联合检测CEA、AFP、CA19-9及CA125在消化系统恶性肿瘤中的诊断意义

Diagnostic value of CEA, AFP, CA19-9 and CA125 in malignancy diseases of digestive system

目的 通过对肿瘤标志物癌胚抗原（CEA）、甲胎蛋白（AFP）、糖类抗原19-9 （CA19-9）、糖类抗原125（CA125）及其联合检测的方法,寻找提高消化道恶性肿瘤诊断的最佳手段.方法 应用电化学发光免疫分析法测定消化系统260例恶性肿瘤、114例良性疾病患者及80例正常体检人群血清CEA、AFP、CA19-9、CA125水平,分别对其阳性率、特异性、准确性、阳性预测值进行比较分析.结果 单检CEA、AFP、CA19-9、CA125诊断消化道恶性肿瘤的阳性率分别为33.08％、26.92％、33.85％、22.31％,联检提高到64.62％；特异性单检为74.31％、98.08％、84.21％和76.32％,联检为54.39％；准确性单检为53.2％、44.12％、49.2％和38.77％,联检为64.17％；阳性预测值单检为89.47％、88.61％、83.02％、77.33％,联检80.00％.结论 CEA＋ AFP＋ CA19-9＋ CA125联合检测诊断常见消化道肿瘤的阳性率和准确性明显提高,对消化系统恶性肿瘤的早期诊断有极其重要的意义.

Objective To investigate the clinical diagnostic significance of serum CEA,AFP,CA19-9 and CA125 in patients with tumors of digestive system.Methods Electrochemical luminescence immunoassay （ECLIA） method was used to detect serum CEA,AFP,CA19-9 and CA125 levels in 260 patients with tumors of digestive system,114 patients with digestive system disease and 80 nomal healthy people.The sensitivity,specificity,accuracy and positive predictive value （PPV）of 4 biomarkers in tumors of digestive system,as well as their combined measurement effect was evaluated.Results The positive rate of serum CEA,AFP,CA19-9 and CA125 to diagnose tumors of digestive system was 33.08％,26.92％,33.85％ and 22.31％ respectively,but the combined examination（CEA ＋ AFP ＋ CA19-9 ＋ CA125） was 64.62％.The specificity of CEA,AFP,CA19-9 and CA125 was 74.31％,98.08％,84.21％ and 76.32％ respectively and 54.39％ in combination.The accuracy increased from 53.2％ （CEA）,44.12％ （AFP）,49.2％ （CA19-9） and 38.77％ （CA125） to 64.17％ （CEA ＋AFP ＋ CA19-9 ＋CA125）.The PPV of CEA,AFP,CA19-9 and CA125 was 89.47％ 、88.61％ 、83.02％ and 77.33％ respectively and 80.00％ in combination.Conclusions With combined determination of CEA,AFP,CA19-9 and CA125,the positive rate and accuracy are enhanced,which is vital importance in the early diagnosis of digestive system tumors.