摘要:目的：探讨嗜铬蛋白A(Chromogranin，CgA)、癌胚抗原(carcino-embryonic antigen，CEA)和糖链抗原(casbohydrate antigen19-9，CA19-9)联合测定在大肠癌中的临床价值。方法：采用放射免疫分析法(radioimmunoassay，RIA)测定32例大肠良性疾病及48例大肠癌患者血清中CGA的水平，采用微粒酶免疫法(micropartical enzyme immunoassay，MEIA)测定两组患者血清CEA和CA19-9的水平。结果：大肠癌患者与大肠良性疾病患者的CgA、CEA和CA19-9水平比较差异有统计学意义( P<0.05～0.01)。血清CgA、CEA和CA19-9的水平随大肠癌病程的进展而逐渐升高；3种肿瘤标志物中以CgA敏感性和特异性最高,分别为55.6%和76.3%，3种肿瘤标志物对诊断的敏感性与大肠癌的分期有关；联合检测可使诊断的敏感性提高至81.7%，尤其是对于伴有远处转移病例的诊断,具有重要的临床意义。结论：血清CgA、CEA和CA19-9水平测定可应用于大肠癌的诊断和疗效的观察,并可用于监测肿瘤的复发和转移。肿瘤标志物的联合检测有助于大肠癌的早期诊断，并增加诊断的敏感性和特异性。

    关键词:大肠癌；免疫分析；血清肿瘤标志物

    Clinical Significance of Combined Assay of Serum CgA、CEA and CA19-9 in Colorectal Carcinoma

    CHEN Jie,HE Zhen-hui,JIE Yu-li

    (The Affiliated Hospital of Guangdong Medical College, Guangdong Zhanjiang 524001,China)

    Abstract：Objective：To investigate the clinical significance of combined assay of serum chromogranin A(CgA), carcino-embryonic antigen(CEA) and casbohydrate antigen19-9(CA19-9) in colorectal carcinoma. Method：The serum level of CgA, CEA and CA19-9 were measured by micropartical enzyme immunoassay(MEIA) and radioimmunoassay(RIA) in 32 cases patients with the benign colorectal diseases and 48 cases patients with colorectal carcinoma. Result：The serum levels of CgA, CEA and CA19-9 in colorectal carcinoma group were significantly higher than those of the benign colorectal disease group (P<0.05~0.01) and elevated gradually along with the course of colorectal carcinoma. CgA was the best diagnostic index among these tumor markers, its sensitivity and specificity were 55.6% and 76.3% respectively.The sensitivity of 3 tumor markers was related with stages of colorectal carcinoma. Combined assay could increase the diagnostic sensitivity to 81.7%.Conclusion：The serum levels of CgA, CEA and CA19-9 have certain value in the diagnosis and could be used to monitor tumor recurrence and matastasis.The combined assay of tumor markers was helpful to early diagnosis of colorectal carcinoma and could increase the sensitivity and specificity in diagnosing colorectal carcinoma. ......