胃癌肿瘤标志物性能的临床研究

Clinical research of gastric cancer tumor markers performance

目的:通过测定血清中甲胎蛋白(AFP)、糖链抗原125(CA125)、糖链抗原19-9(CA19-9)、糖链抗原72-4(CA72-4)、癌胚抗原(CEA)的水平,对其性能进行评价,探讨这几种肿瘤标志物(TM)单独与联用时对胃癌诊断的临床应用价值。方法:使用直接化学发光法测定65例胃部良性疾病患者和38例胃部恶性肿瘤患者血清中TM的水平,计算各指标的平均水平并比较不同TM单独及联合使用时的灵敏度和特异度。结果:胃癌组CA125、CA19-9、CA72-4、CEA水平明显高于良性胃病组(P<0.05);采用单项TM诊断胃癌时,灵敏度最高的为CA19-9,特异度最高的为CEA,ROC曲线下面积最大的为CA19-9;采用不同TM的组合诊断胃癌时,灵敏度和特异度均较好的为CA19-9与CEA组成的组合。结论:血清TM的检测对胃癌的诊断具有较高的辅助价值,选择适当的TM进行联合检测有助于提高诊断的灵敏度。

Objective：To assess the performance of AFP,CA125,CA19-9,CA72-4and CEA,and investigate the clinical value of these tumor markers（TM）using alone or combined for the diagnosis of gastric cancer.Method：The levels of these TM of 65 patients with benign gastric diseases and 38 patients with gastric cancer were detected using automated chemiluminescence immunoassay analyzer,and the sensitivity and specificity of these TMs using alone or combined were compared.Result：The levels of CA125,CA19-9,CA72-4and CEA in gastric cancer group were significantly higher than those in benign gastric disease group（P〈0.05）.When using individual TM to diagnose gastric cancer,the most sensitive TM was CA19-9,the most specific TM was CEA,and the biggest area under ROC curve was CA19-9.When using different combinations of TM to diagnose gastric cancer,CA19-9＋CEA had the most sensitivity and specificity.Conclusion：The detection of serum TMs would have a high auxiliary value in the diagnosis of gastric cancer,so choosing appropriate combination of TMs could help to improve the diagnostic sensitivity.