Schulz U, Zoeller M, Matzku S
Chir Forum Exp Klin Forsch. 1978(1978):221-5.
Preoperative and serial postoperative CEA determinations have become widely accepted tools to aid the early detection of recurrent colorectal cancer. The panel modification of the direct leukocyte migration test (LMT) has proved to be an excellent monitor in these tumor patients. In this study LMT and CEA-RIA were compared. Peripheral blood leukocytes were pulsed with a high dose (2.5 and 0.5 mg/ml) of 3 m KCl extracts of five different colorectal tumors as well as with one 3m KCL extract of normal colonic mucosa. Patients showing a pathologic migration index (less than 0.80 and greater than 1.17) of 3 or more out of five tumor extracts were considered to be "positives." With this test mode 51 of 59 (86%) patients with resectable tumors were reactive, while only 24 of 69 (41%) yielded elevated CEA values. Both LMT and CEA-RIA were positive in 12 of the 13 patients with nonresectable tumors. After curative surgery most patients' leukocyte migration and CEA values were in tne normal range. Of the nine patients with localized tumor recurrence, eight were LMT reactive and five showed elevated CEA values. Of five patients with distant metastases, four demonstrated a positive reaction in the LMT and five a rise in CEA levels. The combination of the LMT with the CEA-RIA promises to improve the detection of recurrent colorectal cancer before the appearance of clinical evidence of recurrence.
术前及术后连续测定癌胚抗原（CEA）已成为广泛认可的辅助早期检测复发性结直肠癌的手段。直接白细胞迁移试验（LMT）的改良方法已被证明是这些肿瘤患者的一种出色监测手段。在本研究中，对LMT和CEA放射免疫分析（CEA-RIA）进行了比较。用五种不同结直肠癌肿瘤的高剂量（2.5和0.5mg/ml）3m KCl提取物以及一种正常结肠黏膜的3m KCl提取物刺激外周血白细胞。在五种肿瘤提取物中，病理迁移指数（小于0.80且大于1.17）有3次或更多次异常的患者被视为“阳性”。采用这种检测方式，59例可切除肿瘤患者中有51例（86%）呈反应性，而69例患者中只有24例（41%）CEA值升高。13例不可切除肿瘤患者中有12例LMT和CEA-RIA均为阳性。根治性手术后，大多数患者的白细胞迁移和CEA值在正常范围内。9例局部肿瘤复发患者中，8例LMT呈反应性，5例CEA值升高。5例远处转移患者中，4例LMT呈阳性反应，5例CEA水平升高。LMT与CEA-RIA联合应用有望在复发性结直肠癌出现临床复发证据之前提高其检测率。
