摘要

肿瘤抗原表达的异质性可能需要根据个别患者或肿瘤选择单克隆抗体，以允许充分的肿瘤定位。癌胚抗原(CEA)和上皮膜抗原(EMA)在结直肠癌患者中的表达以前没有进行过比较。采用CEA和EMA单克隆抗体间接免疫过氧化物酶染色法检测51例结直肠癌患者的肿瘤(52例)、邻近正常结肠(45例)、同步腺瘤(11例)和淋巴结转移(49例)。原发肿瘤阳性细胞百分比分为1:< 25%，2:25-49%，3:50-75%，4 > 75%。所有原发性结直肠癌均表达CEA, 52例中43例表达EMA(83%)。分级显示39例CEA大于EMA, 11例相等，2例小于EMA。CEA染色中，高分化癌(23 / 27)比中分化癌(11 / 22)更频繁地分为3级或4级(p < 0.01)。EMA的等效数据为27例中的4例和22例中的3例(不显著)(NS)，尽管大多数(86%)为1级和2级。1级CEA表达在15个近端病灶中有6个，远端病灶中只有2个(p < 0.01, chi 2检验)，而EMA等效数字为15个中的3个和37个中的6个(NS)。淋巴结沉积全部表达CEA, 49例中45例表达EMA (92%); 29 of 45 normal colon sections showed CEA expression (64%) as did all adenomas. EMA was not expressed by normal colon or adenomas. These results suggest that EMA expression is more specific but less sensitive than CEA for colonic cancer and is independent of tumour differentiation and site. Thus selecting monoclonal antibodies to CEA or EMA based on tumour biopsies may allow improved tumour localisation for imaging or therapy in patents with colorectal cancer.