血清CA199、CA242和CA724含量对消化系恶性肿瘤的诊断价值

Diagnosis value of serum CA199,CA242 and CA724 in malignant tumors of digestive system

目的探讨血清CA199、CA242及CA724含量对消化系恶性肿瘤的临床诊断价值。方法用放射免疫法测定42例胃癌、22例结直肠癌、26例原发性肝癌、9例胆囊癌及胆管癌患者血清CA199、CA242及CA724的含量,并分别与良性病变组、正常对照组比较。结果所有恶性肿瘤患者的血清CA199、CA724、CA242含量均显著高于良性病变组及正常对照组(P<0.01或P<0.05)。其中血清CA199及CA242均以胆囊癌及胆管癌组升高最明显[分别为(548.97±221.87)U/ml和(134.75±94.91)U/ml],血清CA724以胃癌组升高最明显[(19.13±39.69)U/ml]。血清CA199以胆囊癌及胆管癌的敏感性最高(100.00%),胃癌的敏感性最低(38.10%);CA242的敏感性也是以胆囊癌及胆管癌的最高(88.89%),原发性肝癌最低(15.38%);而CA724在胃癌、结直肠癌、原发性肝癌及胆囊癌、胆管癌中的敏感性均不高。结论血清CA199、CA242、CA724是消化系恶性肿瘤良好的诊断指标,有一定的临床应用价值,可针对不同的肿瘤类型进行选择应用。

Objective To explore the clinical diagnostic value of serum CA199,CA242 and CA724 in malignant tumors of digestive system. Methods Serum levels of CA199, CA242 and CA724 were detected by radioimmunoassay in 42 patients with gastric carcinoma, 22 patients with colorectal carcinoma, 26 patients with primary liver cancer, 9 patients with gallbladder carcinoma or cholangiocarcinoma. The patients with benign diseases and healthy subjects were served as controls. Results Serum levels of CA199, CA242 and CA724 in all patients with malignant tumors were significantly higher than that in normal controls and patients with benign diseases （P〈0.01 or P〈0.05）. Serum CA199 and CA242 increased most in patients with gallbladder carcinoma or cholangio carcinoma [ （548.97 ± 221.87） U/ml and （ 134.75 ± 94.91 ）U/ml, respectively], and serum CA724 increased most in patients with gastric carcinoma [ （ 19.13 ± 39.69） U/ml ]. The sensitivity of CA199 was highest （ 100 % ） in gallbladder carcinoma or cholangiocarcinoma, but lowest（38.10% ） in gastric carcinoma. The sensitivity of CA242 was also highest（88.89% ） in gallbladder carcinoma or cholangiocarcinoma,but lowest（15.38% ） in primary liver cancer. The sensitivity of CA724 was not high in gastric carcinoma, oolorectal carcinoma, primary liver cancer, gallbladder carcinoma or cholangiocarcinoma. Conclusion Serum CA199, CA242 and CA724 are good markers in diagnosing digestive tract neoplasms, and may be chosen in diagnosing different tumor.