胃癌患者手术前后CA_(50)等肿瘤标志物的临床意义

Clinical significance of pre-and postoperative serum CA_50 in patients with carcinoma of the stomach

目的探讨胃癌时血清ＣＡ５０、ＣＥＡ、β２－Ｍ、Ｆｔ肿瘤标志物在手术前后的变化及对胃癌早期诊断和预后的临床意义。方法采用放射免疫分析方法对胃癌４０例和胃良性疾病１１例（对照组〕，血清ＣＡ５０、ＣＥＡ、β２－Ｍ，Ｆｔ进行测定。结果胃癌术前ＣＡ５０阳性率为６０％（２４／４０）、术后为５２．５％（２１／４０）。行胃癌根治术后ＣＡ５０。水平较术前明显下降（Ｐ＜０．０５），而姑息性切除或探查性手术时术前术后ＣＡ５０变化不大（Ｐ＞０．０５）。胃低分化腺癌ＣＡ５０水平明显高于单纯性腺癌者（Ｐ＜０．０５），而单纯性腺癌术后ＣＡ５０水平下降幅度明显高于低分化腺癌。结论ＣＡ５０等肿瘤标志物在胃癌时有较高阳性率，且与肿瘤的病理类型呈正相关。故对胃癌的诊断和预后有重要临床参考价值。

Objective To study the change of pre-and postoperative serum CA_50. β_2-M, CEA. Ft and the clinical signifi-cance of early diagnosis and prognosis in patients with carcinoma of stomach.Methods Using RIA the CA_50、β_2-M、 CEA、Ft levels were determined in 49 patients with gastric cancer pre-and postoperative, 11 patients with benign gastric diseasesas conarol. Results Before operation, the positive rate of CA_50 was 60%, and was 52.5% afteroperation in gastric cancer. Af-ter radical resection of the gastric cancer serum CA_50level decreased significantly (P<0.05). there was no change after pil-lialive operation (P>0.05). The CA_50. levels were significantly higher in those with low differentiated tumors than in simpleadenocarcinomas (P>0.05). However CA. level decreased more significantly in simple adenocarcinomas than in low differ-entiated tumor after radical operation. Conclusion The positive rates of CA_50. CEA and others were higher in gastric tumorand had correlation with the pathological type. Those tumor markers had clinical reference significance in the diagnosis andprognosis of gastric tumor.