消化系统恶性肿瘤患者血清AFP,CEA,CA19-9和CA125的变化及临床意义

Combined detection of AFP, CEA, CA19-9 and CA125 in diagnosing malignant tumors of digestive system

目的探讨AFP,CEA,CA19-9和CA125在消化系统恶性肿瘤诊断中的价值.方法确诊的消化系统恶性肿瘤120例,其中肝癌36例,胃癌32例,胰腺癌28例,结肠癌24例.选消化系统良性病变119例作对照,其中肝硬化35例,消化性溃疡40例,胰腺炎23例,溃疡性结肠炎21例.用放射免疫分析法测定研究对象血中AFP,CEA,CA19-9和CA125含量并分析其敏感性、特异性及准确性.结果肝癌患者血清AFP,CEA和CA19-9水平显著高于肝硬化组(P<0.05,P<0.01),而CA125无显著性差异(P>0.05).胃癌、胰腺癌和结肠癌患者血清CEA,CA19-9和CA125水平明显升高,而AFP无明显差异(P>0.05).AFP,CEA,CA19-9和CA125联合检测其敏感性在肝癌91.7%,胰腺癌89.3%,结肠癌83.3%,胃癌78.1%,总敏感性达85.8%;准确性分别是83.1%,79.2%,82.4%和82.2%,总准确性81.6%.结论消化系统恶性肿瘤中用AFP,CEA,CA19-9和CA125联合检测可明显提高临床诊断的敏感性和准确性.

AIM： To study the value of combined detection of ATP, CEA, CA19-9 and CA125 in the diagnosis of malignant tumors of digestive system. METHODS： Totally 120 cases affirmatively diagnosed by pathological analysis as malignant tumor of digestive system were subjected to the study, including 36 cases of liver cancer, 32 cases of gastric cancer, 28 cases of pancreatic cancer and 24 cases of colon cancer. Totally 119 cases of corresponding benign diseases were used as controls, including 35 cases of cirrhosis, 40 cases of peptic ulcer, 23 cases of pancreatitis and 21 cases of ulcerative colitis. Radioimmunoassay was used to detect the content of AFP, CEA, CA19-9 and CA125 and analyze their sensitivity, specificity and accuracy. RESULTS： The contents of AFP, CEA and CA19-9 in liver cancer were significantly higher than those in cirrhosis （ P 〈 0.05 or P 〈0.01 ）, while CA125 was not significantly different （P 〉 0.05）. The contents of CEA, CA19-9 and CA125 in gastric cancer, pancreatic cancer and colon cancer were significantly higher than those in controls, while AFP had no statistical difference （ P 〉 0.05 ）. The sensitivity and accuracy of combined test of AFP, CEA, CA19-9 and CA125 were respectively 91.7% and 83.1% in liver cancer, 89.3 % and 79.2% in pancreatic cancer, 83.3% and 82.4% in colon cancer, 78.1% and 82.2% in gastric cancer. Totally the sensitivity was 85.8% and the accuracy was 81. 6%. CONCLUSION： The combined analysis of AFP, CEA, CA19-9 and CA125 significantly improves the detectable rate and the diagnostic accuracy of malignant tumors of digestive system.