胃癌前疾病患者血清胃液中三种肿瘤标志物的临床研究

Clinical research of CA72-4,CA19-9 and CEA in blood and gastric juice of patients with precancerous lesions of gastric cancer

目的研究胃癌前病变血清和胃液中糖类抗原72-4(CA72-4)、糖类抗原19-9(CA19-9)、癌胚抗原(CEA)等肿瘤标志物的水平差异。方法采用胃镜获取胃癌患者、癌前病变(包括胃溃疡、萎缩性胃炎、十二指肠溃疡等)及良性病变患者的胃液和组织学标本,并经病理组织学证实,将83例患者分为胃癌组12例,癌前病变组44例,良性病变组(对照组,多为慢性浅表性胃炎)27例;同时采集患者静脉血,采用电化学发光免疫测定技术(ECLIA)分别检测血清和胃液内CEA、CA72-4和CA19-9的水平。结果胃癌、癌前疾病、对照组胃液中CA72-4、CA19-9、CEA的浓度显著高于血清(P<0.05);癌前病变组和良性病变组3种血清肿瘤标志物水平比较,差异无统计学意义(P>0.05),而胃液中检测结果差异有统计学意义(P<0.05)。结论测定胃液中的CA72-4、CA19-9、CEA等肿瘤标志物较血清测定更有利于胃癌前疾病的诊断与疗效追踪。

Objective To explore the expression of CA72-4,CA19-9 and CEA in serum and gastric juice in precancerous lesions of gastric cancer.Methods The gastric juice and histological specimens from the patients with gastric cancer,precancerous lesion（including gastric ulcer,atrophic gastritis and duodenal ulcer） and benign diseases were collected by gastroscope.83 patients were divided into three groups： gastric cancer（12 cases）,precancerous lesions（44 cases） and chronic superficial gastritis（27 cases）.The venous blood was collected at the same time.The content of CA72-4,CA19-9 and CEA in serum and gastric juice were detected by electrochemiluminescence immunoassay（ECLIA）.Results In the 3 groups,the concentration of CA72-4,CA19-9 and CEA of gastric juice was much higher than that of serum（P0.05）.In the preconcerous lesion group and the control group,these 3 kinds of tumor markers in serum had no statistical difference（P0.05）,but in gastric juice had significant difference（P0.05）.Conclusion Detecting the content of CA72-4,CA19-9 and CEA in gastric juice is much benificial to the diagnosis and curative effect tracing of precancerous disease than serum.