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[目的]研究血清中多种肿瘤标志物的变化及联合检测在大肠癌诊断中的价值。[方法]采用电化学发光免疫分析方法对161例大肠癌患者进行血清CEA、CA19-9、CA72-4和CYFRA21-1共4项肿瘤标志物检测,并与100例正常体检者进行对比分析其诊断价值。[结果]161例大肠癌患者的CEA、CYFRA21-1、CA72-4和CA19-9的阳性率分别为55.9%、42.2%、38.5%和36.9%,平均浓度分别为29.5±18.6、52.4±19.2、16.7±9.4和13.1±10.5,均明显高于正常对照组(P<0.01)。采用平行联合检测可使诊断敏感度提高至80.5%,系列联合检测则使特异性提高到100%。Dukes’B、C期患者4项肿瘤标志物均明显高于Dukes’A期患者,术后4项指标均有下降。当肿瘤复发和转移时,CEA、CA72-4和CYFRA21-1再度明显升高。[结论]联合检测血清肿瘤标志物CEA、CA19-9、CA72-4和CYFRA21-1可提高大肠癌的诊断率,有助于大肠癌的早期诊断,并可用于判断大肠癌的疗效和预后。
[Objective] To study the changes of serum tumor markers and the value of combined detection in the diagnosis of colorectal cancer. [Method] Electrochemiluminescence immunoassay was used to detect four tumor markers of CEA, CA19-9, CA72-4 and CYFRA21-1 in 161 patients with colorectal cancer and compared with 100 normal subjects Diagnostic value. [Results] The positive rates of CEA, CYFRA21-1, CA72-4 and CA19-9 in 161 patients with colorectal cancer were 55.9%, 42.2%, 38.5% and 36.9% respectively, with the average concentrations of 29.5 ± 18.6 and 52.4 ± 19.2 , 16.7 ± 9.4 and 13.1 ± 10.5, respectively, which were significantly higher than those in the normal control group (P <0.01). The use of parallel joint detection can increase diagnostic sensitivity to 80.5%, while serial joint detection increases specificity to 100%. The four tumor markers in Dukes’B and C patients were significantly higher than those in Dukes’A patients, and all the four indexes decreased after operation. When tumor recurrence and metastasis, CEA, CA72-4 and CYFRA21-1 again significantly increased. [Conclusion] Combined detection of serum tumor markers CEA, CA19-9, CA72-4 and CYFRA21-1 can improve the diagnosis rate of colorectal cancer, contribute to the early diagnosis of colorectal cancer, and can be used to judge the curative effect and prognosis of colorectal cancer.