肿瘤标志物联合检测诊断胃肠道肿瘤的应用价值

Application value of combined tumor marker measurement in diagnosis of gastroenterological neoplasm

目的探讨血清肿瘤标志物癌胚抗原(CEA)、糖链抗原19-9(CA19-9)、糖链抗原72-4(CA72-4)、糖链抗原242(CA242)对胃肠道肿瘤的诊断价值。方法应用电化学发光免疫测定(ECLIA)系统检测CEA、CA19-9和CA72-4,应用ELISA检测CA242。对30例健康成人和60例不同的胃肠道肿瘤患者血清进行测定。结果胃癌和大肠癌患者血清CEA、CA19-9、CA72-4和CA242值均明显高于对照组(P<0.05),大肠癌组CEA、CA19-9和CA242浓度显著高于胃癌(P<0.05),而CA72-4浓度显著低于胃癌(P<0.05)。肿瘤标志物对乳头状腺癌和粘液腺癌的检出率均显著高于管状腺癌的检出率(P<0.05)。四种肿瘤标志物组合检测后,对胃癌的敏感性较单项显著提高(P<0.05);对大肠癌敏感性较单项CA19-9和CA72-4显著提高(P<0.05)。结论四种肿瘤标志物对于胃肠道肿瘤的诊断有一定意义,不同肿瘤标志物组合后可以提高胃癌的检出率。

Objective To determine the application value of four serum tumor markers that CEA,CA19-9, CA72-4 and CA242 in diagnosis of gastroenterological neoplasm and various histological classifications. Methods The serum samples from 30 cases of controlled adults and 60 cases of patients with gastroenterological neoplasm were tested by electronic chemistry luminescence immunity assay system for CEA, CA19-9 and CA72-4, and by ELISA for CA242. Results The serum CEA, CA19-9, CA72-4 and CA242 levels in patients with gastric carcinoma and colorectal carcinoma were much higher than those in controls（ P 〈 0.05 ）. The serum CEA, CA19-9 and CA242 levels in patients with colorectal carcinoma were significantly higher than that in patients with gastric carcinoma（ P 〈 0.05）, but the serum CA72-4 level in the former was markedly lower（ P 〈 0.05） than that in the latter. The sensitivity of tumor marker for mastoid adenocarcinoma and mucus adenocarcinoma was significantly higher than that for fistulae adenocarcinoma（ P 〈 0.05 ）. The combination of four tumor markers could be more sensitive than single test for detecting gastric carcinoma and colorectal carcinoma（P 〈 0.05）. Conclusion Four tumor markers are useful for diagnosing gastroenterological neoplasm. The combined measurements of 4 tumor markers can increase the sensitivity of detecting gastric carcinoma.