Shinozaki T, Chigira M
Department of Orthopaedic Surgery, Gunma University School of Medicine, Japan.
Nihon Seikeigeka Gakkai Zasshi. 1991 Aug;65(8):441-6.
Levels of serum tumor markers including CEA, AFP, CA 15-3, CA 19-9, CA 125 and TPA were measured in 26 patients with bone metastases and in 9 patients with primary bone tumors. TPA was the most sensitive marker to detect skeletal metastasis being elevated in 15 of the 22 patients (68.2%). High sensitivity was observed in CEA (46.1%), CA 15-3 (40%), and CA 125 (35%), and AFP showed relatively low sensitivity (4.3%). When elevation of TPA only or elevation of more than two tumor markers including TPA was used as a screening test for skeletal metastasis, over-all sensitivity, specificity, and accuracy were 73.1%, 88.9%, and 81% respectively. No definite correlation between the markers could be seen in this study. A combination of serum tumor markers was useful in the differential diagnosis of bone metastases from primary bone lesions. However, organ specificity of the markers were relatively low.
对26例骨转移患者和9例原发性骨肿瘤患者检测了血清肿瘤标志物水平,包括癌胚抗原(CEA)、甲胎蛋白(AFP)、糖类抗原15-3(CA 15-3)、糖类抗原19-9(CA 19-9)、糖类抗原125(CA 125)和组织多肽抗原(TPA)。TPA是检测骨转移最敏感的标志物,22例患者中有15例(68.2%)升高。癌胚抗原(CEA,46.1%)、糖类抗原15-3(CA 15-3,40%)和糖类抗原125(CA 125,35%)观察到高敏感性,而甲胎蛋白(AFP)显示相对较低的敏感性(4.3%)。当仅TPA升高或包括TPA在内的两种以上肿瘤标志物升高用作骨转移筛查试验时,总体敏感性、特异性和准确性分别为73.1%、88.9%和81%。本研究中未发现标志物之间有明确的相关性。血清肿瘤标志物联合应用有助于原发性骨病变骨转移的鉴别诊断。然而,这些标志物的器官特异性相对较低。