血清肿瘤标志物在预测胃癌病理学分期中的应用价值研究

Study on the value of serum tumor markers in predicting pathological stages of gastric cancer

目的:研究血清肿瘤标志物在预测胃癌病理学分期中应用价值。方法:选取本院接受诊治的200例胃癌患者作为研究对象,检测所有患者血清CEA、CA19-9、CA72-4、CA125水平,记录TNM分期、肿瘤大小、病理类型、淋巴结转移、胃壁浸润深度等特点,分析血清肿瘤标志物与TNM分期、肿瘤大小、病理类型、淋巴结转移、胃壁浸润深度等相关性。结果:血清CEA、CA19-9、CA72-4、CA125水平在胃癌病理学分期中表达为Ⅳ期>Ⅲ期>Ⅱ期>Ⅰ期,差异有统计学意义(P<0.05);在病理学分期Ⅱ期、Ⅲ期、Ⅳ期中四项联合检测阳性率明显高于各单项检测,差异有统计学意义(P<0.05);Ⅰ期胃癌患者中单项检测与联合检测阳性率比较,差异无统计学意义(P>0.05);胃癌患者血清CEA、CA19-9、CA72-4在肿瘤大小方面比较,差异有统计学意义(P<0.05);血清CA125在肿瘤大小方面比较,差异无统计学意义(P>0.05);血清CEA、CA19-9、CA72-4、CA125水平在不同病理类型中比较,差异无统计学意义(P>0.05);淋巴结转移患者血清CEA、CA72-4、CA125、CA19-9水平高于淋巴结未转移患者,差异有统计学意义(P<0.05);在不同胃壁浸润深度中血清CA19-9、CA72-4表达水平比较,差异有统计学意义(P<0.05);在不同胃壁浸润深度中血清CEA、CA125表达水平比较,差异无统计学意义(P>0.05)。结论:血清CEA、CA19-9、CA72-4、CA125表达与胃癌病理学分期有关,与肿瘤大小及淋巴结转移、胃壁浸润深度存在明显相关性,能作为胃癌辅助诊断,且联合检测价值高于各单项检测。

Objective：To study the value of serum tumor markers in predicting the staging of gastric cancer.Methods：200 cases of patients with gastric cancer who underwent treatment in our hospital were selected as the subjects.The levels of serum CEA,CA19-9,CA72-4 and CA125 were measured,and the TNM staging,tumor size,pathological type,lymph node metastasis and depth of gastric wall were recorded.The correlation between serum tumor markers and TNM stage,tumor size,pathological type,lymph node metastasis and depth of invasion of gastric wall were analyzed.Results：The levels of serum CEA,CA19-9,CA72-4 and CA125 were expressed in stage Ⅳ stage Ⅲ stage Ⅱ stageⅠ,the difference was statistically significant （P〈0.05）.The positive rate of four combined detection in stage Ⅱ,Ⅲ and Ⅳ of pathology was significantly higher than that of single test,the difference was statistically significant （P〈0.05）.There was no significant difference in the positive rate of single detection and combined detection between patients with stage Ⅰ gastric cancer （P〈0.05）.The levels of serum CEA,CA19-9 and CA72-4 in patients with gastric cancer were significantly different in the size of tumor （P〈0.05）.There was no significant difference in the size of tumor CA125 between the two groups （P〈0.05）.The levels of serum CEA,CA19-9,CA72-4 and CA125 in different pathological types were not statistically significant （P〉0.05）.The levels of serum CEA,CA72-4,CA125 and CA19-9 in patients with lymph node metastasis were significantly higher than those in patients without lymph node metastasis （P〈0.05）.The levels of serum CA19-9 and CA72-4 in different depths of gastric wall were significantly different （P〈0.05）.There was no significant difference in serum CEA and CA125 expression between different depths of gastric wall （P〈0.05）.Conclusion：The expression of serum CEA,CA19-9,CA72-4 and CA125 are correlated with the staging of gastric cancer,which are correlated with tumor size and lymph node metastasis and depth of gastric wall invasion.It could be used as assistant diagnosis of gastric cancer,and the combined detection value is higher than that of individual.