三种血清肿瘤标志物联合检测对恶性肿瘤的诊断价值

Three Serum Tumor Markers of Diagnostic Value of Joint Detection Analysis

目的评估血清标志物糖类抗原125(CA125)、糖类抗原15-3(CA15-3)、糖类抗原242(CA242)联合检测对恶性肿瘤诊断的价值。方法对长海医院肿瘤科于2004年9月～2005年9月期间收治的554例恶性肿瘤患者及60例为对照组的健康人的血清进行CA125、CA15-3、CA242检测。结果恶性肿瘤组三种肿瘤标志物检测的阳性率显著高于对照组(P<0.01)。除鼻咽癌、骨肉瘤及淋巴瘤以外,联合检测阳性率均大于50%。三种标志物联合检测的阳性率高于CA125、CA15-3、CA242单独检测的阳性率(P<0.05);三种标志物联合检测的阳性率高于CA125、CA15-3联合检测的阳性率(P<0.05);三种标志物联合检测的阳性率高于CA242、CA15-3联合检测的阳性率(P<0.05);三种标志物联合检测的阳性率与CA125、CA242联合检测的阳性率无统计学上的差异(P>0.05)。联合检测肿瘤标志物的阳性率分别为:荷瘤转移组(77.08%)、荷瘤未转移组(60.05%)、手术后组(53.40%)。结论CA125、CA242联合检测能明显提高肿瘤的检出率。CA15-3的检测对于肿瘤的筛查并不能明显提高肿瘤的检出率,价值有限,但是对胆囊癌、乳腺癌、肺癌的诊断具有重要意义。三种肿瘤标志物联合检测可为临床判定患者病情状态提供帮助。

Objective To investigate the clinical significance of combined detection of serum CA125, CA15 -3 and CA242 levels in diagnosis of cancer. Methods 554 patients with cancer were collected from 2004.9 - 2005.9 in ChangHai Hospital, and 60 health people were also collected. Serum markers of CA125, CAl5 -3 and CA242 were detected in all the included people. Results There was a significantly higher level in the patients with cancer than in the health controls （ P 〈 0.01 ）. Positive rates are all above 50% except nasopharyngeal carcinoma, osteosarcoma and lymphadenoma patients. Positive rate of three markers combined detection was higher than one marker alone detection（ P 〈 0.05 ） ; Positive rate of three markers combined detection was higher than CA125 and CA15 - 3 combined detection（ P 〈 0.05 ） ; Positive rate of three markers combined detection was higher than CA242 and CA15 - 3 combined detection（ P 〈 0.05 ）. There was no significant difference between the three markers combined detection and CA125 and CA242 combined detection（ P 〉 0.05 ）. Positive rates of three markers combined detection were as fllows： tumor metastasis group （ 77. 08% ） , tumor without metastasis group （ 60. 05% ） and postoperation group （53.40%）. Conclusion Combined detection of serum markers CA125and CA242 can improve the detection rate of malignant tumors. The value of CA15 -3 detection in the cancer diagnosis was limited except in the diagnosis of carcinoma of gallbladder, breast cancer and lung cancer. Combined detection of serum markers CA125, CA15 -3 and CA242 might be helpful in the evaluation of the prognosis of the cancer.