肿瘤标记物联合检测对肿瘤高危人群筛查的临床意义

Clinical significicance of tumor markers combined detection in screening for tumor high-risk groups

目的 研究应用肿瘤标记物联合检测对恶性肿瘤高危人群筛查的临床价值.方法 选择血清肿瘤标记物组合对3 766例恶性肿瘤高危人员进行检测,对肿瘤标记（CA125、CEA、Cyfra21-1、CA19-9、AFP、NSE、CA72-4、SCC、CA153）升高人员进一步行颈胸部CT、腹盆部CT或内窥镜检查,女性进行妇科检查,未明确诊断者进行长期随访（大于6个月）.结果 经过随访,共发现肿瘤患者69例,其中发现肿瘤标志物升高6个月内诊断为恶性肿瘤20例（62.5％）,6个月至1年诊断5例（15.6％）,1年至2年诊断4例（12.5％）,2年至3年诊断2例（9.4％）.COX分析显示肿瘤标志物升高的程度（RR=2.308,95％ CI：2.517 ～2.475,P＜0.001）、肿瘤标志物逐渐升高（RR=7.727,95％ CI：3.008 ～ 19.836,P＜0.05）和有相关临床症状（RR=7.879,95％ CI：2.357 ～ 26.384,P＜0.05）是筛查肿瘤标志物升高人员患肿瘤的危险因素.结论 血清肿瘤标记物联合检测对肿瘤筛查人群应答率高,危险因素调查是肿瘤筛查的有效手段.

Objective To investigate the clinical value of combined detection of tumor markers in screening malignant tumor high-risk population.Methods 3 766 people with malignant tumor high-risk were tested with corresponding tumor markers CA125,CEA,Cyfra21-1,CA19-9,AFP,NSE,CA72 4,SCC,CA153 were rised.These people were inspected with cervico thoracicor,abdominal,and pelvic CT or endoscopy.Moreover,these women were followed up for more than 6 months.Results After follow-up,there were 69 cancer patients were found.Among them,20 cases （62.5 %） were diagnosed in 6 months with rised tumor markers,Five cases（15.9%） were diagosed as cancer in 6 months to 1 year.Four cases （12.5%） were diagosed in 1 to 2 years,and two cases （9.4%） were diagosed in 2 to 3 years.COX analysis showed that the degree of the elevated tumor markers （RR =2.308,95% CI：2.517 ～ 2.475,P 〈 0.001）.The gradually increased tumor markers （RR =7.727,95% CI：3.008-19.836,P 〈 0.05）,and relevant symptoms （RR =7.879,95% CI：2.357-26.384,P 〈 0.05） were the cancer risk factors.Conclusion Combined detection of serum tumor markers is an efficient methed in tumor screening.