Plebani M, De Paoli M, Basso D, Roveroni G, Giacomini A, Galeotti F, Corsini A
Dipartimento di Medicina di Laboratorio, University Hospital of Padua, Italy.
J Surg Oncol. 1996 Aug;62(4):239-44. doi: 10.1002/(SICI)1096-9098(199608)62:4<239::AID-JSO2>3.0.CO;2-7.
Early diagnosis of colorectal cancer, a frequent neoplasia in industrialized countries, permits curative surgery. In this study we assessed the clinical role of serum tumor markers determination in diagnosing, staging, and grading colorectal cancer; the role of carcinoembryonic antigen (CEA), CA 19-9, tissue polypeptide antigen (TPA) and CA 72-4 in colorectal cancer follow-up was also assessed. In 114 patients with colorectal cancer, the oncofetal antigen CEA was compared with the membrane-associated glycoproteins CA 19-9, CA 242, and CA 72-4 and with the cytokeratins TPA, tissue polypeptide-specific antigen (TPS) and tissue polypeptide monoclonal antigen (TPM). Overall, the most sensitive indices were TPA and TPS (67% and 70%, respectively). Tumor stage influenced the levels of CEA, CA 19-9, and TPA, but not those of TPS, while tumor grade influenced CEA and TPS, but not CA 72-4, TPA, and TPM. TPA was the most sensitive index in identifying early or well-differentiated colorectal cancers. The sensitivity was enhanced when this marker was determined in combination with CEA, in diagnosing both advanced and early colorectal tumors. Seventy-seven patients were followed up after therapy for at least 18 months. CEA was the most sensitive index of recurrence (58%); however, this sensitivity is too low to consider tumor markers useful in colorectal cancer follow-up.
在工业化国家，结直肠癌是一种常见的肿瘤，早期诊断可进行根治性手术。在本研究中，我们评估了血清肿瘤标志物检测在结直肠癌诊断、分期和分级中的临床作用；还评估了癌胚抗原（CEA）、CA 19-9、组织多肽抗原（TPA）和CA 72-4在结直肠癌随访中的作用。在114例结直肠癌患者中，将癌胚抗原CEA与膜相关糖蛋白CA 19-9、CA 242和CA 72-4以及细胞角蛋白TPA、组织多肽特异性抗原（TPS）和组织多肽单克隆抗原（TPM）进行了比较。总体而言，最敏感的指标是TPA和TPS（分别为67%和70%）。肿瘤分期影响CEA、CA 19-9和TPA的水平，但不影响TPS的水平，而肿瘤分级影响CEA和TPS，但不影响CA 72-4、TPA和TPM。TPA是识别早期或高分化结直肠癌最敏感的指标。当该标志物与CEA联合检测时，在诊断晚期和早期结直肠癌时敏感性增强。77例患者在治疗后进行了至少18个月的随访。CEA是复发最敏感的指标（58%）；然而，这种敏感性太低，以至于认为肿瘤标志物在结直肠癌随访中无用。
