金标法与免疫发光法检测CEA在健康体检中的应用

目的：探讨金标法和免疫发光法检测CEA在健康体检中的应用价值。方法：对728例健康体检的个人同时应用金标法和免疫发光法测定CEA,对结果进行分析。结果：金标法测定的阳性率为0．69％,免疫发光法测定的阳性率为0．41％,两者具有高度一致性。结论：对健康体检人群应先用金标法进行定性,对阳性结果再用免疫发光法进行定量。     

中老年健康体检人群多项肿瘤标志物筛查结果及与年龄和性别的关系分析

摘要 目的：研究中老年健康体检人群多项肿瘤标志物（TM）筛查结果,分析其与年龄和性别的关系。方法：将自2017年6月至2019年12月于我院接受健康体检的600例中老年体检者纳入研究,分别以流式荧光发光法检测甲胎蛋白（AFP）、癌胚抗原（CEA）、糖类抗原-153（CA-153）、糖类抗原-125（CA-125）水平,并分析不同性别、年龄的体检者上述TM阳性率情况,分析各项TM阳性率检出疾病情况。结果：600例体检者AFP、CEA、CA-153、CA-125水平分别为（17.48±3.84）ng/mL、（4.54±1.19）ng/mL、（29.23±7.10）U/mL、（30.65±6.39）U/mL,阳性率分别为1.67%、4.00%、3.33%、3.83%。男性体检者CEA及CA-153阳性率均高于女性,而CA-125阳性率低于女性（P＜0.05）;男性与女性AFP阳性率对比不明显（P＞0.05）。81～89岁体检者的AFP、CEA、CA-153、CA-125阳性率均高于其他年龄段体检者（P＜0.05）。AFP、CEA、CA-153、CA-125阳性体检者恶性肿瘤检出率较低。结论：AFP、CEA、CA-153、CA-125表达升高,可能是中老年人群肿瘤发生、发展的早期预警,应予以高度重视,且和年龄、性别关系密切。中老年人群定期体检能够早期发现疾病并治疗,防止疾病继续恶化,保证身心健康。     

基于磁珠法的荧光定量PCR检测HBV-DNA临床应用评价

目的评价基于磁珠法的荧光定量PCR检测HBV-DNA的临床应用。方法选用磁珠法定量检测试剂和煮沸法定量检测试剂,对一系列临床患者血清标本进行检测,比较两种试剂检出率的差异;通过浓度为1×108的样本的梯度稀释结果考察两者的灵敏度和线性范围。结果 68例临床样本中,磁珠法试剂检测的阳性率为69.12%,煮沸法试剂检测的阳性率为32.35%(P0.05);两种试剂对103IU/m L阳性样本检测结果:y=0.913x-0.261,r=0.919;磁珠法线性范围3.9×(101~108),灵敏度39 IU/m L,煮沸法线性范围2.4×(102~107),灵敏度240 IU/m L。结论磁珠法核酸提取试剂线性范围宽,灵敏度高,临床检出率明显高于煮沸法,对于高浓度和低浓度样本都能准确的定值,适合于乙肝治疗后监测与体检筛查。     

血清AFP、CEA与肝癌患者临床病理分期和预后的关系及其诊断价值分析

目的:探讨血清甲胎蛋白(AFP)、癌胚抗原(CEA)与肝癌患者临床病理分期和预后的关系及其诊断价值。方法:选取2010年3月至2014年4月期间我院就诊的90例肝癌患者作为肝癌组,并选择同期在我院进行体检的90例健康体检者作为健康组。统计两组的血清AFP、CEA水平及阳性率,比较不同TNM分期肝癌患者的血清AFP和CEA水平。分析肝癌患者的5年无复发生存率以及血清AFP和CEA水平对肝癌的诊断价值。结果:与健康组相比,肝癌组血清AFP、CEA水平及阳性率明显升高(P0.05)。Ⅳ期血清AFP和CEA水平最高,其次Ⅲ期,Ⅱ期次之,Ⅰ期最低(P0.05)。血清AFP、CEA阳性患者5年无复发生存率明显低于血清AFP、CEA阴性患者(P0.05),血清AFP、CEA联合诊断具有较高的敏感性和特异性。结论:肝癌患者的血清AFP和CEA水平升高,并随TNM分期增加而上调。血清AFP阳性以及CEA阳性患者的5年无复发生存率明显下降,血清AFP联合血清CEA检测在肝癌诊断中具有一定的临床价值。     

血清CEA、CA125、TSGF联合检测对乳腺癌的诊断价值

目的探讨血清癌胚抗原(CEA)、糖类抗原-125(CA125)以及恶性肿瘤特异生长因子(TSGF)联合检测对乳腺癌临床诊断的价值。方法选取2017年5月至2019年5月我院收治的70例乳腺疾病患者为研究对象,其中包含乳腺癌患者35例(乳腺癌组),良性乳腺增生患者35例(良性乳腺结节组)。选取同期于我院进行健康体检的健康女性30例作为对照组。分析各组对象血清CEA、CA125、TSGF表达情况,以及CEA、CA125、TSGF联合检测在乳腺癌诊断中的应用。结果乳腺癌组患者血清中CEA、CA125、TSGF水平明显高于良性乳腺结节组及对照组(均P<0.05),而良性乳腺结节组患者血清CEA、CA125以及TSGF水平与对照组差异无统计学意义(均P>0.05)。CEA诊断阳性率、阴性率分别为47.1%、52.9%;CA125诊断阳性率、阴性率分别为51.4%、48.6%;TSGF诊断阳性率、阴性率分别为50.0%,50.0%,联合诊断阳性率、阴性率分别为64.3%、35.7%。CEA、CA125以及TSGF单独检测的诊断灵敏度、特异度、准确度以及约登指数差异无统计学意义(均P>0.05),而联合检测诊断的灵敏度均显著高于CEA、CA125、TSGF单独检测(均P<0.05)。联合检测诊断的特异度、准确度和约定指数与CEA、CA125、TSGF单独检测水平差异均无统计学意义(均P>0.05)。结论乳腺癌发病期间存在多种因子的水平变化。CEA、CA125、TSGF联合检测可以提高乳腺癌的诊断效能。     

荧光染色法与KOH法在皮肤真菌检查中的效果比较

目的探讨真菌荧光法在皮肤浅部真菌筛查的敏感性。方法收集皮肤科门诊疑似真菌感染的患者标本,同时用KOH湿片法和真菌荧光染色法进行检测,并对检验结果进行对比。结果 1 209例患者中真菌荧光染色法阳性的阳性率为42.76%,KOH湿片法的阳性率为24.81%,结果差异有统计学意义(χ^2=87.094,P<0.05)。荧光染色法和KOH法在患者不同部位的阳性率:头面部为55.59%、7.90%,体股部为46.93%、30.06%,手足部为27.37%、26.25%,外阴部为31.85%、14.07%,指甲(趾甲)部为51.64%、48.36%;在不同疾病中的阳性率:马拉色毛囊炎为77.00%、8.50%,手足癣为48.04%、46.08%,体癣为50.31%、33.44%,甲癣为51.64%、48.36%,花斑癣为66.67%、48.00%,湿疹为10.24%、5.42%,皮炎为48.11%、9.43%。结论荧光染色法是一种简单、快速、准确的真菌镜检方法,值得在临床上推广使用。其总体的阳性率比KOH湿片法高,毛囊虫、疥疮等真菌荧光染色法在镜下更容易辨认。头面部、外阴等油脂分泌旺盛的部位以及马拉色毛囊炎、湿疹和皮炎等疾病推荐使用荧光染色法来排除是否有真菌的感染。     

温阳化瘀法对月经周期紊乱患者p53,p21,MDM2蛋白表达的影响

目的:通过对月经周期紊乱患者的细胞周期相关基因的表达水平进行分析,得出温阳化瘀法在此病上的治疗效果。方法:选取我院妇科收治的月经周期紊乱患者120例,参照随机原则共分为2组,其中西医治疗组59例,给予醋酸甲羟孕酮片和克罗米芬口服;实验组61例,在西医治疗基础上给予温阳化瘀中药治疗,每日1剂;另外随机选取同期体检健康的60名女性作为正常对照组,在治疗结束后,应用免疫组化方法对全部受试者进行p53、p21以及MDM2蛋白表达检测,同时应用统计学软件对相关结果进行分析。结果:1p53和p21蛋白的阳性表达主要在细胞核,MDM2蛋白阳性表达定位在细胞核和(或)胞质;2正常子宫内膜组织中p53蛋白阳性表达率为(36.67%),p21表达率为(33.33%),显著高于月经周期紊乱患者,中药治疗组的p53蛋白阳性表达率为(19.67%),p21达率为(18.03%),显著高于西医治疗组,P0.05,差异有统计学意义;3正常子宫内膜组织中MDM2蛋白阳性表达率为(1.67%),显著低于月经周期紊乱患者,中药治疗组的MDM2蛋白阳性表达率为(32.77%),显著低于西医治疗组(50.85%),P0.05,差异有统计学意义。结论:与健康妇女相比,月经周期紊乱患者的p53和p21蛋白阳性表达率显著降低,MDM2蛋白阳性率显著升高,应用温阳化瘀法能够显著改善月经周期紊乱患者细胞周期相关基因的表达水平。     

酶联免疫法和胶体金法在胃镜检查前检测乙肝表面抗原的结果观察

目的:比较酶联免疫法和胶体金法在胃镜检查前检测乙肝表面抗原的结果,以探讨酶联免疫法和胶体金法在检验与病理科乙肝表面抗原检测中的应用价值。方法:选择2017年1月~2019年12月我院进行胃镜检查的100例上消化道疾病患者,均在胃镜检查前检测乙肝表面抗原,对照组使用胶体金法进行检测,观察组使用酶联免疫法进行检测。比较酶联免疫法和胶体金法在胃镜检查前检测乙肝表面抗原的阳性率、敏感度以及特异度。结果:酶联免疫法和胶体金法在胃镜检查前检测乙肝表面抗原的阳性率分别为35.00%(35/100)和33.00%(33/100),两种方法相比较没有明显的差异(P>0.05);酶联免疫法在胃镜检查前检测乙肝表面抗原的敏感度(97.34%)与特异度(98.12%)均明显高于胶体金法(P<0.05)。结论:酶联免疫法和胶体金法在胃镜检查前对乙肝表面抗原均有比较高的阳性检测率,但是酶联免疫法具有更高的敏感度以及特异度,仍然是现今检测乙肝表面抗原的主要方法,胶体金法由于检测方法更加简便和直观、方便携带、结果更加快捷,而且不需要特殊的仪器设备,更加适用于临床上紧急状态下患者的检测以及感染者初筛等情况。     

肿瘤标志物在卵巢恶性肿瘤早期误诊预防中的价值

目的:探讨糖类抗原CA125、CEA与CA199联合检测对卵巢癌有一定的鉴别诊断价值。方法:应用化学发光免疫法对126例经病理查证实的卵巢癌患者(试验组)、104例良性肿瘤患者(对照组)进行血清CA125、CEA与CA199检测。结果:试验组血清检测结果和阳性率均明显高于对照组(P<0.01),联合检测阳性率高于单项检测(P<0.01)。结论:应用检验医学进行CA125、CEA与CA199联合检测对卵巢癌有一定的鉴别诊断价值。可降低误诊率。     

全自动直接定量法与定量比值法检测红细胞葡糖-6-磷酸脱氢酶活性的比较

目的:与定量比值法比较,探讨全自动直接定量法检测红细胞葡糖-6-磷酸脱氢酶(G-6-PD)活性的可行性。方法:同时采用定量比值法(即硝基四氮唑蓝定量法)和全自动直接定量法,检测219例肝素抗凝静脉血标本的红细胞G-6-PD活性。结果:定量比值法检测G-6-PD缺乏的阳性率为9.13%,全自动直接定量法检测的G-6-PD缺乏阳性率为9.58%,两种方法检测结果无显著性差异(P>0.05)。结论:定量比值法简单易行,适用于卫生条件有限的基层医疗单位;全自动直接定量法快速准确,是一种可批量检测的理想筛选方法。     

Carcinoembryonic antigen in effusions. A diagnostic adjunct to cytology

A total of 189 effusion specimens (100 benign and 89 malignant) submitted for cytologic examination were assayed for carcinoembryonic antigen (CEA) by an enzyme immunoassay to determine whether the addition of CEA evaluation to cytologic study would improve the diagnostic accuracy for the detection of malignancy. The sensitivity and specificity were 78% and 90%, respectively, for a cytologic diagnosis of malignancy and 68% and 99%, respectively, for a positive CEA (greater than 5 ng/mL). CEA assay was negative in the most common epithelial malignancies of the female genital tract (15 of 17 cases), mesotheliomas (5), lymphomas (7) and alveolar-cell carcinoma of lung (1). CEA assay was positive in 55 of 89 cases of malignancy, including 14 cases with cytologically negative malignant effusions. The CEA assay sensitivity for lung carcinoma (95% for adenocarcinoma, 100% for oat-cell carcinoma and 100% for carcinosarcoma), breast carcinoma (95%), and gastrointestinal carcinoma (100%) were all over 90%. No significant difference in the levels of CEA was noted between gastrointestinal and lung adenocarcinomas. Oat-cell carcinomas and squamous-cell carcinomas had lower values. In cases of an effusion with an unknown primary, an elevated CEA in the fluid is diagnostic of metastatic carcinoma arising from the breast, lung or gastrointestinal tract.     

癌胚抗原蛋白芯片的研发及其在肝癌检测中的评价

目的:研究建立一种简便、快速、特异性高、低成本的检测血清中癌胚抗原(CEA)浓度的蛋白芯片,并通过检测肝细胞肝癌(HCC)对其进行评价。方法:采用双抗体夹心法,制备能够形成捕获抗体-抗原-检测抗体的"三明治"结构的蛋白芯片检测血清中CEA浓度。通过用该蛋白芯片检测50例CEA阳性HCC患者血清和56例健康人血清,对其进行盲法验证。结果:以CEA5 ng/m L为阳性判定标准,得出CEA蛋白芯片的灵敏度为92%(46/50),特异度为100%(56/56)。受试者工作特征(ROC)曲线分析显示该蛋白芯片检测出血清CEA的ROC曲线下面积(AUC)为0.960,与0.5相比差异有统计学意义(P0.001),其判定CEA阳性的准确性较高。结论:成功建立检测血清中CEA浓度的蛋白芯片,为下一步研发多种标志物联合检测HCC的蛋白芯片提供候选血清标志物。     

Rapid dot sputum and serum assay in pulmonary tuberculosis

A rapid direct sputum (Sp.) and/or antibody assay, based on immunoblotting and enzyme immunoassay is described. The test can detect mycobacterial antigens or antibodies in clinical specimens from pulmonary tuberculosis (TB) patients. In this study, 87 sputa, 87 sera and 40 paired sputa and sera were utilized from smear-positive and smear-negative, culture-positive patients; 59 sputa, 37 sera and 22 paired sputa and sera from nontuberculosis respiratory disease patients and 68 sera from healthy controls. The antigen detection in sputum by dot assay has 86.1% sensitivity on active tuberculosis patients, 92.9% specificity, 91.6% positive predictive value (PPV), 88.2% negative predictive value (NPV) and 10.3% error. The antibody assay has 83.6% sensitivity, 95.4% specificity, 94.4% positive predictive value, 85.6% negative predictive value and 11% error. The test performed on paired sputum and serum (Sr.) samples has a sensitivity of 93.3%, which rose to 96.1% on smear-positive and culture-positive patients, but the specificity decreased to 83% in sputum, whereas in serum it was 92%. The results of the assay, combined with clinical and radiological data, could form the basis for starting an earlier course of treatment for tuberculosis.     

Combined carcinoembryonic antigen and cytopathologic examination in ascites

OBJECTIVE: To investigate use of the combined carcinoembryonic antigen (CEA) test and cytopathologic examination to improve the diagnosis of neoplastic vs. nonneoplastic ascites. STUDY DESIGN: The tests were performed prospectively on 130 patients with ascites whose effusions were submitted for cytologic examination. RESULTS: Sixty-seven patients had epithelial tumors, and the cytologic examination was positive in 39 (58.2%). The CEA level was > or = 11.0 ng/mL in 36 patients (53.73%). CEA was helpful in the diagnosis in 18 cases, increasing to 57 (85.07%) the number of positive diagnoses. Eight samples of nonepithelial tumors had low levels of CEA. In 55 patients with nonneoplasic ascites the cytopathologic examination was negative, but the CEA assay was > 11.0 ng/mL in 3 patients. CONCLUSION: The cytopathologic examination should be performed in all cases, and the CEA assay should be done in suspected cases of epithelial neoplasia in which the cytologic examination was negative, there was uncertainty about the histologic type of neoplasia, or a diagnosis of nonepithelial neoplasia was made. When ascitic leukocytosis or hepatic failure is present, one should be cautious in interpreting the CEA assay because false positivity can occur.     

Monoclonal antibodies against the plant cytokinin isopentenyl adenosine

Sixteen monoclonal antibodies against isopentenyl adenosine (iPA) were developed and characterized for reactivity towards this cytokinin and structurally related molecules by use of a competition fluorescence enzyme immunoassay. Antibodies with suitable affinity and specificity were used in an immunoassay to detect and quantify isopentenyl adenosine. Logit/log plots of fluorescence vs pmol of the cytokinin indicated that the assay had a measurement range of 0.03–256 pmol (10–8500 pg) with high linearity (r =–0.98). This competition fluorescence enzyme immunoassay showed that three antibodies cross-reacted with N-6-benzyladenine and its riboside: cross-reactivity with dihydrozeatin and its riboside, cis -zeatin, trans -zeatin riboside, adenine and adenosine was minor. When an immunoaffinity-HPLC technique was used to measure the cross-reactivity of two of the antibodies in the presence of known quantities of multiple cytokinins, iPA was bound in preference to the other cytokinins. One of the antibodies was used to quantify this cytokinin in developing wheat ( Triticum aestivum L. cv. Stephens) seeds and in wheat seeds spiked with known amounts of certain other cytokinins. The use of these antibodies in immunoassay in combination with HPCL for quantification of iPA in plant extracts is discussed.     

一种联合检测乙型肝炎病毒前S1抗原与核心抗原方法的建立及其与病毒核酸检测结果的一致性

本研究以与血清中HBV DNA含量高度相关的两种HBV抗原(前S1抗原与核心抗原)为靶标,建立了联合检测这两种HBV核酸相关抗原(NRAg)的双抗体夹心法ELISA试剂.对系列稀释血清的检测表明,该试剂的平均分析灵敏度为103.2基因组拷贝/mL(95%可信限102.2-4.2基因组拷贝/mL),显著高于前S1抗原或核心抗原的单独检测.对994份HBsAg阴性血清的检测结果表明NRAg ELISA的特异性为99.7%(95%可信限:99.1%～99.9%).对271份临床慢性肝炎血清进行检测,结果NRAg ELISA与HBV DNA结果的总符合率达96.3%(95%可信限:93.3%～98.2%),NRAg ELISA的读值/临界值比(S/CO)与HBV基因组拷贝数呈正相关.利用NRAg试剂,发现了1例HBsAg"a"抗原表位突变的变异株.这些结果显示HBV NRAg ELISA与HBV DNA具有高度相关性,并能够检测出HBsAg抗原变异株,有望成为HBsAg变异株筛选的有力工具,并为广大基层医疗单位提供一种便捷的替代HBV DNA定性检测的手段.     

Enzyme immunoassay of pancreatic glucagon at the picogram level using beta-D-galactosidase as a label.

An enzyme immunoassay of pancreatic glucagon was established by using E. coli beta-D-galactosidease [EC 3.2.1.23] as a marker. In order to increase the sensitivity of the immunoassay, different peptides obtained from glucagon fragments were used to produce the enzyme conjugate and the immunogen. Antiserum N6E raised against C-terminal fragment peptide (15-29) could be diluted to more than 1 : 100,000 in the assay and was highly specific for pancreatic glucagon. The antiserum reacted well with the C-terminal fragment peptide (21-29) as well as another fragment peptide (15-29) and pancreatic glucagon. The enzyme immunoassay using antiserum N6E and fragment peptide (21-29)-enzyme conjugate could detect as little as 1 to 2 pg of glucagon. The mean recovery of glucagon added to serum specimens was 104% and the coefficients of variation were 3.7-14.5% (within assay) and 9.0-18.5% (between assay).     

Enzyme immunoassay of serum testosterone.

An enzyme immunoassay of serum testosterone using the testosterone-glucoamylase complex is described. Testosterone was estimated by the enzyme immunoassay after extraction with hexan: ether (4:1) for serum from men and additional thin layer chromatographic step for serum from women. The within and between assay errors, measured as the coefficient of variation were 11.1 percent (n=8) and 12.0 percent (n=12). The sensitivity of this assay was 0.25 ng. The mean testosterone concentration (+/- SD) in 19 normal men and 4 normal cycling women were 5.3 +/- 1.8 and 0.52 +/- 0.12 ng/ml, respectively. The level of testosterone found by the present assay compared favorably with those obtained by other methods.     

胶体金渗滤法检测贝氏柯克斯体的研究

本文建立一种快速、敏感、适于基层应用的贝氏柯克斯体（俗称Ｑ热立克次体）的检测方法。将Ｑ热立克次体多克隆抗体点于硝酸膜上,用以捕获待检标本中的Ｑ热立克次体抗原,通过胶体金标记的鼠抗Ｑ热立克次体单克隆抗体直接显色,阳性者出现红色斑点。结果表明,用该法检测Ｑ热立克次休实验感染豚鼠血液,小鼠肝或脾,蜱血淋巴等标本取得了较满意的结果,整个过程仅需５－６分钟。与其他病原体无交叉反应,敏感度不低于５０ｎｇ立克次