血清肿瘤标志物检测在贲门癌及胃窦癌诊断中的应用价值

Application value of serum tumor markers in the diagnosis of cardiac and gastric carcinoma

目的 比较血清肿瘤标志物联合检测在贲门癌及胃窦癌诊断中阳性率的差异,探讨其临床应用价值. 方法 选择2010-12 ～2014-03就诊于我院并且资料完整的212例胃癌患者进行研究,根据其癌症部位分为胃窦癌组和贲门癌组,并以200例健康体检病人作为正常对照组进行分析.比较三种血清肿瘤标志物血清癌胚抗原（CEA）、糖类抗原72-4（CA72-4）以及糖类抗原19-9（CA19-9）单独检测以及联合检测对贲门癌及胃窦癌诊断阳性率的影响. 结果 单独检测3种肿瘤标志物对贲门癌和胃窦癌的阳性率经统计学分析差异无统计学意义（P＞0.05）;而联合肿瘤标志物进行检测时,CA72-4联合CA19-9检测对其阳性率影响不大（P＞0.05）,但CEA的联合检测阳性率明显提高,胃窦癌组三者联合检测的阳性率可高达72.90％,而贲门癌组三者联合检测的阳性率也可达58.10％,差异有统计学意义（P＜0.05）. 结论 血清CEA、CA72-4以及CA19-9水平在贲门癌及胃窦癌的诊断上具有一定的临床意义,联合检测可显著提高胃癌尤其是胃窦癌的诊断阳性率,其结果优于单独检测,值得在临床上推广使用.

Objective To compare the difference of serum tumor markers in the diagnosis of cardia cancer and gastric antrum cancer, and to explore its clinical application value. Methods A total of 212 cases of gastric cancer with complete clinical information from December 2010 to March 2014 in our hospital were chosen in this study, and they were divided into gastric cancer group and cardia cancer group according to the cancer site. Another 200 cases of healthy subjects were chosen as control group. The positive rate of sin- gle or combined detection of serum carcinoembryonie antigen（ CEA）, carbohydrate antigen 72-4 （CA72-4 ） and carbohydrate antigen 19- 9 （ CA19- 9） among three groups was compared. Results There was no statistical difference in the positive rate of single detec- tion of three tumor markers for cardia cancer and gastric antrum cancer（ P 〉 0.05 ）. The combined detection of CA72-4 and CA19-9 had no significant difference in the diagnosis of cardia cancer and gastric antrum cancer （P 〉 0.05 ）, while the positive rate of combined detection with CEA was improved. The positive rate of combined detection of three markers was 72.90% for gastric antrum cancer and 58.10% for cardiac cancer（ P 〈 0.05 ）. Conclusion Serum CEA, CA72-4 and CA19-9 levels have certain clinical significance in the diagnosis of gastric cardia cancer and gastric antrum cancer, and the combined detection can significantly improve the positive diag- nosis rate of gastric cancer, especially the gastric antrum cancer,which is better than the single detection and worthy of clinical applica- tion.