CT联合DR对早期周围型肺癌的诊断价值

目的:分析数字X线摄片(DR)、CT及其联合应用对周围型肺癌的诊断价值。方法:选择该院2012年2月~2016年3月收治早期周围型肺癌患者90例为研究对象,分别进行数字化X线摄影和CT检查,以手术切除或病理结果为最终诊断的金标准,计算两种检查方法及其联合对早期诊断周围型肺癌的敏感度、特异度和准确率阳性预测值以及阴性预测值。结果:胸部DR检出空泡征者7例(7.8%),分叶征47例(52.2%),边缘有细小毛刺征36例(40%),胸膜凹陷征9例(10%);CT见病变边缘分叶征71例(78.8%),长短毛刺征57例(63.3%),空洞征27例(30%),胸膜凹陷征32例(35.6%)。DR诊断周围型肺癌的敏感性、特异性及准确性分别为85%、81%、85.6%,而CT则为90%,87.6%,90.5%,均高于DR。DR与CT两者联合诊断周围型肺癌的敏感性为98.4%,显著高于DR(85%)和CT(90%)。结论:在早期周围型肺癌的影像学诊断中,CT的临床价值显著优于DR,而两者联合诊断的临床价值明显优于单独检测。     

血清肿瘤标志物CEA、CA199及CA153联合检测对肺癌的诊断价值

目的：评价血清CEA、CA199及CA153联合检测对肺癌诊断及分期的临床价值。方法：用化学发光分析法测定144例不同类型及分期的肺癌患者、92例肺良性疾病患者及76例健康体检者血清CEA、CA199及CA153水平的变化。结果：肺癌组血清CEA、CA199及CA153水平均高于正常对照组及肺良性疾病患者,有显著性差异,且TNM分期越晚,其水平越高;3项肿瘤标志联合检测可提高敏感性及准确性。结论：CEA、CA199及CA153联合检测可以为肺癌的诊断及分期提供有价值的实验室依据。     

低剂量螺旋CT联合肺癌自身抗体、肿瘤标志物CA12-5、CA19-9在肺癌诊断中的临床应用价值

摘要 目的：探讨低剂量螺旋CT联合肺癌自身抗体、肿瘤标志物糖类抗原（CA）12-5、CA19-9在肺癌诊断中的临床应用价值。方法：选择2019年1月至2021年12月在我院经低剂量螺旋CT检查发现肺部病灶的患者86例,以病理诊断结果分为肺癌组49例、肺部良性病变组37例,另选取同期健康体检志愿者30例作为对照组。观察肺癌的低剂量螺旋CT影像学特征,检测比较各组血清肺癌自身抗体[p53、SOX区域Y相关HMG蛋白家族成员2（SOX2）、G抗原7（GAGE7）、RNA解旋酶自身抗体4-5（GBU4-5）]及CA12-5、CA19-9水平,并对比阳性表达情况,分析低剂量螺旋CT联合肺癌自身抗体、CA12-5、CA19-9对肺癌的诊断价值。结果：49例肺癌患者经低剂量螺旋CT检查共发现51个病灶,其中实性结节或部分实性结节30个,非实性结节21个;病灶平均直径（10.92±1.17）mm,＜5 mm者9个,5～10 mm者17个,≥10 mm者25个;11个病灶伴有钙化,16个病灶有毛刺征,20个病灶有分叶征;有6例表现为空洞,空洞通常壁薄厚不均匀,呈中心性或偏心性。肺癌组血清p53、SOX2、GAGE7、GBU4-5及CA12-5、CA19-9水平均明显高于肺部良性病变组和对照组,肺部良性病变组上述指标水平均明显高于对照组（P<0.05）。肺癌组CA12-5、CA19-9、4项肺癌自身抗体单独及联合的阳性率均明显高于肺部良性病变组和对照组（P<0.05）,肺部良性病变组CA12-5、CA19-9及4项肺癌自身抗体联合的阳性率高于对照组（P<0.05）。低剂量螺旋CT联合4项肺癌自身抗体、CA12-5、CA19-9对肺癌诊断的灵敏度为91.84%,特异度为97.30%,准确度为94.19%。结论：低剂量螺旋CT联合肺癌自身抗体、肿瘤标志物CA12-5、CA19-9在肺癌诊断中有较好的临床应用价值。     

葡萄糖-6-磷酸异构酶抗原对类风湿关节炎的诊断价值

目的:通过比较类风湿关节炎(Rheumatoid arthritis,RA)患者、非RA风湿病患者及健康对照者血清中葡萄糖-6-磷酸异构酶(glucose-6-phosphate isomerase,GPI)抗原的阳性率来探讨GPI对RA的诊断意义,并探讨GPI,抗CCP抗体和RF联合应用对RA的诊断价值.方法:对110例RA患者、223例非RA风湿病患者和55例健康对照者共388份血清标本进行了检测.GPI抗原和抗CCP抗体采用ELISA方法,RF采用免疫比浊法定量检测.结果:RA组、非RA风湿病组和健康对照组血清中的GPI抗原阳性率分别为83.64%,30.04%和20.00%,RA组阳性率显著高于其它组(P＜0.01).GPI抗原对RAt诊断的敏感性和特异性分别为83.64%和71.58%.GPI和抗CCP抗体联合检测的敏感性和特异性分别为90.91%和71.22%,GPI和RF联合检测的敏感性和特异性分别为92.73%和 61.87%,如果三者同时检测,其敏感性和特异性分别为94.55%和60.43%.结论:RA患者的血清GPI阳性率明显高于其它自身免疫性疾病患者和健康对照者.GPI抗原时RA具有诊断价值,联合检测GPI、抗CCP抗体和RF可以提高RA诊断的敏感性.     

血清CA199、CYFR21-1、CEA、NSE水平与肺癌的相关性研究

目的：分析血清CA199、CYFR21-1、CEA、NSE 水平检测在肺癌诊断及疗效评估中的临床价值,探讨其与肺癌的相关性。方 法：采用化学发光免疫法检测78 例肺癌患者、50 例肺部良性疾病及50 例健康体检者血清CA199、CYFR21-1、CEA、NSE 水平,比 较治疗前后肺癌患者肿瘤标志物水平的变化。结果：肺癌组血清CA199、CYFR21-1、CEA、NSE 水平较对照组、肺良性疾病组均显 著升高(P<0.05);Ⅲ-Ⅳ期肺癌患者各肿瘤标志物水平均较Ⅰ-Ⅱ期患者明显升高（P<0.05）;四项联合检测的敏感性为79.5 %,明显 高于CA199、CYFR21-1、CEA、NSE 任一单项肿瘤标志物的敏感性（P<0.05）;随着疗效的下降,血清CA199、CYFR21-1、CEA、NSE 水平逐渐升高（P<0.05）。结论：肺癌患者血清CA199、CYFR21-1、CEA、NSE 水平呈高表达状态,且其表达水平与肺癌病情程度密 切相关,联合检测有助于提高肺癌诊断的敏感度及指导治疗方案选择。     

血清孕酮、β-HCG及CA125水平在宫外孕诊断中的临床应用

目的:探讨血清孕酮、人绒毛膜促性腺激素(HCG)及癌抗原125(CA125)水平在宫外孕诊断中的临床应用价值。方法:选择我院妇产科收治的61例宫外孕患者作为观察组,同期选择正常早孕孕妇35例作为对照组,检测并对比两组血清孕酮、β-HCG 48h内增长率及CA125水平,研究三项指标分别检测和联合检测对宫外孕诊断的特异性、敏感性。结果:观察组血清孕酮、β-HCG48 h增长率及CA125检测水平均显著低于对照组,比较差异有统计学意义(P0.05);单独应用时CA125对于宫外孕具有较高的特异性,而β-HCG 48 h内增长率具有较高的敏感性,三项指标联合检测特异性及敏感性均显著优于单一指标,比较差异具有统计学意义(P0.05)。结论:血清孕酮、β-HCG及CA125指标水平的分别检测或联合检测,对宫外孕的诊断均有一定的临床价值,而三项指标的联合检测显著优于单一指标。     

肿瘤自身抗体检测对早期肺癌的诊断价值

目的探讨肺癌自身抗体P53、PGP9.5、SOX2、GAGE7、GBU4-5、MAGEA1和CAGE对早期肺癌的诊断价值。方法采用ELISA法检测肺癌组(46例首次确诊的肺癌患者)和对照组(包含22名肺部良性疾病患者及23例健康体检者)血清中肺癌自身抗体P53、PGP9.5、SOX2、GAGE7、GBU4-5、MAGEA1和CAGE表达水平,分析评价7种肺癌自身抗体单独检测和联合检测对肺癌的临床诊断价值。结果肺癌组患者血清中7种自身抗体的水平明显高于对照组(均P<0.05)。肺癌组患者7种抗体联合检测的阳性率明显高于对照组(65.22%vs 15.56%,χ²=23.252,P<0.001)。单一肺癌自身抗体检测的敏感性为4.35%~36.96%,特异性为93.30%~100.00%,AUC为0.695~0.832。7种肺癌抗体联合检测的敏感性为65.22%,特异性为84.44%,AUC为0.897。结论早期肺癌患者血清中7种肺癌自身抗体水平均较高。单一肺癌自身抗体检测的特异性较高,但敏感性较低。7种肺癌自身抗体联合检测具有较高的敏感性,可成为临床早期肺癌新的辅助诊断指标。     

OPN联合CA125检测在卵巢癌早期诊断中的价值

目的:观察骨桥蛋白(OPN)和癌抗原125 (CA125)联合检测在卵巢癌早期诊断中的价值.方法:采用酶联免疫吸附法(ELISA)测定32例卵巢癌患者(A组)及40例卵巢良性病变(B组)血清中ONP、CA125水平.结果:卵巢癌患者血清中OPN及CA125水平明显高于良性对照组(P＜0.05);OPN、CA125检测的敏感性分别为81.3％和71.9％,OPN+CA125联合检测的敏感性为93.8％,均高于二者的单独检测;OPN、CA125检测的特异性分别为92.5％和87.5％,OPN+CA125联合检测的敏感性为95.0％,均高于二者的单项检测;OPN+CA125联合检测的阳性预测值和阴性预测值均高于二者的单项检测.结论:OPN联合CA125联合检测可提高卵巢癌的早期诊断水平.     

血清AFP,CEA,CA125单独或联合检测对原发性肝癌早期诊断的临床价值研究

目的:探讨血清中甲胎蛋白(AFP)、癌胚抗原(CEA)、糖类抗原125(CA125)单独以及联合检测对于原发性肝癌的早期诊断临床价值。方法:选择2012年1月~2016年6月在我院检验科确诊的120例原发性肝癌患者作为观察组,并以80例健康志愿者作为对照组,检测和比较两组的AFP、CEA和CA125水平,分析血清AFP、CEA、CA125单项及联合检测检出原发性肝癌的阳性率和约登指数。结果:观察组血清AFP(319.53±35.78 ng/mL)、CEA(81.4±27.8 ng/mL)、CA125(20.67±4.61 ng/mL)水平均明显高于健康对照组(P0.05)。血清AFP、CEA、CA125在单独检测时诊断原发性肝癌的敏感性分别为65%(78/120)、75%(90/120)和60%(72/120),而三者的联合检测能够使检测的敏感性达到92%(112/120),显著高于单独检测时的敏感度(P0.05)。血清AFP、CEA、CA125单项检测约登指数均显著低于联合检测(P0.05)。结论:相较于血清AFP、CEA、CA125的单独检测,三者联合检测可明显提高原发性肝癌的检出率。     

肿瘤型M2-PK、CEA与CA199检测在结直肠癌诊断中应用的临床观察

目的:通过分析肿瘤型M2-PK、CEA与CA199在结直肠癌患者中的检测结果,探讨对结直肠癌早期诊断与评判预后的有效检测手段。方法:选择健康体检者30例与结直肠癌患者45例,分析肿瘤型M2-PK、CEA与CA199在健康人群与不同结直肠癌分期(Dukes分期)中的改变,并分析肿瘤型M2-PK、CEA与CA199联合检测在结直肠癌患者中的敏感性、特异性与准确性。结果:以上三项肿瘤血清标志物与结直肠癌的进展呈正相关性(P<0.01),且不同Dukes分期患者与健康人差异具有统计学意义(P<0.05,P<0.01);血清tumor M2-PK检测的敏感性与准确性显著优于另两项指标(P<0.01,P<0.05),三项联合检测的敏感性与准确性则显著优于血清tumor M2-PK(P<0.01,P<0.05)。结论:血清tumor M2-PK、血清CEA和血清CA199检测可作为结直肠癌患者早期诊断与预后评估的有效指标,血清tumor M2-PK的敏感性与准确性优于其他两项指标,而三项联合检测可显著提高敏感性与准确性。     

Tumor antigen NB/70K and CA 125 levels in the blood of preoperative ovarian cancer patients and controls: a preliminary report of the use of the NB12123 and CA 125 radioimmunoassays alone and in combination

The NB12123 and CA125 radioimmunoassays, murine monoclonal antibody assays for measuring circulating levels of human ovarian tumor associated antigens NB/70K and CA 125, respectively, have been previously described. In the present study, preoperative serum samples were obtained from patients undergoing laparotomy for benign neoplastic ovarian tumors (N = 16), cancer of the cervix (N = 22), cancer of the uterus (N = 20), and cancer of the ovary (N = 47). Controls (N = 50) were obtained from healthy blood bank donors. No correlation was observed between the levels of NB/70K and CA 125 in these samples (r2 = .079, linear regression analysis). In general, increasing levels of both antigens were present with increasing tumor burden and higher histological grade. In addition, both markers were most elevated in the serum of ovarian cancer patients with serous and unclassified adenocarcinomas. Using 40 AU and 35 unit cut-offs for the NB/70K and CA 125 assay, respectively, overall specificity for healthy controls and patients with benign diseases approaches 100%. The combined sensitivity of the assays for ovarian cancer patient sera in this study indicates that the assays may be helpful in establishing a pre operative diagnosis of ovarian cancer. Complementarity of the NB/70K and CA 125 assays has been demonstrated, indicating that one or both assays may be used to monitor as many as 85% of ovarian cancer patients.     

Tumour associated antigens CA 15.3 and CA 125 in ovarian cancer

CA 125 and CA 15.3 antigens were determined by enzyme immunoassay in 78 patients with ovarian cancer for a total of 540 determinations. The antigens were also investigated in sera from 100 women with other gynaecological diseases, 82 lung cancer patients and in 39 pleural fluids of varying origin. CA 15.3 reference values were evaluated in 91 healthy women (cut-off: 25 U/ml). CA 15.3 sensitivity at diagnosis (60%) and for detecting relapse (44%) was lower than that of CA 125 (90% and 64.7%, respectively). However, CA 15.3 does not increase with aspecific mesothelial cell reaction and thus it is more specific than CA 125. Combined use of the markers during follow-up improves early detection of relapse (at least one of the two was positive in 79% of cases). Therefore both CA 15.3 and CA 125 should be routinely determined for the detection and monitoring of ovarian cancer.     

MCA in patients with breast cancer: correlation with CEA and CA15-3

MCA serum levels were determined in 27 healthy subjects, 136 with benign pathology (42 breast) and in 289 patients with cancer (247 active). The last group includes 223 patients with breast cancer (96 without metastases, 89 with metastases and 38 no-evidence of disease). CEA and CA15-3 serum levels were determined in all the patients with breast diseases. The mean levels of MCA were 4.7 + 2.4 U/ml in the control group, considering less than 11 U/ml as normal. MCA values were abnormal in 15.4% of patients with benign pathology, mainly in those with liver cirrhosis (8/20) and lung diseases (4/20). In the majority of these cases, the rise was only moderate, lower than 15 U/ml in 97.5% of patients. In malignant diseases, important increments were found in breast cancer (19.8% Mo, 77.5% M1) and ovarian cancer stages III-IV (44.4%). When we compared MCA serum levels with CA15-3 and CEA in breast pathology, a similar specificity was observed: 92.3%, 92.3% and 100% in cases with benign pathology and 92.1%, 94.7%, and 97.4% in NED patients, respectively. MCA and CA15-3 sensitivity was similar in breast cancer without metastases (19.8%) and lower for CEA (16.7%). In patients with breast cancer without metastases, we found a relation between positivity of these tumor markers and prognostic factors (tumor size, nodal involvement). The disease free interval in patients with locoregional breast cancer was shorter in cases with abnormal presurgical levels of some of the tumor markers, but only the difference from MCA was significant (p less than 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)     

Comparison of CA 15-3 and CEA in diagnosis and monitoring of breast cancer

In order to assess the utility of the tumor-associated antigen CA15-3 in the diagnosis of breast cancer, this new tumor marker was measured pre-operatively in 1342 patients. This group comprised 509 patients with malignant disease (134 with breast cancer and 375 with other malignancies not involving the breast) and 833 patients with benign surgical diseases (95 patients with fibroadenoma of the breast, 738 with other benign diseases). The results were compared with those for carcino-embryonic antigen (CEA) in the diagnosis of breast cancer. CA15-3 was above the normal limits of 25 U/ml in 31% of the patients with breast cancer, in 22% of patients with other malignancies, and in 9% of patients with benign diseases. CEA was elevated in 26% of patients with breast cancer (greater than 3 ng/ml). CA15-3 levels were above 50 U/ml in 13% of the breast cancer patients, in 6% of patients with other malignancies, and in 0.2% of the patients with benign diseases. There was a good correlation between CA15-3 level and tumor stage in breast cancer. CA15-3 serum levels were over 50 U/ml in respectively 0%, 2%, 13%, and 73% of the patients with stages I, II, III, and IV. CA15-3 and CEA were also determined in 671 patients who had received initial curative surgery of breast cancer, and who regularly attended our follow-up clinic. CA15-3 was found to be more sensitive than CEA in detecting recurrences of breast cancer.(ABSTRACT TRUNCATED AT 250 WORDS)     

循环肿瘤细胞在肺癌诊断中的应用及临床意义

为了探讨循环肿瘤细胞(circulating tumor cells,CTCs)在肺癌诊断中的应用及临床意义,本研究收集了我院2014年10月至2017年12月收治并确诊的肺癌患者87例、健康体检者40名以及肺部良性疾病患者50例作为研究对象,采用人循环肿瘤细胞试剂盒测定外周血CTC水平,两组间比较采用Mann-Whitney U检验,多组间比较采用Kruskal-Wallis检验,利用ROC曲线评价CTC在肺癌诊断上的灵敏度以及特异度。实验发现肺癌患者CTC水平(M=12.67 Unints/3 mL)显著高于肺部良性病患者(M=4.76 Unints/3 mL)和健康者(M=4.48 Unints/3 mL),差异存在统计学意义(p<0.001)。在不同性别、不同年龄段以及不同病理类型之间肺癌患者的CTC水平比较差异无统计学意义(p>0.05)。Ⅲ+Ⅳ期肺癌患者CTC水平显著高于Ⅰ+Ⅱ期患者,差异存在统计学意义(p<0.001)。有远处转移的肺癌患者CTC水平显著高于无远处转移的肺癌患者,差异存在统计学意义(p<0.001)。ROC曲线下面积为0.878(95%CI 0.820~0.936),临界值为6.34 Unints/3 mL,对应的灵敏度为0.77,特异度为0.989。本研究初步认为,CTC检测对肺癌诊断具有较高的灵敏度以及特异度,可能存在重要的临床应用价值。     

Detection by monoclonal antibody of carbohydrate antigen CA 50 in serum of patients with carcinoma.

A solid phase radioimmunoassay was devised for measuring the value of the carcinoma associated carbohydrate antigen CA 50 in serum based on the use of a specific monoclonal antibody (C 50). Samples of serum from 259 patients with carcinoma, 114 patients with other malignancies or inflammatory diseases, and 150 healthy controls were examined. Serum values of CA 50 exceeding the mean plus three standard deviations for control samples from blood donors were found in a high proportion of patients with colorectal adenocarcinomas (50% of those with early, localised tumours and 75% of advanced cases), other gastrointestinal carcinomas (69%), uterine cancer (75% of those with corporeal and 88% of those with cervical cancer), prostatic cancer (90%), lung cancer (52%), and breast, ovarian, kidney, and urinary bladder carcinoma (26-67%). The CA 50 values in samples from patients with inflammatory diseases, including ulcerative colitis, with rare exceptions (0-7%) were within the normal range, as were those in patients with various sarcomas and malignant melanoma. Measuring serum values of CA 50, which is evidently a generalised carcinoma associated antigen, may be useful in clinical research studies of the diagnosis, management, and prognosis of patients with different types of carcinoma.     

血清OPN、HE4和CA125检测对卵巢癌的临床意义

目的：探讨联合检测血清OPN、HE4和CA125对卵巢癌的临床意义。方法：选择2010年6月-2012年7月西安市中心医院妇科及陕西省肿瘤医院妇瘤科收治的35例卵巢癌患者、73例卵巢良性肿瘤患者及40例同期体检的健康妇女为研究对象,应用ELISA法检测患者手术前后血清OPN、HE4水平,电化学发光法检测患者手术前后血清CA125水平,计算3种肿瘤标志物单项以及联合检测在卵巢癌诊断中的敏感性及特异性。结果：（1）卵巢癌患者术前血清OPN、HE4和CA125水平分别为94.6±61.06ng/mL、412.3±278.62 pmol/mL和398.64±220.91 U/mL,与卵巢良性肿瘤组及正常对照组比较差异有统计学意义（P〈0.05）;（2）卵巢癌患者手术前与术后1月血清OPN、HE4和CA125水平比较,差异均有统计学意义（P〈0.05）;（3）血清OPN、HE4和CA125水平联合检测诊断卵巢癌的敏感性（94.3%）显著高于血清OPN、HE4和CA125单项指标检测（分别为37.1%、71.4%和77.1%）,联合检测与单项指标检测比较差异均有统计学意义（P〈0.05）,而血清OPN、HE4和CA125联合检测诊断卵巢癌的特异性（78.8%）稍低于血清OPN、HE4和CA125单项指标检测（分别为87.6%、100%和80.5%）,联合检测与单项指标检测的特异性比较差异无统计学意义（P〉0.05）。血清HE4单项指标检测的特异性高达100%。结论：联合检测卵巢癌患者血清OPN、HE4和CA125水平可作为诊断和评估卵巢癌预后的参考指标。     

肿瘤标志物联合检测在乳腺癌早期诊断中的应用

目的:探讨肿瘤标志物癌胚抗原(CEA)、糖链抗原19-9(CA19-9)、糖链抗原15-3(CA15-3)联合检测在乳腺癌早期诊断中的应用价值。方法:检测87例乳腺癌患者,55例乳腺良性肿瘤患者和35例健康人血清中CEA、CA19-9、CA153等肿瘤标志物的水平及3种标志物不同组合对乳腺癌的阳性检出率。结果:乳腺癌患者3种肿瘤标志物显著高于正常对照组及乳腺良性肿瘤组(P<0.01)。3项标志物不同组合对不同分期乳腺癌检出的敏感性均高于单项标志物。其中CEA+CA199+CA153组合的检出敏感性较其他组合均高,特别是对早期患者检出率明显提高。结论:CEA+CA199+CA153联合检测能提高乳腺癌的早期诊断率。     

血清肿瘤标志物在肺癌辅助诊断中的应用

目的探讨血清肿瘤标志物在肺癌诊断中的临床价值。方法收集40例健康人、45例肺部良性疾病患者和90例肺癌患者,采用电化学发光分析检测患者血清中肿瘤标志物细胞角蛋白19(CYFRA21-1)、鳞状细胞癌相关抗原(SCC)和癌胚抗原(CEA),以及胃泌素释放肽前体(pro-GRP)和神经元特异性烯醇化酶(NSE)的含量。结果健康人组和肺部良性疾病患者组血清NSE、pro-GRP、CYFRA21-1、SCC和CEA水平较肺癌患者组水平低,差异有统计学意义(P0.01)。NSE和pro-GRP在小细胞肺癌患者中的水平均明显高于其他类型的肺癌患者(P0.01),CYFRA21-1和SCC在鳞癌患者中的含量比其他类型肺癌患者高(P0.01)。联合检测此5种血清肿瘤标志物敏感性高于单独的肿瘤标志物(P0.01)。结论联合检测NSE、pro-GRP、CYFRA21-1、SCC和CEA可以提高肺癌诊断的灵敏度。