摘要
【目的】评价肿瘤标志物角蛋白19（CKl9）、癌胚抗原（CEA）和癌链抗原19—9（CAl9—9）联合检测对结直肠癌术后化疗效果及预后评估的临床价值。【方法】选取经手术后病理证实的68例结直肠癌患者，应用化学发光免疫分析方法检测第1周期化疗前后CKl9的含量并结合化疗前、足疗程化疗后血清CEA、CAl9—9的含量，联合随访的影像学检查结果，客观评价联合标志物检测与肿瘤复发和化疗效果的关联。【结果】联合三种肿瘤标志物，术后转移组100％（16／16）至少有一项高于正常，75％（12／16）至少两项高于正常，25％（4／16）三种肿瘤标志物均高于正常；未转移组42．31％（22／52）只其中一种肿瘤标志物高于正常，无两者或三者同时高于正常。未转移组中的18例患者，化疗前CEA或CA19—9高于阳性参考值，经足疗程化疗后降至正常，与化疗初期动态监测CK19凋亡诱发的规律性变化的符合率为66．7％（12／18）。【结论】OCK19、CEA和CA19—9联合检测能比较准确地预测结直肠癌术后复发。②化疗初期CKl9规律性变化特征与效果之间有直接关联性，可作为预测疗效的指标，具有重要的临床价值。
[Objective] To explore the clinical value of combined measurement of tumor markers CK19, CEA and CA19-9 in different mechanism levels for the evaluation of the efficacy of postoperative chemotherapy in colorectal cancer. [Methods] Sixty eight patients with colorectal cancer confirmed by surgical pathology were chosen. Chemiluminescence immunoassay was used to detect the level of CKI9 before and after the first course of chemotherapy and the levels of serum CEA and CA19-9 before and after full course of chemotherapy.The measurement of above markers combined with the result of follow-up tmagmg was usea to analyze tne corremtion between the combined measurement of tumor markers, tumor recurrence and chemotherapy efficacy. [Results]In metastasis group, at least one marker was normal in all patients（100 %）, and at least two markers were above normal in 12 patients（75 %）, and all three markers were above normal in 4 patients（25 %）. In non- metastasis group, only one marker was normal in 22 patients（42.31 %）, and the two or three markers were normal simultaneously in none of patients. Eighteen cases in non-metastasis group, the level of CEA or CA19- 9 before chemotherapy were above positive reference, and decreased to the normal after full course of chemotherapy, and its coincidence with the regular changes of CK due to apoptosis during the initial chemotherapy was 66.7 %. [Conclusion]Combined measurement of CK19, CEA and CA19-9 can predict the postoperative re- currence of colorectal cancer accurately. The characteristics of the regular change of CK19 during the initial chemotherapy have a direct correlation with the efficacy of chemotherapy, and can be the indicator of predicting the efficacy of chemotherapy, so they have an important clinical value.
出处
《医学临床研究》
CAS
2011年第5期804-806,809,共4页
Journal of Clinical Research
基金
首都医学科研发展基金N02007-3047
