老年胃癌患者胃液中肿瘤标志物联合检测的临床意义

Clinical Significance of Combined Detection of Tumor Markers in Gastric Fluid of the Elderly Patients With Gastric Cancer

目的探讨老年患者胃液中TNFα、CA199和CA724联合检测对胃癌的诊断意义。方法采用放射免疫技术测定42例胃癌、30例浅表性胃炎和31例胃癌前病变的老年患者胃液中TNFα、CA199和CA724浓度。结果胃癌组胃液中TNFα、CA199和CA724的浓度分别显著高于浅表性胃炎组、胃癌前病变组(8.96±2.10)ng/mlvs(5.66±1.65)ng/ml,(4.92±1.24)ng/ml;(59.47±10.58)U/mlvs(38.73±9.23)U/ml,(36.89±11.23)U/ml;(37.08±7.06)U/mlvs(25.42±7.26)U/ml,(23.87±6.31)U/ml;P均<0.001);胃癌组联合检测胃液中TNFα、CA199和CA724,其敏感度、特异度分别为86.9%,83.3%,均分别高于3项标志物的敏感度和特异度(TNFα69.1%,75.4%;CA19965.7%,67.2%;CA72466.7%,70.5%)。结论联合检测胃液中TNFα、CA199和CA724等肿瘤标志物能有助于提高老年患者胃癌的诊断准确率。

Objective To explore the clinical significance of combined detection of tumor necrosis factor alpha （TNFα）, carbohydrate antigen 199 （CA199） and carbohydrate antigen 724 （CA724） in gastric fluid of elderly patients diagnosed with gastric cancer. Methods The 103 patients who underwent upper gastrointestinal endoscopic examination were classified as follows： gastric cancer （gastric cancer group） （n = 42）, superficial gastritis （superficial gastritis group） （n = 30）, atrophy gastritis with various degrees of the intestinal metaplasia or atypical hyperplasia （precancerosis group） （n = 31）. The levels of TNFα, CA199 and CA724 in gastric fluid were determined, respectively, using immunoradiometric assay （IRMA）. Results The levels of TNFα, CA199 and CA724 in gastric fluid were significantly elevated in the gastric cancer group than those in the superficial gastritis group and precancerosis group （8.96±2.10） ng/ml vs （5.66±1.65） ng/ml, （4.92±1.24） ng/ml; （59.47±10.58） U/ml vs （38.73±9.23） U/ml, （36.89±11.23） U/ml; （37.08±7.06） U/ml vs （25.42±7.26） U/ml, （23.87±6.31） U/ml, respectively, all P 〈 0.001. The sensitivity and specificity of combined detection for TNFα, CA199 and CA724 were 86.9 % and 83.3%, respectively, which were markedly higher than those of any three markers detection, respectively （TNFα 69.1%, 75.4 %; CA199 65.7 %, 67.2 %; CA724 66.7 %, 70.5 %）. Conclusion Combined detection of TNFα, CA199 and CA724 can improve the diagnosis capacity of gastric cancer in the elderly patients.