问题 问答题 简答题

简述肿瘤标志物

答案

参考答案:

一、甲胎蛋白(AFP)【参考值】<25μg/L。【临床意义】①原发性肝癌增高,诊断阈值为超过300μg/L。②生殖腺胚胎癌、胃癌或胰腺癌时,血中AFP含量也可升高。③病毒性肝炎、肝硬化时也有不同程度的升高。④妊娠3~4个月,孕妇AFP开始升高,7~8月达高峰,以后下降。

二、癌胚抗原(CEA.【参考值】<5μg/L。【临床意义】①CEA升高主要见于胰腺癌、结肠癌、直肠癌、乳腺癌、胃癌、肺癌等;病情好转时,浓度下降,病情加重时可升高。②结肠炎、胰腺炎、肝脏疾病、肺气肿及支气管哮喘等也常见轻度升高。③大量吸烟的人可以升高。

三、雌激素受体(ER)和孕激素受体(PR)【参考值】ER<20pmol/ml。PR<50pmol/ml。【临床意义】ER、PR在大量激素的作用下,可影响妇科肿瘤的发生和发展。ER阳性率在卵巢恶性肿瘤中明显高于正常卵巢组织及良性肿瘤,而PR则相反,说明卵巢癌的发生与雌激素的过度刺激有关,导致其相应的ER过度表达。不同分化的恶性肿瘤,其ER、PR的阳性率也不同。卵巢恶性肿瘤随着分化程度的降低,PR阳性率也随之降低;同样,子宫内膜癌和宫颈癌ER、PR阳性率在高分化肿瘤中阳性率明显较高。

四、糖链抗原19-9(CA19-9)【参考值】<3.7万单位/升。【临床意义】胰腺癌、肝胆和胃肠道疾病时血清CA19-9明显升高。①目前认为,CA19-9是胰腺癌的首选标志物。②对于肝胆和胃肠道癌,无早期诊断价值。③连续检测对病情进展、手术疗效、预后估计及复发诊断有重要价值。④急性胰腺炎、胆汁淤积性胆管炎、胆石症、急性肝炎、肝硬化等,也有不同程度升高。⑤结合CEA检测,对胃癌诊断价值较大。

五、癌抗原125(CA125)【参考值】<3.5万单位/升。【临床意义】①卵巢上皮癌CA125水平明显升高,对诊断卵巢癌有较大临床价值,尤其对观察治疗效果和判断复发较为灵敏。②盆腔肿瘤的鉴别。③宫颈癌、乳腺癌、胰腺癌、胆道癌、肝癌、胃癌、结肠癌、肺癌等也可呈阳性反应。④良性卵巢瘤、子宫肌瘤有时也会增高。⑤肝硬化失代偿期明显增高。⑥孕早期也可升高。

单项选择题
完形填空

Dorothy Brown was very happy as she sat in the theatre listening to the music. Today her little daughter Lauren was giving her ___1___ concert. She had been waiting for this __2__ for years and years. “Now it is here at last,” she thought. “How beautiful her ___3___ is.”

The song made her ___4___ to the days when she was Lauren’s ___5___. As a young ___6___, Dorothy wanted to be a concert singer. She studied ___7___ in France, Italy and in the United States. “You can become a fine ___8___ in the future,” her teachers told her. “But you must be ___9___ to study hard and work for many years. There will be ___10___ time for anything but music in your life.”

Dorothy was ___11___ at that time and she was ___12___ that music was all she wanted or needed to ___13___ her life. For almost a year Dorothy  ___14___  of nothing else. Then she ___15___ David,  a young engineer traveling Europe. They soon fell in ___16___. David asked her to be his ___17___. Dorothy also wanted to marry David. But she loved ___18___, too. She didn’t know what to do. David was against her being a singer. He said, “If you want to be a singer, you must forget about getting married. You can’t ___19___ do both.” Thus her days were gone and would never return.

Now Lauren became a singer instead of her, which was her ___20___.

1. A. sorry                       B. successful             C. first                      D. wonderful

2. A. dance                      B. moment                C. show                    D. party

3. A. voice                       B. face                      C. dress                    D. life

4. A. think of                   B. bring back            C. go back                D. come back

5. A. age                          B. friend                   C. mother                 D. teacher

6. A. musician                  B. pop star                C. lady                     D. girl

7. A. French                     B. music                   C. piano                    D. dance

8. A. actress                     B. student                 C. singer                   D. dancer

9. A. prepared                  B. learning                C. driven                  D. waiting

10. A. some                     B. any                      C. no                      D. enough

11. A. eight                      B. eighteen                C. eighty                   D. eighty-eight

12. A. lucky                     B. sure                      C. afraid                   D. fond

13. A. fill                        B. live                      C. lead                      D. take

14. A. heard                     B. knew                    C. talked                   D. thought

15. A. saw off                 B. learned from         C. heard of               D. met with

16. A. love                       B. feeling                  C. music                   D. touch

17. A. assistant                 B. teacher                 C. wife                     D. student

18. A. him                       B. engineering           C. herself                  D. music

19. A. certainly                B. possibly                C. only                     D. mainly

20. A. thought          B. hope                   C. purpose                D. will