D-二聚体和肿瘤标记物在胃癌诊断中的价值

Role of D-dimer and serum tumor markers in diagnosis of gastric cancer

目的探讨血清D-二聚体与肿瘤标志物癌胚抗原(CEA)、糖类抗原72-4(CA72-4)和糖类抗原199(CA199)在胃癌诊断中的价值。方法通过免疫比浊法及放射免疫分析法检测157例胃癌患者(A组)、50例胃良性疾病患者(B组)和50例健康对照(C组)的血清D-二聚体、CEA、CA72-4和CA199水平。结果 A组患者上述4项指标均高于B组和C组(P<0.05)。Ⅱ期胃癌患者的血清CA72-4和Ⅲ、Ⅳ期胃癌患者的上述4项指标均高于C组(P<0.05)。CA72-4+CA199+D-二聚体联合检测的胃癌诊断灵敏度最高(91.08%)。结论胃癌患者血清D-二聚体、CA72-4、CEA和CA199水平随肿瘤临床分期的进展而明显升高。其中,D-二聚体阳性检出率最高,与肿瘤标志物联合检测可进一步提高胃癌诊断灵敏度。

Objective To investigate the diagnostic value of D-dimer and serum tumor markers in the diagnosis of gastric cancer.Methods With immunoturbidimetry and radioimmunoassay,serum levels of D-dimer,carcinoma embryonic antigen（CEA）,carbohydrate antigen 72-4（CA72-4）and carbohydrate antigen 199（CA199）were detected in 157 patients with gastric cancer（group A）,50 cases with gastric benign lesions（group B）and 50 healthy persons（group C）.Results Serum levels of D-dimer,CEA,CA72-4and CA199 were higher in group A than those in groups of B and C（P0.05）,which were not significantly different between groups of B and C（P0.05）.Serum levels of CA72-4in the patients with TNM stageⅡ and D-dimer,CA72-4,CEA and CA199 in those with TNM stageⅢ-Ⅳin group A were higher than those in group C（P0.05）.The sensitivity in the diagnosis of gastric cancer was the highest（91.08%）when combined detection of CA72-4＋CA199＋D-dimer.Conclusion Serum levels of D-dimer,CA72-4,CEA and CA199 are increased as the TNM stage is elevated.The positive rate of D-dimer for the diagnosis of gastric cancer is the highest among four markers mentioned above.The sensitivity for the diagnosis of gastric cancer may be improved by combined detection of D-dimer and tumor markers.