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(收稿日期:2008-09-10)

文章编号:1007-4287(2009)08-1128-06

结肠癌相关肿瘤标志物及临床意义

唐素玫,杨铁生审校

(北京大学人民医院检验科免疫室,北京100044)

结肠癌是最常见的恶性肿瘤之一,全世界每年大约新增一百万的结肠癌患者有五十万左右的结肠癌患者死亡[1]。结肠癌的发生发展是因为一系列遗传性改变累积而成,包括癌基因、抑癌基因和DNA 修复基因的改变[2]。在散发性结肠癌中,这些基因的改变是必要的,主要可能是由一些外源性或者内源性的致癌物质引起的。相反,在一些肿瘤结合征比如家族性结直肠息肉结合征(FAP)和遗传性非息肉病性结直肠癌(H NPCC)中,这些基因的改变是遗传获得的[3]。在家族性结直肠息肉综合症中,是由于APC基因的胚系突变造成腺瘤样息肉;而遗传非息肉病性结直肠癌则是由于DNA修复基因的突变造成遗传性改变加性累积从而增加癌症发生的风险。近年来出现了很多有可能用于结肠癌的标志物,这些标志物可以在血清、组织和粪便中检测到,从而对结肠癌的早期诊断和预后给予一定的指导作用[4-6]。本综述系统地阐述了结肠癌的各种标志物以及其临床意义。

1　血清标志物

1.1　癌胚抗原(CEA)　1965年,研究者首次报道CE A与结肠癌具有相关性[7]。CE A是一种大分子糖蛋白,正常的结肠上皮细胞并不存在CE A,而在约