胃癌患者术前血清和唾液中肿瘤标志物测定的临床价值

The Clinical Value of Preoperatively Detecting Serum and Salivary Tumor Markers in Patients with Gastric Cancer.

本文旨在探讨胃癌患者术前血清和唾液中肿瘤标志物测定的临床价值以及标志物联合应用的意义。方法:采用放射免疫分析法检测40例胃癌病人、12例胃溃疡病人及21名正常人血清和唾液中CEA、CA50、CA19-9、CA72-4及MgAg的含量。结果:上述标志物中以血清CA72-4(55.0％)和唾液Mgag(67.5％)最为敏感。在相关性的研究中,血清CA19-9与胃癌的相关性最好。标志物联合应用中,敏感性最好的是合用唾液CA50和唾液MgAg(82.5％),特异性最好的是合用血清CA72-4和唾液CA19-9(83.3％)。结论:血清CA72-4可用于良恶性胃病的鉴别诊断。血清CA19-9与胃癌情况的相关性最好。可用于评估病人的预后。另外,标志物的联合应用明显优于单一应用。唾液肿瘤标志物有一定的临床应用价值,可以是胃癌流行病学调查的一个简便、经济和无损伤性方法。

To evaluate the usefulness of tumor markers in gastric cancer patients and the sig-nificance of the combined use of tumor markers. Methods: Serum and salivary levels of the tumor markers CEA, CA50, CA19-9, CA72-4 and MgAg were measured preoperatively in 40 patients with gastric cancer, in 12 patients with gastric ulcer and in 21 healthy volunteers by immunoradiometric assay. Results: The salivary MgAg showed the highest sensitivity of 67.5%, followed by CA72-4 with a sensitivity of 55.0%. Among all the tumor markers, serum CA19-9 bore the closest correlationship with gastric cancer. When salivary CA50 was used together with salivary MgAg, the sensitivity was 82.5%. The combined use of serum CA72-4 and serum CA19-9 carried the highest specificity of 83.3%. Conclusions: Serum CA72-4 is useful to differentiate gastric cancer from ulcer, and serum CA19-9 is useful in predicting the prognosis of gastric cancer patients. The determination of salivary tumor marker is an easy and economical method in the screening of gastric cancer patients.