摘要
目的观察和分析应用癌胚抗原(CEA)、糖链抗原199(CA199)、CA242、CA724等血清肿瘤标志物联检对胃癌进行早期诊断的临床应用效果。方法选取80例胃癌患者作为观察组,选取同期慢性萎缩性胃炎伴重度不典型增生50例作为CAGD组,选取同期胃粘膜检查正常或浅表性胃炎者50例作为对照组,对三组研究对象的血清肿瘤标志物CA199、CA242、CA724、CEA水平进行检测和比较。结果观察组患者的血清CA199、CA242、CA724、CEA水平均显著高于CAGD组(P<0.05),而CAGD组患者的上述血清肿瘤标志物水平均显著高于对照组(P<0.05);低分化程度肿瘤患者的血清CA199、CA242、CA724阳性率均显著高于高、中分化程度肿瘤患者(P<0.05);有肝转移患者的血清CA199、CA242、CA724、CEA阳性率均显著高于无肝转移的患者(P<0.05);临床分期为Ⅲ期或Ⅳ期的患者的血清CA199、CA242、CA724、CEA阳性率均显著高于临床分期为Ⅰ-Ⅱ期的患者(P<0.05);应用4项血清肿瘤标志物进行联合检测时,敏感度和特异度分别可达85%和92.5%,敏感度显著高于应用3项、2项或单项血清肿瘤标志物进行检测(P<0.05),特异度与应用2项或单项血清肿瘤标志物检测的差异无显著性(P>0.05)。结论 CA199、CA242、CA724、CEA等血清肿瘤标志物水平的异常升高可提示有癌前病变或初期胃癌的发生,可作为胃癌早期诊断的辅助指标,其检测阳性率与病情的进展具有相关性,可用于预测患者的病情进展和预后情况,联合应用4项血清肿瘤标志物进行检测时可提高胃癌早期诊断的敏感度。
Objective To observe and analyze the clinical application effects of the combined detection of serum tumor markers of carcinoembryonic antigen （CEA）,carbohydrate antigen 199（CA199）,CA242,CA724 in the early di-agnosis of gastric cancer.Methods 80 cases of gastric cancer patients were selected as the observation group.50 cases of the patients with chronic atrophic gastritis complicated with severe atypical hyperplasia at the same period were se-lected as the CAGD group.50 cases with normal gastric mucosa or superficial gastritis at the same period were selected as the control group.The serum tumor marker of CEA,CA199,CA242,CA724 levels of the objects in the three groups were detected and compared.Results The serum CA199,CA242,CA724,CEA levels of the patients in the observation group were significantly higher than those of the CAGD group （P 〈0.05）,and the serum tumor markers of the patients in the CAGD group were significantly higher than those of the control group （P 〈0.05）;the serum CA199,CA242, CA724 positive rates of the patients with low tumor differentiation were significantly higher than those of high or medi-um differentiation of tumor patients （P 〈0.05）;the serum CA199,CA242,CA724,CEA positive rates of the patients with liver metastasis were higher than those of the patients without metastasis （P 〈0.05）;the serum CA199,CA242, CA724,CEA positive rates of the patients at clinical stage III or IV stage were significantly higher than those of the pa-tients at clinical stage Ⅰ-Ⅱ patients （P 〈0.05）;when 4 serum tumor markers joint detection was applied,the sensitivi-ty and specificity was 85% and 92.5%,the sensitivity was significantly higher than that when 3,2 or single serum tumor markers were detected （P 〈0.05）and the difference of specificity was not significant when 2 or single serum tumor markers were detected （P 〉0.05）.Conclusion the abnormal increasing of the serum tumor markers of CA199, CA242,CA724,CEA may indicate the occurrence of gastric precancerous lesions or early tumor and can be used as the auxiliary indexes in the early diagnosis of gastric cancer.The positive detection rate of the tumor markers detection is correlated with the progression of the disease and can be used to predict the disease progression and the prognosis of patients.The application of the combined detection of the 4 serum tumor markers in the early diagnosis of gastric cancer can improve the sensitivity of the diagnosis.
出处
《中国实验诊断学》
2014年第6期899-902,共4页
Chinese Journal of Laboratory Diagnosis
