血清CEA、CA199、CA125和SF对结肠癌化疗效果的评估价值

周丽娜，顾金花，冯春霞，谭悦，唐敏（昆山市第一人民医院肿瘤科；检验中心，江苏5300）

血清CEA、CA199、CA125和SF对结肠癌化疗效果的评估价值

周丽娜1*，顾金花2，冯春霞1，谭悦1，唐敏1
（昆山市第一人民医院1肿瘤科；2检验中心，江苏215300）

目的：评价联合检测晚期结肠癌患者血清癌胚抗原（CEA）、糖类抗原199（CA199）、糖类抗原125（CA125）和铁蛋白（SF）在化疗疗效评估中的价值。方法：测定晚期结肠癌63例患者化疗前、化疗1周期后血CEA、CA199、CA125、SF的水平；并在化疗2周期后进行疗效评价。结果：（1）血清CEA、CA199、CA125、SF4项指标：有效组化疗前分别为72.3±130.7ng/mL、101.3±134.0U/mL、58.4±76.3U/mL、88.7±79.5μg/L，化疗后94.3ng/mL、65.7±109.0U/ mL、27.4±18.1U/mL、54.8±43.8μg/L；进展组化疗前分别为82.5±122.8ng/mL、93.2±91.1U/mL、115.1±127.1U/mL、142.0± 98.2μg/L，化疗后165.9±170.3ng/mL、206.8±163.9U/mL、127.4±120.0U/mL、143.2±98.0μg/L；稳定组化疗前分别为34.4± 87.7ng/mL、78.8±143.7U/mL、24.8±20.4U/mL、118.3±91.4μg/L，化疗后42.1±116.3ng/mL、97.9±190.7U/mL、29.3±40.9U/ mL、139.1±102.9μg/L。化疗有效组化疗后浓度均较化疗前明显下降（P<0.05）；进展组化疗后浓度均较化疗前明显升高（P<0.05）；稳定组化疗前后没明显变化（P>0.05）。多重回归分析显示，血清CEA、CA199、CA125浓度变化与化疗效果相关，有统计学意义，而血清SF与化疗效果相关性无统计学意义（t＝1.822，P＝0.074）。血清肿瘤标志物水平变化与化疗效果相关性由大到小依次为CEA、CA199、CA125和SF。结论：血清CEA、CA199、CA125水平变化与结肠癌化疗效果相关，其检测对评估化疗效果有一定的价值。

结肠癌；肿瘤指标；化疗；电化学发光免疫分析法

[Abstract]Objective:To investigate the values of serum carcinoembryonic antigen(CEA)，carbohydrate antigen 19-9 (CA199)，carbohydrate antigen 125(CA125)and ferritin(SF)determination in assessing the effect of chemotherapy in patients with advanced colon cancer.Methods:The concerntrations of serum CEA,CA199,CA125 and SF for 63 patients with advanced colon cancer were determined,before and after 1cycle of chemotherapy and the effect of chemotherapy was evaluated after 2 cycles of chemotherapy.Results:In effective group serum concentrations of CEA,CA199,CA125 and SF were 72.3±130.7ng/mL、101.3±134.0U/mL、58.4±76.3U/mL、88.7±79.5μg/L before chemotherapy respectively,they were 48.0± 94.3ng/mL、65.7±109.0U/mL、27.4±18.1U/mL、54.8±43.8μg/L after chemotherapy respectively,the serum concentrations significantly decreased after 1 cycle of chemotherapy（P<0.05）,compared with those before chemotherapy.Serum concentrations of CEA,CA199 in progress group were 82.5±122.8ng/mL、93.2±91.1U/mL before chemotherapy respectively,they were 165.9±170.3ng/mL、206.8±163.9U/mL after chemotherapy respectively,the serum concentrations significantly increased after 1 cycle of chemotherapy（P<0.05）.Serum concentrations of CEA、CA199、CA125、SF in stable group and CA125、SF in progress group were 34.4±87.7ng/mL、78.8±143.7U/mL、24.8±20.4U/mL、118.3±91.4μg/L before chemotherapy respectively,they were 42.1±116.3ng/mL、97.9±190.7U/mL、29.3±40.9U/mL、139.1±102.9μg/L after chemotherapy respectively,serum concentrations did not change significantly（P>0.05）.Multiple regression analysis showed that serum CEA, CA199,CA125 concentration changes correlated with the effect of chemotherapy,while serum SF didn’t（t＝1.822，P＝0.074）. Conclusions:Serum CEA,CA199,CA125 concentration changes were associated with the efficacy of chemotherapy in colon cancer,which helps predict the effect of chemotherapy.

[Key words]colon cancer;tumor marker;chemotherapy;Eletro-chemiluminescence immunoassay

近年来结肠癌发病率在我国有逐渐上升趋势，现已达恶性肿瘤的第3位[1]。确诊时大多数患者已达晚期，治疗以化疗为主。目前临床大多采用每两周期化疗后行CT检查一次的方法评价化疗效果[2-3]。但此法很难早期发现化疗无效者，且费用高，如何能快捷准确地发现这类患者，有着非常重要的临床价值。检测血清肿瘤生物标志水平变化是辅助判断手术疗效、有无复发转移的有效方法[4]，但能否用于监测化疗疗效，需进一步的研究来鉴定。……