肿瘤标志物联检在诊断胃、结直肠癌中的应用

Diagnostic Value of Combined Tumor Markers Detection for Gastric and Colorectal Cancers

目的:通过对肿瘤标志物联检,探讨该方法在提高胃、结直肠癌临床诊断的敏感性、特异性和有效性中的作用。方法:46例胃癌血清,62例结直肠癌血清,采用放射免疫分析检测CEA、CA199、CA125、CA242,分析单个肿瘤标志物和四种标志物联检在病理诊断明确的胃、结直肠癌病人血清中的测定值,敏感性、特异性和有效性。经统计分析了解单个检测和组合测定各项指标的差异。结果:CEA单独检测的敏感性、特异性和有效性在胃癌中分别为37.0%、96.7%、59.2%,在结直肠癌中分别为51.6%、96.7%、66.3%;CA199单独检测的敏感性、特异性和有效性在胃癌中分别为47.8%、100.0%、65.8%,在结直肠癌中分别为43.5%、100.0%、62.0%;CA125单独检测的敏感性、特异性和有效性在胃癌中分别为41.3%、96.7%、63.2%,在结直肠癌中分别为38.7%、100.0%、58.7%;CA242单独检测的敏感性、特异性和有效性在胃癌中分别为54.3%、100.0%、71.5%,在结直肠癌中分别为51.6%、100.0%、67.4%。四种标志物联检在胃癌中分别为73.9%、93.3%、82.9%;在结直肠癌中分别是77.4%、96.7%、83.7%,与单独检测相比,具有显著的统计学差异(P<0.05)。结论:肿瘤标志物联检可以提高胃、结直肠癌的敏感性和有效性,是筛查胃、结直肠癌的一种简单、有效的检测方法。

Objective To investigate the value of combined tumor markers detection in the clinical diagnosis for gastric cancer and colorectal cancer. Methods The serum concentration of CEA, CA199, CA125, CA242 were measured by radioimmunoassay and Immunoradioassy in 46 patients with gastric cancer 62 patients with colo - rectal cancer and 30 controls. Results The diagnostic sensitivity, specificity, and accuracy of CEA were 37.0%, 96.7%, 59.2% respectively in gastric cancer,and 51.6%, 96.7%, 66.3% respectively in colorectal cancer, those of CA199 were 47.8%, 100.0%, 65.8% in gastric cancer, and 43.5%, 100.0%, 62, 0% in colorectal cancer, those of CA125 were41.3%, 96.7% , 63.2% in gastric cancer,and 38.7%, 100.0%, 58.7% in colorectal cancer, those of CA242 were 54.3%, 100.0%, 71.5% in gastric cancer,and 51.6%, 100.0%, 67.4% in colorectal cancer. The diagnostic sensitivity specificity and accuracy of combined four markers were 73.9%, 93.3%, 82.9% in gastric cancer,and 77.4%, 96.7%, 83.7% in colorectal cancer. Compared with the respective value of any single marker, the diagnastic sensitivity and accuracy were significantly imprrved （P 〈 0.05）. Conclusion Combined tumor markers detection could improve the diagostic sensitivity and accuracy in gastric and colorectal cancers and was helpful for screening.