血清肿瘤标志物联合与动态检测用于结直肠癌患者病情监测的临床研究  

Clinical Research on Combined and Dynamic Detection of Serum Tumor Markers for Disease Monitoring on Patients with Colorectal Cancer

作　　者：曹玉娟[1] 王德林[1] 杜芳[1] 郝龙英[1] 曹凤[1] CAO Yujuan;WANG Delin;DU Fang;HAO Longying;CAO Feng(Dept.of Medical Oncology,Peking University Shougang Hospital,Beijing 100041,China)

机构地区：[1]北京大学首钢医院肿瘤内科,北京100041

出　　处：《中国医院用药评价与分析》2018年第9期1179-1181,1184,共4页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：首都临床特色应用研究与成果推广课题基金(No.Z16110000516003)

摘　　要：目的:探讨联合与动态检测血清肿瘤标志物在结直肠癌患者诊断与病情监测中的临床意义。方法:选取2014年1月1日至2015年12月31日北京大学首钢医院收治的结直肠癌患者156例作为观察组,选取同期同样病例数的结直肠良性疾病患者作为对照组,自首诊后入组2年时间内每3个月检测血清肿瘤标志物癌胚抗原(CEA)、糖类抗原19-9(CA19-9)、糖类抗原242(CA242)及糖类抗原125(CA125)水平。观察组患者按TNM分期、手术前后、术后有无复发及化疗效果分别分组并分析肿瘤标志物检测结果。结果:(1)首诊时156例观察组患者CEA、CA19-9、CA242及CA125水平明显高于对照组,差异均有统计学意义(P<0.05)。(2)TNM分期Ⅰ、Ⅱ期患者CEA、CA19-9及CA125水平明显低于Ⅲ、Ⅳ期,差异均有统计学意义(P<0.05)。(3)术后3个月,101例接受根治性手术患者CEA、CA19-9水平明显低于术前,差异有统计学意义(P<0.05)。(4)接受根治性手术患者(101例)中,29例患者观察期内有肿瘤复发,复发患者CEA水平明显高于72例未复发患者,差异有统计学意义(P<0.05)。(5)55例未接受手术治疗或仅接受姑息性手术治疗的患者中,13例患者接受了姑息性手术联合化疗并获得客观缓解,其CEA、CA199水平明显低于42例未接受化疗或化疗后未获得缓解的患者,差异有统计学意义(P<0.05)。结论:联合与动态检测肿瘤标志物CEA、CA19-9、CA242及CA125水平,对结直肠癌的诊断与病情监测有较高的临床应用价值。OBJECTIVE： To probe into the clinical significance of combined and dynamic detection of serum tumor markers for disease monitoring on patients with colorectal cancer. METHODS： 156 patients with colorectal cancer admitted into Peking University Shougang Hospital from Jan. 1st 2014 to Dec. 31 st 2015 was selected and set as observation group,the same number of patients with colorectal benign disease in the same period were selected and set as control group. Serum tumor markers of CEA,CA19-9,CA242 and CA125 were measured every 3 months in two years after the first visit. The observation group were divided into different groups according to TNM staging,chemotherapy effects,recurrence in pre-operation and post-operation,so as to analyze the results of detection of tumor markers. RESULTS：（ 1） the levels of CEA,CA19-9,CA242 and CA125 in the 156 patients in observation group were significantly higher than those of the control group at the first visit,with statistically significant differences（ P〈0. 05）.（ 2） the levels of CEA,CA19-9 and CA125 of patients in the Ⅰ and Ⅱ stages of TNM were significantly lower than those of patients in the Ⅲ and IV stages,with statistically significant differences（ P〈0. 05）.（ 3） at 3 months after operation,the CEA and CA19-9 levels of 101 patients received radical operation were significantly lower than those of before operation,with statistically significant differences（ P〈0. 05）.（ 4） among the patients who received radical surgery（ 101 cases）,29 patients had tumor recurrence during the observation period,and the CEA level of patients with recurrence was significantly higher than that of 72 patients without recurrence,with statistically significant differences（ P〈0. 05）.（ 5） of the 55 patients who were not treated with surgery or received palliative surgery only,13 patients who received palliative surgery combined with chemotherapy had achieved objective remission,the CEA andCA199 levels were significantly lower than those of 42 pa

关 键 词：肿瘤标志物 结直肠癌 联合检测 动态检测 

分 类 号：R735.3[医药卫生—肿瘤]