H

21-05-2012

( )

( )

Ma

AFP

, 70 KD

Ca 125

,
200KD

Ca 15.3

,
>250 KD

Ca 72.4

, 48KD

Ca 19.9

Lewis, 1000 KD

CEA

, 180 KD

CYFRA
21.1

19, 30 KD

HCG

2 ,
36KD

NSGCT,
, ,

NSE

, 87KD

SCLC, ,

PLAP

, 86KD

PSA

, 36KD

SCC

, 48 KD

TPA

8,18,19, 22KD

TPS

18, 22KD

K
AFP : t1/2: 4-5

( ,
, )

HCG: ,

, t1/2: 24-30
(,
)

PLAP: t1/2: 0.6-2.8

(, ,

,
)
LDH :

i (36%):
LDH, -HCG

(64%):
: -HCG
:

AFP
:
AFP, -HCG

AFP

HCG

FSH, LH TSH

-
-

-
HCG + HCG

HCG ( HCG)
, ,

HCG ( HCG)

(
)

: ,

(10-30%),
,

Ka

-CG

-CG

10

CEA
CEA (carcinoembryonic antigen)

52-77%
61-68%
40-60%
40-60%
80%
50-70%
30-50%
47-50%
27%
47-50%
27%
11

CEA












12

CEA -
(>5)

( 80% - 70%)
-


13

Ca 19-9
81%, 90%

,
, .. , ,

(55% <3 cm )

14

Ca 19-9

Ca 19-9

15

CEA, Ca 19-9, Ca 72-4 ()

Ca 72-4

16


Ca
SCC (squamous cell carcinoma antigen):)
SCC a ,
-,
, ,

(CYFRA 21-1, TPA, TPS)

A
Ca19-9

17

AFP
AFP (alpha-fetoprotein):

= 40-65%,

= 76-96%

sAg
3

C
= 52% (>3cm), 25%

(<3cm)

( >
)

L3, P4 P5

>400 ng/ml :

Ca

18


Ca 15-3, CEA, MCA, BR27-29, BRMA, CA549
Ca 15-3 (MUC-1):
UC1 MCA,

BR27-29, BRMA CA549

Ca 15-3

15-35%

19


40-

60% - 5,2

60-80%

,

20

CEA
test
MUC1
,
CA15-3/BR27-29

CA15-3/BR27-29

21

Ca-125
Ca-125 :

22

Ca 125

Ca 125

50%

90%

92.1%

93.9%

23

 CA125 ...

Ca

24%

10%

31-33%

40%

25%

8%

17-20%

15%

100%

52-58%

10%

29-37%

32%

50-78%

2%

15%

30%

46%

10%
67%

24

Ca-125

ECHO

>90%

25

K

Ka
SCC
Ca 125 ()

Ca 125

26

 PSA
PSA ( o ):

10 PSA

.
27

 PSA
;
PSA > 4 ng/ml

.
PSA,

.

PSA: PSA

0,35-0,4 ng/ml/ Ca

2 ng/ml/

28

PSA

10-12

PSA
PSA
(75%)
X PSA

29

Ka

:
NSE (neuron specific enolase, 87kD)
CEA (carcinoembryonic antigen)
CYFRA21-1 (cytokeratin 19 fragments, 30kD)
SCC (squamous cell carcinoma antigen)

Ca 125 (cancer antigen 125)

TPA (tissue polypeptide antigen, 22kD)

30

Ka

NSE : SCLC
SCC (>2ng/ml) : SCLC (95%)

(80%)

Ca 125 (>100U/ml) CEA (>10ng/ml) :

Ca o Ca

31


(Tg):

Tg r-TSH

Tg:
:

Tg r-TSH :
6-24
(>5-10 ng/ml)

:
Tg:

32

()


(:
)

FNA

:
(,
Ca):

C

(SCLC,
, ,
, ,
Zollinger)
( ,
)
Tests :
, Ca++

33

(5-10% )

CCN & ESMO guidelines:

AFP, HCG PSA

FP, HCG
Ca-125

R, PR, Her-2

34


,
.
, ,
,
.

35

36

37