Serum levels of carcinoembryonic antigen, gastrointestinal cancer-associated antigen and alphafetoprotein in staging and management of patients with advanced carcinoma of the stomach

Serum levels of carcinoembryonic antigen (CEA), gastrointestinal cancer-associated antigen (GICA or CA 19-9), and alphafetoprotein (AFP) were concurrently determined in patients with carcinoma of the stomach: in 84 preoperatively, and in 67 serially postoperatively. Before surgery, serum CEA gave information about the tumor load analogous to serum GICA in 69% of the patients: true-positive in 25% and false-negative in 43%; less information in 18% and more in 14%. The sensitivity of the test tended to be better in the more advanced stages, and was higher for CEA with GICA than for CEA alone or GICA alone. During follow-up, serum CEA gave information about the presence or absence of active disease analogous to serum GICA in 78% of the patients: true-positive in 30%, true-negative in 36% and false-negative in 12%; less information in 9% and more in 13%. Neither test gave any false-positive indications. Sensitivity of the test rose from 67% for CEA alone and 60% for GICA alone to 81% for CEA with GICA. Serum AFP was elevated only preoperatively in 2% of patients. We conclude that joint application of CEA and GICA tests gave only slightly better preoperative sensitivity than CEA alone or GICA alone but proved fairly sensitive for postoperative follow-up of the patients. AFP was of little value for either purpose.     

CEA levels in gastric juice in precancerous conditions and cancer

First described in 1965 as a specific antigen for cancer of the colon, CEA is now considered to be an antigen associated with many types of malignant neoplasia, although the CEA-Test's role in clinical routine has yet to be clearly defined. In the present study CEA levels in gastric juice were measured in subjects with gastric carcinoma (n = 25) and with benign gastric lesions (n = 171). CEA was significantly (p less than 0.05) higher in patients with gastric carcinoma (GC) than in subjects with benign gastric lesions, other than chronic atrophic gastritis (CAG) associated with intestinal metaplasia (IM). In this latter condition CEA levels were similar to those in patients with GC. These results suggest that the assay of CEA in gastric juice could be included in the diagnostic program for gastric cancer and its precursors with the aim of assessing its utility as risk indicator in the management of precancerous conditions and lesion.     

Serum values of vitamins A, E, C and carotenoids in healthy adult subjects and those with breast neoplasia

Serum values of retinol, carotenoids, tocopherol and ascorbic acid were assayed in healthy adult females (Group A: 20 cases) and in subjects with fibrocistic mastopathy (Group B: 20 cases), benign breast neoplasms, as fibroadenomas and intraductal papillomas (Group C: 18 cases), and breast carcinoma in situ (Group D: 36 cases). Retinol and carotenoids were evaluated by spectrophotometry using trifluoroacetic acid. Tocopherol was determined by a colorimetric method involving the reduction of Fe to Fe++ by tocopherol with the formation of a red complex of the Fe++ with alpha, alpha'-dipirydyl. Ascorbic acid was estimated by a colorimetric method after derivatization with 2,4-dinitrophenylhydrazine. Our results point out that there is a highly significant decrease (p less than 0.001) of average retinol serum levels in all three patient groups as compared with group A, whereas carotenoids resulted decreased but not significantly. Tocopherol was found to be significantly lower only in groups B (p less than 0.05) and D (p less than 0.01), ascorbic acid in groups B (p less than 0.01) C (p less than 0.05) and D (p less than 0.001).     

Significance of pregnancy-associated alpha 2-glycoprotein (alpha 2-PAG) in patients with breast, gastric and colorectal cancer

Pregnancy-associated alpha 2-glycoprotein (alpha 2-PAG) levels were measured in human sera by a modification of Laurell's electroimmunoassay using rabbit anti-alpha 2-PAG serum. Sera were obtained from healthy controls (32 males and 46 females), patients with benign breast diseases (55 cases), and patients with breast (82 cases), gastric (89 cases), or colorectal (22 cases) cancers. In healthy controls, the mean alpha 2-PAG value for females was higher than that for males (p less than 0.05), so alpha 2-PAG values for males and females were considered separately in this study. Serum alpha 2-PAG levels in patients with benign breast tumors were almost the same as those of controls. In patients with primary breast and gastric cancer, alpha 2-PAG levels were higher than those of controls (p less than 0.005) and tended to increase with progress of the disease. Raised alpha 2-PAG levels decreased in these patients after curative surgery. These results show that serum alpha 2-PAG is useful as a marker in both the initial diagnosis and follow-up of breast and gastric cancer. The reliability of alpha 2-PAG as a tumor-associated marker was reinforced by comparison of the positive rates of the three parameters alpha 2-PAG, carcinoembryonic antigen (CEA), and immunosuppressive acidic protein (IAP) in patients with breast and gastric cancer.     

Phosphohexose isomerase and carcinoembryonic antigen in the sera of patients with primary lung cancer

Phosphohexose isomerase (PHI) and carcinoembryonic antigen (CEA) were measured at the time of diagnosis in 300 patients with lung cancer. Serum levels were high in 75.7% and 53.0% of patients respectively. PHI levels were higher in large cell and small cell carcinomas (p less than 0.001). CEA levels were higher in adenocarcinomas (p less than 0.001). Metastatic carcinomas showed higher levels on PHI and CEA than localized cases. Survival was significantly longer in patients with normal PHI (p less than 0.001) and normal CEA (p less than 0.005) than in cases with elevated markers. The prognostic significance of PHI persisted in the different pathological types and stages, whereas CEA only had prognostic impact in non-small cell cases. Serial PHI determinations were useful for follow-up in 82.4% of cases with initial abnormal values and in 55.4% of cases with a normal value. Serial CEA was useful in 41% of cases with initially high value but in less than 15% of those with baseline normal. We conclude that PHI has prognostic significance independently of pathology and stage, whereas CEA was a prognostic indicator only in non-small cell cases; serial PHI determinations were useful more often than CEA for follow-up.     

血清NSE、SCCA及CEA在肺癌早期诊断和预后预测中的应用价值研究

目的:研究血清神经元特异性烯醇化酶(NSE)、鳞状细胞癌抗原(SCCA)及癌胚抗原(CEA)在肺癌早期诊断和预后预测中的应用价值。方法:选择我院2013年1月~2017年1月收治的110例肺癌患者(肺癌组)及同期96例肺部良性疾病患者(肺良性病组)和85例门诊健康体检者(对照组)。比较各组血清NSE、SCCA及CEA水平,采用受试者工作特征(ROC)曲线分析以上指标对肺癌的诊断价值。结果:肺癌组血清NSE、SCCA、CEA水平高于肺良性病组及对照组,肺良性病组血清NSE、SCCA、CEA水平高于对照组(P<0.05)。肺癌Ⅲ+Ⅳ组血清NSE、SCCA及CEA水平高于Ⅰ+Ⅱ组(P<0.05)。小细胞肺癌组血清NSE水平高于鳞癌组、腺癌组,鳞癌组血清SCCA水平高于腺癌组及小细胞肺癌组,腺癌组血清CEA水平高于鳞癌组及小细胞肺癌组(P<0.05)。NSE<16.0μg/L者平均无疾病进展生存期(PFS)长于NSE≥16.0μg/L,SCCA<1.5μg/L者平均PFS长于SCCA≥1.5μg/L,CEA<5.0μg/L平均PFS长于CEA≥5.0μg/L(P<0.05)。NSE、SCCA和CEA及三者联合诊断肺癌的ROC曲线下面积分别为0.880、0.651、0.830及0.937,NSE+SCCA+CEA联合诊断的曲线下面积高于单个指标单独诊断(P<0.05)。结论:血清NSE、SCCA及CEA对肺癌的诊断有重要的参考价值,且有利于肺癌的分期、分型及预后评价。     

Effect of opium smoking on concentrations of carcinoembryonic antigen and tissue polypeptide antigen

Previous studies have related opium and its pyrolysates to the risk of developing certain cancers. The aim of this work was to evaluate the clinical usefulness of determining carcinoembryonic antigen (CEA) and tissue polypeptide antigen (TPA) levels in habitual opium smokers. Serum CEA concentrations were measured in 128 opium smokers and in 44 controls of cigarette only smokers and 47 normal non-smokers by an EIA-based assay. TPA levels were also determined in serum and urine of a subgroup in the study population. The results indicated that serum CEA concentrations are higher in opium smokers than in healthy tobacco smokers (p = 0.004) and non-smokers (p = 0.001). The amount of opium used correlated with the serum CEA level (r = 0.276, p < 0.0001). The mean urine and serum TPA levels of the opium-addicted population were also higher than that of the non-smoking control group, but the differences were not statistically significant. We conclude that opium smoking is associated with elevated serum CEA levels. Therefore, for management of opium users with neoplastic diseases, increased levels of serum CEA should be viewed with caution to avoid misdiagnosis.     

Functional significance of the serum/saliva testosterone ratio in various diseases]

Serum/salivary testosterone ratio (ST/SlvT) expresses the relationship in absolute values between bound and unbound testosterone. This ST/SlvT ratio in supposedly healthy men (n = 25) and women (n = 72) and in patients with several disorders, prostatic carcinoma (n = 19), varicocele (n = 9) and hirsute women (n = 16), has been studied. Both serum and salivary testosterone were measured by an RIA method. ST/SlvT ratio values found in healthy men (78.4 +/- 30.9) did not differ significantly from values found in the varicocele group (111.1 +/- 49.3), but a significant difference (p less than 0.001) from those found in men with prostatic carcinoma (12.3 +/- 7.2) was observed. When the ST/SlvT ratio values obtained in healthy women (18.1 +/- 7.3) were compared with those obtained in hirsute women (1.56 +/- 5.7) no significant differences were observed. The results obtained may indicate the dissociation among the hormone transport, testosterone metabolic clearance and hormone secretion by the salivary glands.     

非小细胞肺癌患者血清CYFRA21-1、VEGF及CEA的表达及与临床病理特征的相关性研究

目的:研究非小细胞肺癌(NSCLC)患者血清细胞角蛋白19片段(CYFRA21-1)、血管内皮生长因子(VEGF)、癌胚抗原(CEA)的表达及与临床病理特征的相关性。方法:选取2015年12月至2016年4月在我院接受治疗的NSCLC患者120例作为观察组,另选取同期在我院接受治疗的肺部良性病变患者50例作为良性对照组,比较两组患者血清中CYFRA21-1、VEGF及CEA的表达,分析观察组患者血清中CYFRA21-1、VEGF及CEA的表达与临床病理特征之间的关系,采用Pearson相关系数分析观察组患者血清中CYFRA21-1、VEGF、CEA的相关性。结果:观察组患者血清中的CYFRA21-1、VEGF及CEA水平均高于良性对照组(P0.05)。鳞状细胞癌患者血清中CYFRA21-1水平高于腺癌患者,CEA水平低于腺癌患者(P0.05),鳞状细胞癌患者和腺癌患者血清中VEGF水平比较无统计学差异(P0.05)。TNM分期为III-IV期的观察组患者血清中CYFRA21-1、VEGF及CEA水平均明显高于I-II期患者,有统计学差异(P0.05)。经Pearson相关系数分析显示,观察组患者血清中CYFRA21-1与VEGF、CEA呈正相关(r=0.512,0.423,P=0.000,0.000),VEGF与CEA呈正相关(r=0.452,P=0.000)。结论:NSCLC患者血清中CYFRA21-1、VEGF及CEA呈高表达,且CYFRA21-1、CEA与病理类型和TNM分期有关,VEGF与TNM分期有关,且三种指标存在一定的相关性。     

孤立性肺结节患者血清CEA、NSE、Cyfra21-1水平与结节直径的关系及联合高分辨率CT的诊断价值研究

摘要 目的：研究孤立性肺结节（SPN）患者血清癌胚抗原（CEA）、神经特异性烯醇化酶（NSE）、细胞角蛋白19片段（Cyfra21-1）水平与结节直径的关系及联合高分辨率CT的诊断价值。方法：将医院从2017年3月～2020年3月期间收治的SPN患者154例纳入研究。根据术后病理检查结果分为恶性结节组104例和良性结节组50例。对所有患者均进行高分辨率CT胸部增强扫描,并比较不同结节患者的CT影像征象表现。此外,检测并比较不同结节患者的血清CEA、NSE、Cyfra21-1水平,分析血清CEA、NSE、Cyfra21-1与结节直径的关系。通过受试者工作特征（ROC）曲线分析血清CEA、NSE、Cyfra21-1水平联合高分辨率CT诊断SPN良恶性的效能。结果：肺恶性结节患者胸部CT影像征象表现为毛刺征、深分叶征、胸膜凹陷征、血管集数征、棘突征人数占比均高于良性结节,而钙化征人数占比低于良性结节（均P＜0.05）。肺恶性结节患者的血清CEA、NSE、Cyfra21-1水平均明显高于良性结节患者（均P＜0.05）。结节最大直径＞2.0 cm的SPN患者血清CEA明显高于结节最大直径1.0～2.0 cm患者,而结节最大直径1.0～2.0 cm患者血清CEA明显高于结节最大直径＜1.0c m患者（均P＜0.05）;且经Spearman相关性分析显示,血清CEA水平与SPN患者结节直径呈正相关,而血清NSE、Cyfra21-1水平与SPN患者结节直径无相关性。经ROC曲线分析可得,血清CEA、NSE、Cyfra21-1联合高分辨率CT诊断SPN良恶性的曲线下面积、灵敏度、特异度均明显高于上述各项血清学指标和高分辨率CT单独诊断。结论：SPN患者血清CEA水平与结节直径呈正相关,而血清NSE、Cyfra21-1水平与结节直径无明显相关,血清CEA、NSE、Cyfra21-1联合高分辨率CT诊断SPN良恶性的价值较高。     

Testosterone in saliva: application to the follow-up of prostate cancer

The basic aspects of steroid hormones transport, their tissular release and the interpretation of salivary testosterone values as a reflect of the free hormone in serum are reviewed in this article, as well as the salivary testosterone applications in several disorders, with a special emphasis on prostatic carcinoma. The usefulness of salivary testosterone in the short-term (n = 4) and long-term (n = 13) follow-up of patients affected by prostatic carcinoma after medical or surgical orchiectomy has also been studied. Our results show a correlation (r = 0.62) between salivary and serum concentration values, as well as a significative decrease (p less than 0.001) in both quantities after treatment. Both these findings and the advantages inherent to the sampling obtaining, lead to the conclusion that salivary testosterone is a good alternative to serum testosterone.     

磁共振胰胆管成像联合血清CA125、CA19-9、CEA对良恶性梗阻性黄疸的诊断价值

摘要 目的：研究磁共振胰胆管成像（MRCP）联合血清糖类抗原125（CA125）、糖类抗原19-9（CA19-9）、癌胚抗原（CEA）对良恶性梗阻性黄疸的诊断价值。方法：将医院从2018年1月～2020年2月期间收治的90例良恶性梗阻性黄疸患者纳入研究。将其按照良恶性的差异分为良性梗阻性黄疸51例以及恶性梗阻性黄疸39例。分别对所有患者进行MRCP检测,并分析良恶性梗阻性黄疸MRCP影像学表现特征的差异。此外,采集所有患者清晨空腹静脉血,检测血清CA125、CA19-9、CEA水平并进行对比。通过受试者工作特征（ROC）曲线分析明确MRCP联合血清CA125、CA19-9、CEA对良恶性梗阻性黄疸的诊断价值。结果：恶性梗阻性黄疸部位为十二指肠乳头区人数占比明显高于良性梗阻性黄疸,而胰头上区、胰头区人数占比均明显低于良性梗阻性黄疸;且恶性梗阻性黄疸梗阻重度扩张人数占比明显高于良性梗阻性黄疸,而梗阻轻度扩张人数占比明显低于良性梗阻性黄疸,差异均有统计学意义（均P＜0.05）。恶性梗阻性黄疸患者血清CA125、CEA水平均明显高于良性梗阻性黄疸患者（均P＜0.05）;而两组血清CA19-9水平对比不明显（P＞0.05）。MRCP联合血清CA125、CA19-9、CEA诊断良恶性梗阻性黄疸的曲线下面积、灵敏度、特异度、约登指数均明显高于MRCP和血清CA125、CA19-9、CEA单独诊断。结论：MRCP联合血清CA125、CA19-9、CEA对良恶性梗阻性黄疸的诊断价值较高,值得临床推广应用。     

Population of K-lymphocytes in various kinds of thyroid disease

We have measured the population of Killer (K) lymphocytes in the peripheral blood of 108 patients with various kinds of thyroid disease. In the patients with Hashimoto's thyroiditis and Graves' disease, the relative and absolute numbers of K-lymphocytes were significantly lower than those seen in healthy controls (p less than 0.001), and the longer the duration of medication, the lower the K-lymphocyte population. However, there was no apparent correlation between the serum titers of thyroid autoantibodies and the K-lymphocyte population. In the patients with malignant and benign thyroid tumors, the relative and absolute numbers of K-lymphocytes significantly decreased when compared with those of controls (p less than 0.001), the decrease was more prominent after surgical operation than before operation. A prominent decrease in the K-lymphocyte population was evoked to maximum 2 to 4 weeks after surgical operation. The patients with both malignant and benign tumors having abundant lymphocytic infiltration in their surgical specimens generally revealed a lower K-lymphocyte population than those having no lymphocytic infiltration.     

肺癌患者血清CEA、CYFRA21-1和NSE的检测及临床意义

目的探讨外周血癌胚抗原(CEA)、细胞角蛋白19片段(CYFRA21-1)和神经元特异性烯醇化酶(NSE)的检测对肺癌的诊断、病理分型和疗效判断的临床用价值。方法采用化学发光法检测了62例肺癌患者、54例良性肺部疾病患者、36例健康人、40例肺癌患者手术前后血清CEA、CYFRA21-1和NSE的水平。结果肺癌患者手术前血清CEA、CYFRA21-1和NSE的含量明显高于良性肺部疾病组及正常对照组(P0.01)。鳞癌组、腺癌组和小细胞癌组之间肿瘤标志物CEA、CYFRA21-1和NSE水平差异有统计学意义。CEA阳性率以腺癌组最高(84%),CYFRA21-1阳性率以鳞癌组最高(85.2%),NSE阳性率以小细胞癌组最高(80.0%)。手术治疗后未复发转移组CEA、CYFRA21-1和NSE水平低于术前,而复发转移组与术前比变化不显著(P0.05)。结论血清CEA、CYFRA21-1和NSE的检测对不同病理类型肺癌患者的诊断、病情检测及疗效判断有较好的临床参考价值。     

Urinary neopterin in patients with advanced colorectal carcinoma

In previous studies, mostly in patients with early stage colorectal carcinoma, neopterin, an indicator of systemic immune activation, has been associated with poor prognosis. The aim of the present study was to evaluate urinary neopterin in patients with advanced or metastatic colorectal carcinoma treated with chemotherapy. A retrospective analysis was performed of urinary neopterin, determined by high-performance liquid chromatography, in 88 patients with advanced or metastatic colorectal carcinoma. Peripheral blood cell count and serum carcinoembryonic antigen (CEA) were determined in 72 patients before the start of chemotherapy. Urinary neopterin in colorectal carcinoma patients was significantly increased compared to controls, but lower than in patients with inflammatory bowel disease. Neopterin correlated significantly with serum CEA, age, peripheral blood leukocyte and platelet counts. The median survival of colorectal carcinoma patients with urinary neopterin below 214 micromol/mol creatinine was significantly longer compared to that of patients with higher neopterin concentrations (median 18 vs 5 months, log-rank test p=0.003). CEA and hemoglobin were also associated with survival in univariate analysis, but in multivariate analysis only urinary neopterin and serum CEA were independent predictors of survival. High urinary neopterin during follow-up was also predictive of poor prognosis.     

经直肠剪切波弹性成像技术联合血清CEA、PSA、FPSA对前列腺良恶性病变的鉴别诊断价值研究

摘要 目的：研究经直肠剪切波弹性成像技术（TRSWE）联合血清癌胚抗原（CEA）、前列腺特异性抗原（PSA）、游离前列腺特异性抗原（FPSA）对前列腺良恶性病变的鉴别诊断价值。方法：选取合肥市第二人民医院2019年1月～2022年6月收治的90例前列腺病变患者,根据病理检查分为前列腺癌组（47例）和前列腺良性病变组（43例）。对所有前列腺病变患者均行TRSWE检查,分析前列腺良恶性病变的图像差异以及弹性模量最大值（Emax）、弹性模量平均值（Emean）。检测所有前列腺病变患者的血清CEA、PSA、FPSA水平并进行对比。采用受试者工作特征（ROC）曲线分析明确Emax值、Emean值以及血清CEA、PSA、FPSA水平联合诊断前列腺良恶性病变的效能。结果：前列腺癌组Emax值、Emean值均高于前列腺良性病变组（均P＜0.05）。前列腺癌组血清CEA、PSA及FPSA水平均高于前列腺良性病变组（均P＜0.05）。经ROC曲线分析发现,Emax值、Emean值以及血清CEA、PSA、FPSA水平联合检测诊断前列腺良恶性病变的效能优于上述5项指标单独检测。结论：TRSWE联合血清CEA、PSA、FPSA对前列腺良恶性病变的鉴别诊断价值较高,可有效提升前列腺癌的检出率,可能值得临床推广应用。     

Levels of circulating cell-free serum DNA in benign and malignant breast lesions

PURPOSES OF THE STUDY: We analyzed circulating cell-free DNA in the serum of patients with benign and malignant breast disease and in healthy individuals to determine its diagnostic value. BASIC PROCEDURES: Serum samples were obtained from 50 healthy individuals, 33 patients with malignant breast disease and 32 patients with benign breast disease. Circulatory DNA was extracted from serum samples. Cell-free DNA was quantified by real-time quantitative PCR for the glyceraldehyde-3-phosphate dehydrogenase (GAPDH) gene. Tissue samples from patients with malignant and benign breast lesions were histopathologically examined. MAIN FINDINGS: The mean levels of circulating cell-free DNA in serum samples were 41,149 genome equivalents (GE)/mL in patients with malignant disease, 30,826 GE/mL in patients with benign disease, and 13,267 GE/mL in healthy individuals. Healthy individuals had significantly lower levels of cell-free DNA than patients with malignant or benign breast disease (p=0.001, p=0.031). No significant difference was observed between malignant and benign disease. There was a correlation between cell-free DNA levels and tumor size but not with other tumor characteristics. PRINCIPAL CONCLUSION: Our results suggest that levels of circulating cell-free DNA in serum could have diagnostic value to discriminate between healthy individuals and patients with breast lesions but not between patients with malignant and benign breast lesions.     

Significance of CA72.4 in patients with colorectal cancer. Comparison with CEA and CA19.9.

CA72.4 is a new tumor-associated antigen identified by monoclonal antibodies cc49 and B72.3. Serum levels of CA72.4 were measured in patients with benign and malignant diseases. The cut-off used was 4 U/mL. CA72.4 is a highly specific marker since only 3% of 162 patients with benign diseases had elevated levels of antigen. Forty-four percent of 89 patients with colorectal cancer had elevated CA72.4 levels. Compared with CEA and CA19.9, we have found that CEA (75%) is the most sensitive marker (p less than 0.001). The simultaneous use of two or three markers did not further contribute to the evaluation of patients with colorectal cancer.     

Serum immunoreactive pancreatic phospholipase A2 in patients with various malignant tumors.

The high incidence (40.6%) of elevated serum pancreatic phospholipase A2 (PLA2) was demonstrated in patients with various malignancies. Serum PLA2 was significantly increased in cancer patients compared with healthy sex- and age-matched blood donors (358.4 +/- 168.0 vs. 241.7 +/- 69.0 ng/dl; p less than 0.01). No correlation was observed between serum PLA2 and carcinoembryonic antigen (CEA) in these patients. Although patients with advanced and distantly metastatic cancer of the liver, gallbladder and pancreas showed higher PLA2 levels in serum than those with early cancer, patients with other cancers showed no correlation between serum PLA2 and clinical stage. A combined assay of PLA2 and CEA increased the sensitivity of detection of cancers to 60.8%.     

The clinical value of the tumor markers CA 19/9 and carcinoembryonic antigen (CEA) in colorectal carcinomas: a critical comparison

The monoclonal antibody serum test CA 19.9 after having been described as being colon tumor specific, was advertised as being more sensitive than CEA in the detection of both early and advanced colorectal carcinomas. Furthermore, the combined estimation of the two markers, CEA and CA 19.9 was said to improve the detection rate significantly. However, our own comparative studies as well as those of several other groups recently published have shown CA 19.9 measurements to be less valuable, because being less sensitive than those of CEA. This is especially true for the early stages of intestinal carcinomas. The parallel determinations of CA 19.9 and CEA improved the positivity rate insignificantly, because in only 3.5% of all cases C 19.9 was elevated in CEA negative cancer sera. However, CA 19.9 was found to have a much lower rate of (false) positive results than CEA in benign intestinal diseases.