多种肿瘤标志物联合监测胃癌术后复发

Detection Value of Combined Four Tumor Markers in the Diagnosis of Gastric Cancer of Postoperative Recurrence

目的:探讨联合检测血清肿瘤标志物癌胚抗原(CEA)、糖类抗原19-9(CA19-9)、糖类抗原153(CA153)和糖类抗原125(CA125)在胃癌复发患者诊断中的临床价值。方法:应用美国Abbott公司AXSYM全自动免疫分析仪测定40例胃癌术后复发患者血清中的CEA、CA19-9、CA153和CA125的含量,同时进行胃镜检查和活体组织病理检查以明确诊断,并进行腹部B超或CT等检查。结果:复发病例多项肿瘤标志物水平明显上升,甚至高于术前水平,复诊时未复发病例各项肿瘤标志物均未见明显上升;腹腔种植、局部复发病例肿瘤标志物水平均明显高于未复发者(P<0.05),而局部复发病例与腹腔多脏器转移者肿瘤标志物水平无明显差异(P>0.05);CA153于胃癌根治术前、术后、复发比较无明显差异(P>0.05);CEA与CA19-9均为阳性者70.1%确诊为胃癌复发;CEA、CA19-9与CA125均为阳性者75.6%确诊为胃癌复发。结论:联合多项肿瘤血清免疫标志物检测诊断胃癌术后复发是一个较有价值、值得推荐的随访检查手段。

Objective： Objective： To investigate the clinical value of combined tumor markers of serum CEA, CA153, CA19 -9, and CA125 in diagnosis of patients with recurrent gastric cancer. Method： 40 patients with gastric cancer of postoperative recurrence had the examination of serum CEA, CA19 - 9, CA153 and CA125, abdominal ultrasound or CT check, gastroseopy and diagnosed by pathology if necessary. Results ： Multiple tumor marker levels in gastric cancer recurrence patients were significantly higher, even higher than the preoperative level. But If there was no recurrence, the tumor markers were not increasing. Tumor marker levels in tumor relapse of abdominal cavity, and local were significantly higher than which did not relapse. But there was no significantly difference of tumor marker levels between mutiple places and local recurrence in abdominal cavity. There was no difference of CA153 in recurrence for gastric cancer between before and after curative resection. Combined detection of CEA and CA19 -9 were confirmed as positive for 70.1% recurrence of gastric cancer, and combined detection of CEA, CA19 -9 and CA125 were confirmed as positive for 75.6% recurrence of gastric cancer. Conclusion： Combined detection of multiple immune serum tumor markers is a effective way for diagnosis of patients with gastric cancer of postoperative recurrence.