结直肠癌论文联合检测肿瘤型M2-PKCEA与CA19-9在结直肠癌临床中的应用价值.doc

结直肠癌论文：联合检测肿瘤型M2-PK、CEA与CA19-9在结直肠癌临床中的应用价值 【中文摘要】1.检测结直肠癌(CRC)患者血浆中Tu M2-PK、血清CEA和CA19-9的水平。2.探讨结直肠癌(CRC)患者血浆中Tu M2-PK和血清CEA、CA19-9水平与结直肠癌TNM分期、Broder分级及淋巴结转移的关系及其临床意义。3.探讨血浆Tu M2-PK和血清CEA、CA19-9水平检测在结直肠癌(CRC)中的诊断价值,以及联合检测的意义。方法：运用酶联免疫吸附(ELISA)法和电化学免疫发光(ECLIA)法分别检测并分析比较结直肠癌患者45例术前,结直肠良性病变患者14例,健康体检者40例空腹外周静脉血浆肿瘤型M2-PK的水平和血清CEA、CA19-9的含量。根据其水平,对受试者的临床资料结直肠癌的TNM分期、Broder分级、淋巴结转移等归类分析,所有资料用SPSS13.0统计软件进行处理。结果：1.TNMⅠ、Ⅱ期结直肠癌患者术前血浆Tu M2-PK的水平(22.9±8.9U/ml)较结直肠良性病变组(11.2±3.9U/ml)及健康对照组(7.2±1.7/ml)显著增高(P0.05)。血清CEA、CA19-9的含量在三组中无显著性差异；2.结直肠癌TNM分期越晚,血浆Tu M2-PK的水平越高(P0.05)；血清CEA水平也越高(P0.05)；血清CA19-9水平也越高(P0.05),差异均有统计学意义。3.在结直肠癌Broder分级中,分级越高,分化程度越低,血清Tu M2-PK水平越高(P0.05)；血清CEA水平也越高(P0.05)；血清CA19-9水平也越高(P0.05)。4.结直肠癌患者血浆Tu M2-PK和血清CEA、CA19-9的含量与淋巴结转移有关(P0.05),淋巴结转移数越多,其含量越高。5.结直肠癌患者单项检测Tu M2-PK诊断敏感性为77.8%,高于CEA(53.3%)、CA19-9(40.0%);Tu M2-PK与CEA、TuM2-PK与CA19-9联合检测敏感性分为86.7%,80.0%,均高于单项检测Tu M2-PK(77.8%)、CEA(53.3%)、CA19-9(40.0%)；三项联合检测其敏感性(91.1%)与特异性(100%)最高,诊断正确率最高(96.0%)。结论：1.血浆Tu M2-PK与血清CEA、CA19-9对结直肠癌的诊断都有肯定的价值。2.对结直肠癌,Tu M2-PK灵敏度高于传统的肿瘤标志物CEA、CA19-9,是很有前途的肿瘤标志物。3.Tu M2-PK对与结直肠癌的早期诊断判断更有意义,可考虑应用于普查,以帮助恶性肿瘤的早发现、早治疗。4.血浆Tu M2-PK与血清CEA、CA19-9进行联合检测提高结直肠癌诊断的敏感性与准确性。 【英文摘要】:1. To discuss the levels of serum of Tu M2-PK,CEA and CA19-9 in patients with colorectal cancer.2. To discuss the relation between the levels of serum of Tu M2-PK, CEA and CA19-9 and the clinicopathologic stage, Broder degree and lymph node metastasis in colorectal cancer.3. To evaluate the diagnostic value of Tu M2-PK, CEA and CA19-9,as well as the diagnostic value of combined detection with Tu M2-PK,CEA and CA19-9.Methods:45 newly-diagnosed inpatients with colorecatal cancer in the first affiliated hospital of Nanchang university were enrolled as the study group.14 patients with benign colorecatal diseases and 40 healthy adults respectively served as the control groups.The level of tumor M2 pyruvate kinase (M2-PK),carcinoembryonie antigen (CEA),