位性病变良恶性效能.结果:超声检查收缩期峰值血流速度两组无差异(P>0.05),恶性组阻力指数小于良性组、内膜厚度大于良性组;恶性组血清癌胚抗原(CEA)、糖类抗原125、CA153水平均高于良性组(均P<0.05).ROC曲线结果显示,经阴道超声、血清CEA、CA125、CA153各指标单独或联合应用鉴别诊断子宫腔占位性病良恶性的AUC分别为0.822、0.713、0.728、0.797及0.915,均有价值,但联合诊断价值最高.结论:经阴道超声、血清CEA、CA125、CA153联合应用对宫腔占位性病变良恶性鉴别诊断效能较高,有较好的临床应用价值.

基于FIB、HB、FOBT、CEA构建的Logistic回归模型对结直肠癌的诊断价值

目的 评价纤维蛋白原(FIB)、血红蛋白(HB)、癌胚抗原(CEA)和粪便隐血试验(FOBT)联合检测在结直肠癌患者中的诊断价值,为结直肠癌诊断提供参考。方法 选取宁夏医科大学总医院2021年1月至2022年6月结直肠外科收治的110例结直肠癌患者作为癌症组,选取同期病房收治的43例良性结直肠疾病患者为非癌症组。回顾性分析并比较癌症组及非癌症组常规实验室指标(血常规、生化常规、肿瘤标志物、细胞因子、FOBT)结果,采用Logistic回归分析结直肠癌的影响因素并构建Logistic回归模型,采用受试者工作特征(ROC)曲线分析Logistic回归模型对结直肠癌的诊断价值;进一步构建诊断结直肠癌的列线图并绘制校准曲线图进行内部验证。结果 癌症组患者血FIB、CEA水平及FOBT阳性率高于非癌症组,A/G、HB水平低于非癌症组,差异均有统计学意义(P<0.05)。将FIB、HB、FOBT、CEA进行多因素Logistic回归分析,建立Logistic回归模型作为4项指标联合检测模型:P=1/[1+e^(-(13.792-0.144×X_(1)+1.057×X_(2)+0.560×X_(3)+3.029×X_(4)))],其中X_(1)为HB水平,X_(2)为FIB水平,X_(3)为CEA水平,X_(4)为FOBT检测结果(阳性=1,阴性=0)。ROC曲线分析结果显示,当最大约登指数为0.841时,Logistic回归模型诊断结直肠癌的灵敏度为86.4%,特异度为97.7%,曲线下面积(AUC)为0.961(95%CI:0.933~0.988)。建立Logistic回归模型的列线图,并绘制校准曲线图,结果提示该模型的预测概率与实际概率具有较好的一致性。结论 基于FIB、HB、CEA和FOBT 4项指标构建的Logistic回归模型,对结直肠癌有着较好的诊断价值,也为临床对结直肠癌的早期筛查和诊断提供了一定的方向。