多种肿瘤标志物在胃癌诊断中的临床价值研究

Study on clinical value of five tumor markers in the diagnosis of gastric cancer

[目的]探讨5种常见肿瘤标志物(CEA、CA125、CA19-9、CA72-4、AFP)单独与联用时在胃癌诊断中的临床价值。[方法]检测60例胃部良性疾病患者(良性胃病组)和58例胃癌患者(胃癌组)血清肿瘤标志物的水平,比较不同肿瘤标志物单独及联用时的灵敏度和特异度,对各指标的临床价值进行评价。[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),2组AFP水平比较差异无统计学意义。采用单项肿瘤标志物诊断胃癌时,灵敏度最高的为CA19-9(36.52%),特异度最高的为CEA(98.12%),ROC曲线下面积最大的为CA19-9(0.953);采用不同肿瘤标志物的联合检测诊断胃癌时,CA19-9+CEA+CA125组合时,灵敏度64.29%,特异度92.59%。[结论]CA19-9+CEA+CA125联合检测能显著提高诊断的灵敏度,具有较好的临床联合检测价值。

[Objective]To compare the clinical value between single use and combined use of five common tumor markers （AFP, CA125, CA19-9, CA72-4, CEA） in the diagnosis of gastric cancer. [Methods] The serum levels of these tumor markers（TMs）in both 60 cases of benign stomach disorder and 58 cases of gastric malignancy were measured, then the sensitivity and specificity between single use and combined use of these TMs were compared. At last all indexes were evaluated. [Results]The level of CA125 ,CA19-9 ,CA72- 4, CEA in cancer group was significantly higher than that in benign group（P〈0.05）, while the serum level of AFP showed no significant difference between two groups. When these five TMs were individually used, the most sensitive one was CA19-9（36.52%） ,the most specific one was CEA（98.12%） ,and the largest ar- ea under ROC curve was CA19-9（0. 953）. The combination of CA19-9＋CEA＋CA125 showed 64.29% in sensitivity and 92.59% in specificity for diagnosis of gastric cancer. [Conclusion]The combination of CA19- 9＋CEA＋CA125 obviously increases the sensitivity in detecting gastric cancer.