血清相关肿瘤标记物联合检测对消化道恶性肿瘤的临床价值研究

Clinical value of combined detection of serum tumor associated material in alimentary tract malignancies

目的探讨血清甲胎蛋白(AFP)、癌胚抗原(CEA)、糖类抗原19-9(CA19-9)、糖类抗原72-4(CA72-4)联合检测在消化道恶性肿瘤诊断,病情监测及疗效观察中的价值。方法该院体检健康者60例纳入对照组,该院消化道恶性肿瘤患者186例纳入消化道恶性肿瘤组,其中肝癌亚组56例,胰腺癌亚组32例,胃癌亚组63例,结肠癌亚组35例。采用电化学发光免疫技术检测所有被试血清AFP、CEA、CA19-9、CA72-4水平。结果消化道恶性肿瘤患者血清AFP、CEA、CA19-9、CA72-4的水平明显高于对照组,差异有统计学意义(P<0.05),其中血清AFP水平在肝癌亚组,CEA水平在结直肠癌亚组,CA19-9水平在胰腺癌亚组,CA72-4水平在胃癌亚组中明显高于其他各组(P<0.05)。肝癌、胰腺癌亚组中,联合检测AFP、CEA、CA19-9的阳性率明显高于单项检测(P<0.05);胃癌、结肠癌亚组中,联合检测CEA、CA19-9、CA72-4的阳性率明显高于单项检测(P<0.05)。结论血清AFP、CEA、CA19-9、CA72-4联合检测有助于提高消化道肿瘤诊断的灵敏度。对肝癌、胰腺癌检测以AFP、CEA、CA19-9联合检测最佳,胃癌、结肠癌以CEA、CA19-9、CA72-4联合检测最佳。

Objective To investigate the value of combined detection of alpha fetal protein（AFP） ,carcino‐embryonic antigen （CEA） ,serum tumor marker 19‐9（CA19‐9）and serum tumor marker 72‐4（CA72‐4） in the diagnosis ,illness monitoring and curative observation of alimentary tract malignancies .Methods A total of 60 healthy persons were selected into control group ,186 patients with alpha fetal protein were selected into alimentary tract malignancies group ,56 liver cancer patients in liver cancer subgroup ,32 pancreatic cancer patients in pancreatic cancer subgroup ,63 stomach cancer patients in stomach cancer subgroup ,35 colon cancer patients in colon cancer subgroup .Electrochemiluminescence immunoassay was used to detect the levels of AFP ,CEA ,CA19‐9 and CA72‐4 .Results Levels of AFP ,CEA ,CA19‐9 and CA72‐4 in alimentary tract malignancies group were significant higher than those of the control group （P〈 0 .05） .Levels of serum AFP in liver cancer subgroup ,CEA in colon cancer subgroup ,CA19‐9 in pancreatic cancer subgroup and CA72‐4 in stomach cancer subgroup were significant higher than other groups （P〈 0 .05） .The pos‐itive rate of combined detection of AFP ,CEA and CA19‐9 was higher than that of the singe index in liver cancer and pancreatic cancer subgroup （P〈 0 .05） .The positive rate of combined detection of CEA ,CA19‐9 and CA72‐4 was significant higher than the singe index in colon cancer and gastric cancer subgroup （P 〈 0 .05） .Conclusion Combined detection of AFP ,CEA ,CA19‐9 and CA72‐4 could improve the sensitivity of diagnosis of alimentary tract malignancies .Combined detection of AFP ,CEA and CA19‐9 is best for liver cancer and pancreatic cancer .Combined detection of CEA ,CA19‐9 and CA72‐4 is best for gastric cancer and colorectal cancer .