CA_(242),CEA,CA_(19-9)在胃癌及癌前病变组织中表达的相关研究

A Study of the Expressions of CA_(242),CEA,CA_(19-9) in the Disease Tissues for Gastric Cancer and Precancerous Lesion.

目的研究胃癌及癌前病变组织中肿瘤相关抗原表达的临床意义。方法对所有病例均行电子胃境检查,经胃镜取3块病变组织(直径约0.5cm)送病理。经病理诊断分为胃癌组32例,癌前病变组33例,对照组(浅表胃炎组)30例,同时取病变组织2块放入5%EDTA二钠液1ml中消化分离细胞,测3组病人病变组织中CA242、CEA、CA19-9的含量,同时测血清中CA242、CEA、CA19-9的含量。对3组病人组织及血清中CA242、CEA、CA19-9的含量及组织/血清比值分别进行比较。结果(1)CA242、CEA、CA19-9在胃癌及癌前病变组织中的表达明显高于血清中的表达(P<0.01)。(2)CA242、CEA、CA19-9在癌前病变组织中的表达明显高于对照组(P<0.01),且在重度癌前病变组织中的表达明显高于在中度癌前病变组织中的表达(P<0.01),而血清中癌前病变组肿瘤相关抗原的含量与对照组差异无显著性(P>0.05)。(3)组织中CA242、CEA、CA19-9检测对胃癌诊断的灵敏度分别是84.3%、90.63%、87.50%;特异度分别是66.67%、63.49%、69.84%。结论对组织中CA242、CEA、CA19-9表达的检测可预测癌前病变的危险程度,能提高早期胃癌的诊断率,而血清CA242、CEA、CA19-9检测对癌前病变的危险程度及早期胃癌的诊断价值不大。

Objective To study the clinical significance of the expression of tumer related angten in the disease tissue for gastric cancer and precancerous lesion. Methods 95 patients diagnosed by endoscopy and pathology were divided into tinge groups,32 patients in group of gastric cancer ,33 patients in group of gastric precaneerous lesion ,and 30 patients in control group （ CSC group）. The two little cakes of specimen obtained by foreeps biopsy from each patients were put in 1 ml 5% Na3EDTA sloution after digested and dissociated. The tissue and serum revels of CA242 , CEA ,CA19-9; in the three group anti the ratios of tissue/serum were measured and compared. Results （ 1 ） The tissue levels of CA242 , CEA, CA19-9 increased significantly than the serum levels in patients with gartric cancer and precancerous lesion （P 〈 0.01 ）. （2）The tissue levels of CA242 ,CEA,CA19-9 in group of precancerous lesoin increased significantly than those in normal group （ P 〈0.01 ） ,and the tissue levels of CA242 , CEA, CA 19-9 in patients wilh severe precancerous lesion increased significantly than those with medial precanerous lesion. The serum levels of turmer related angten in group of precancereus lesion werc no significant differences with those in normal group （P 〉0.05） , （3）The sensitiveties of CA242 ,CEA, CA 19-9 in the disease tissue were respectively 84.38% ,90. 63%, 87.50%, The specificities of them were respectively 66, 67%, 63, 49% ,69.84%. Conclusions The measure of CA242,CEA ,CA19-9 in the disease tissue can indicate the risk degree of gastric preeancerous lesion real incease the diagnostic ratio of early gastric cancer, but the measure of CA242 , CEA, CA19-9 in blood serum can not.