Lorenz M, Baum R P, Oremek G, Inglis R, Reimann-Kirkowa M, Hör G, Seiffert U, Hottenrott C
Department of Surgery, Johann Wolfgang Goethe University Hospital, Frankfurt Main-FRG.
Int J Biol Markers. 1989 Jan-Mar;4(1):18-26. doi: 10.1177/172460088900400104.
Development of the hybridoma technique has made the identification of several new tumor antigens possible. Although it was hoped that they would be more tumor-specific, none of these markers are found exclusively in tumor or in serum of tumor patients. Compared with carcinoembryionic antigen (CEA) and liver function tests, the roles of these markers (CA 19-9, CA 125, CA 15-3) were prospectively evaluated in 115 patients with colorectal liver metastases. Patients were classified according to tumor volume (T1 less than 25%, T2 25-75%, T3 greater than 75%), and the extension of infiltration (solitary/multiple/diffuse; unilateral, bilateral). Patients with benign liver or biliary disease served as a control group (n = 63). Overall sensitivity was 87% for *1, 50% for *2 and 38% for *3, with a significant correlation with tumor size. CEA serum levels were elevated in 88% of all patients. CA 19-9 was less sensitive: positive in 59%. Because of some complementary elevations, the combined use of CEA, CA 19-9 and CA 125 raised sensitivity to 94%. CA 19-9 and LDH could be useful for confirmation because of their higher specificity; however, the specificity of CEA rose to 93% on using a cut-off of 10 ng/ml instead of 3 ng/ml. The results indicate that CEA and CA 19-9 as well as liver function tests are helpful for preoperative staging in conjunction with imaging procedures before liver resection or regional chemotherapy.
杂交瘤技术的发展使得鉴定几种新的肿瘤抗原成为可能。尽管人们曾希望它们具有更高的肿瘤特异性，但这些标志物均未在肿瘤组织或肿瘤患者血清中单独被发现。与癌胚抗原（CEA）和肝功能检查相比，对115例结直肠癌肝转移患者前瞻性评估了这些标志物（CA 19-9、CA 125、CA 15-3）的作用。患者根据肿瘤体积（T1小于25%、T2为25%-75%、T3大于75%）以及浸润范围（孤立性/多发性/弥漫性；单侧、双侧）进行分类。患有良性肝脏或胆道疾病的患者作为对照组（n = 63）。*1的总体敏感性为87%，*2为50%，*3为38%，与肿瘤大小显著相关。所有患者中88%的CEA血清水平升高。CA 19-9的敏感性较低：阳性率为59%。由于存在一些互补性升高，联合使用CEA、CA 19-9和CA 125可将敏感性提高至94%。CA 19-9和乳酸脱氢酶（LDH）因其较高的特异性可能有助于确诊；然而，将CEA的临界值从3 ng/ml提高到10 ng/ml时，其特异性升至93%。结果表明，CEA、CA 19-9以及肝功能检查在肝切除或区域化疗前结合影像学检查有助于进行术前分期。
