Shi Qiang, Pu Chuan-qiang, Wu Wei-ping, Huang Xu-sheng, Yu Sheng-yuan, Tian Cheng-lin, Huang De-hui, Zhang Jia-tang
Department of Neurology, General Hospital of PLA, Beijing 100853, China.
Nan Fang Yi Ke Da Xue Xue Bao. 2010 May;30(5):1192-4.
To assess the diagnostic value of tumor markers in the cerebrospinal fluid (CSF) for meningeal carcinomatosis (MC).
Twenty-one MC patients (including 13 adenocarcinoma and 8 non-adenocarcinoma patients), 72 patients with tuberculous meningitis (TBM) and 23 with primary intracerebral tumors (PIT) were enrolled in this study. Blood and CSF tumor markers including CEA, CA125, CA15-3, CA19-9, CA72-4, CYFRA21-1, AFP and NSE were measured by Roche E170 electrochemiluminescence analyzer and sandwich assay.
CSF tumor markers CEA, CA125, CA199 and CYFRA21-1 and the serum tumor markers CEA, CA125, CA153, CA199 and AFP were significantly higher in MC group than in the other two groups. CSF CEA and CA15-3 were significantly higher in adenocarcinoma MC than in non-adenocarcinoma MC patients, but no significant differences were found in the serum tumor markers between the two groups (P>0.05). CSF tumor markers including CEA, CA125, CA15-3, CA72-4 and CYFRA21-1 were positively correlated to the serum tumor markers (P<0.05). CA199 was positively correlated to the disease course (P<0.05), and age was not correlated to any of the indexes (P>0.05).
Detection of the tumor markers in the CSF, especially CEA, CA125, CA19-9 and CYFRA21-1, may help in the early diagnosis of MC. CEA and CA15-3 can serve as indicators for differential diagnosis of adenocarcinoma and non-adenocarcinoma.
评估脑脊液(CSF)中肿瘤标志物对脑膜癌病(MC)的诊断价值。
本研究纳入21例MC患者(包括13例腺癌患者和8例非腺癌患者)、72例结核性脑膜炎(TBM)患者和23例原发性脑肿瘤(PIT)患者。采用罗氏E170电化学发光分析仪和夹心测定法检测血液和脑脊液中的肿瘤标志物,包括癌胚抗原(CEA)、糖类抗原125(CA125)、糖类抗原15-3(CA15-3)、糖类抗原19-9(CA19-9)、糖类抗原72-4(CA72-4)、细胞角蛋白19片段(CYFRA21-1)、甲胎蛋白(AFP)和神经元特异性烯醇化酶(NSE)。
MC组脑脊液肿瘤标志物CEA、CA125、CA199和CYFRA21-1以及血清肿瘤标志物CEA、CA125、CA153、CA199和AFP均显著高于其他两组。腺癌性MC患者脑脊液CEA和CA15-3显著高于非腺癌性MC患者,但两组血清肿瘤标志物差异无统计学意义(P>0.05)。脑脊液肿瘤标志物CEA、CA125、CA15-3、CA72-4和CYFRA21-1与血清肿瘤标志物呈正相关(P<0.05)。CA199与病程呈正相关(P<0.05),年龄与各项指标均无相关性(P>0.05)。
检测脑脊液中的肿瘤标志物,尤其是CEA、CA125、CA19-9和CYFRA21-1,可能有助于MC的早期诊断。CEA和CA15-3可作为腺癌和非腺癌鉴别诊断的指标。