血清CEA、CA19-9、CA72-4联合检测对胃癌诊断的价值

Combined detection of CEA,CA19-9 and CA72-4 in diagnosis of gastric cancer

目的探讨肿瘤标志物联合检测在胃癌诊断中的应用价值。方法采用电化学发光分析法测定经病理检查证实的127例各期胃癌患者和105例胃良性病变及98例健康体检者的血清CEA、CA19-9、CA72-4水平并进行统计和分析,计算单项检测与联合检测诊断胃癌的灵敏度及特异度并作比较。结果胃癌患者的CEA、CA19-9、CA72-4水平均明显高于胃良性病变患者及正常对照者,差异均有统计学意义(均P<0.05);胃良性病变患者与正常对照者比较,差异无统计学意义(P>0.05)。3项指标联合检测诊断胃癌的灵敏度达87.4%,明显高于其他任一单项检测的灵敏度,差异有统计学意义(均P<0.05);3项联合检测的特异度为52.7%,虽明显低于其他任一单项检测的特异度,但差异无统计学意义(均P>0.05)。胃癌术后复发者CEA、CA19-9、CA72-4的水平明显高于未复发者,差异有统计学意义(均P<0.01)。结论血清多项肿瘤标记物联合检测有助于提高胃癌诊断的阳性率。

Objective To evaluate the combined detection of CEA, CA19-9 and CA72-4 in diagnosis of gastric cancer. Methods The serum levels of CEA, CA19-9 and CA72-4 were measured by electro-chemiluminescence immunoassay in 127 cases of gastric cancer, 105 cases of benign gastric disease and 98 healthy subjects. The sensitivity and specificity of single or combined detection for diagnosis of gastric cancer were analyzed. Results The serum concentration of CEA, CA19-9 and CA72-4 in patients with gastric cancer were significantly higher than those with benign gastric disease and healthy controls （all P〈0.05）. There were no statistical difference in these markers between patients with benign gastric disease and healthy controls （P 〉0.05）. For diagnosis of gastric cancer the sensitivity of combined detection of three markers was 87.4%, which was higher than that of single-marker detections （P〈0.05）; the specificity of combined detection was 52.7%, which was no difference with single-marker detections（P 〉0.05）.The levels of CEA and CA19-9, CA72-4 in recurrent gastric cancer patients were higher than those without recurrent disease（P〈0.01）. Conclusion Combined detection of serum CEA, CA19-9 and CA72-4 can improve the positive rate for the diagnosis of gastric cancer.