多肿瘤标志物蛋白芯片在胃癌术后复发监测中的应用价值

Clinical Value of Multiple Tumor Marker Protein Biochip in Evaluate Postoperative Recidivation of Gastric Cancer

目的 评价多肿瘤标志物蛋白芯片（C-12）在胃癌术后复发监测的价值,为临床应用选择优化合理、经济实用的肿瘤标志物组合提供参考依据.方法 应用C-12定量检测69例胃癌术后患者（包括29例复发患者和40例无复发患者）血清中CA199,CEA,CA242,β-HCG,AFP,f-PSA,PSA,Ferritin,NSE,CA125,CA153和HGH共12种肿瘤标志物的表达水平,筛选出与胃癌术后复发监测相关性最强的肿瘤标志物组合,并盲法验证最佳标志物联合组合的术后复发监测价值.结果 C-12对胃癌术后复发患者的检测阳性率显著高于无复发患者（P＜0.01）,复发组中CA199,CEA,CA242,Ferritin和CA125的检测阳性率和表达水平显著高于无复发组.不同标志物联合检测组合中,最佳4项组合CEA＋CA125＋CA199＋Ferritin和最佳5项组合CEA＋CA242＋CA125＋CA199＋Ferritin的敏感度、特异度和准确度最高.盲法验证最佳4项组合对胃癌术后复发监测的检测敏感度、特异度和准确度分别为96.0%,92.0%和94.0%,与C-12相比,敏感度稍低,特异度和准确度稍高,但差异均无统计学意义（P＞0.05）.结论 多肿瘤标志物蛋白芯片对胃癌的术后复发监测具有较高的临床应用价值,最佳4项组合足以替代C-12,可能是一种既经济又有效的胃癌术后复发监测组合.

Objective To evaluate the clinical value of multiple tumor markers protein biochip （C-12） in postoperative recidivation of gastric cancer and provide a basis for develop a more optimized multiple tumor markers combination detection system. Methods The serum levels of 12 tumor markers （TMs）,including CA199,NSE,CEA,CA242,Ferritin,β-HCG, AFP,f-PSA,PSA,CA125,CA153 and HGH,were detected in 69 postoperative patients with gastric cancer （include 29 recurrence patients and 40 non-recurrence patients）. The most relevant combinations of TMs to the improvement of postoperative recidivation were determined. Results The recurrence group had significantiy higher positive rate than that of non- recurrence group（P〈0. 01）. The positive rates and serum levels CA199,CEA,CA242,Ferritin and OA125 in the recurrence patients had significantly higher than those of the non-recurrence patients （P〈0. 01）. Among different combinations, the best combinations of 4TMs（CEA＋CA199＋CA125＋Ferritin） and TMs（CEA＋CA199＋CA125＋CA242＋Ferritin） gave the highest sensitivity,specificity and validity for the postoperative recidivation of gastric cancer. The best combina- tions of 4 TMs had not statistically significant comparied with c-12 and yielded a Sensitivity of 96.0% ,a sensitivity of 92. 0% and a validity of 94.0%, respectively. Conclusion The C-12 has a relatively high clinical value for the postoperative recidivation of gastric cancer. The 4 TMs （CEA＋CA199＋CA125＋Ferritin） may be the economical and effective combination in the postoperative recidivation of gastric cancer.