多项肿瘤标志物联检对胃恶性肿瘤诊断的临床价值

Clinical Value of Multi-tumor Markers Detection with(CEA,CA19-9,CA72-4)for Diagnosis of Gastric Malignancy

目的:本文报告CEA、CA19-9、CA72-4三项肿瘤标志物,单项与联检诊断胃恶性肿瘤的临床价值。方法:应用免疫放射分析(IRMA)。结果:本文单项检测阳性率在70%以上,但以CA72-4阳性率最高(84.21%),次为CA19-9(75.43%)。作为单项应用首选CA72-4,次为CA19-9。全文仅4例三项均阴性(假阴性率为1.75%),故三项联检可使阳性率提高到98.25%。本文分三组双项组合检测,按双阳性分析,结果显示A组阳性率最高(61.84%),次为B组(51.31%),C组(48.24%)。结论:单项筛选检测,首选CA72-4,双项组合检测仍以CA72-4+CA19-9为宜,随访可按组织学类型选用。

Objective To assess the clinical value of multi -tumor markers detection with （CEA, CA19 -9, CA72 -4） for diagnosis of gastric malignancy. Methods Serum CEA, CA19 -9, CA72 -4 contents were measured with IRMA in 228 patients with gastric malignancies, 152 patients with benign gastric disorders and 200 controls. Results The positive rates of single marker detection were all above 70% and that of CA72 -4 was the highest （84.21%） , next was CA19 -9（75.43% ）. Three tumor markers were all negative in only 4 cases （ false negative rate was 1. 75% ）. So combined detection of 3 tumor markers could improve the positive rate to 98.25%. With combined determination of two markers, double positive rate for different sets of combinations was： 61.84% for CA72-4＋CA19-9, 51.31% for CA72 -4 ＋ CEA and 48. 24% for CEA＋CA19-9. Conclusion It was suggested that for screeing, CA72 -4 was the first choice in single marker detections, and CA72 -4 ＋ CA19 -9 was the first choice for combined detections of two markers. For follow - up, a combination of 2 markers with highest positive rate for the specific histo - pathologic type （ i. e. carcinoma, leiomyosarcoma or lymphosarcoma） should be used throughout the study.