胃癌患者血清中肿瘤标志物检测的临床分析

Clinical analysis of serum tumor markers detection in gastric cancer patients

目的探讨胃癌患者血清中多项肿瘤标志物检测的意义。方法选择312例胃疾病患者作为胃疾病组,其中良性胃病患者173例,胃癌患者139例,另选择329例健康体检者为对照组,采用化学分光分析仪检测血清癌胚抗原(CEA)、糖类抗原19-9(CA19-9)、糖类抗原125(CA125)、糖类抗原72-4(CA72-4)和糖类抗原15-3(CA15-3)、前列腺特异抗原(T-PSA)、神经元特异性烯醇化酶(NSE)、甲胎蛋白(AFP)的水平,并进行统计学分析。结果与健康对照组、良性胃病组比较,胃癌组血清CEA、CA19-9、CA15-3、CA125、CA72-4水平均显著升高;良性胃病患者的血清CEA、CA19-9、CA72-4水平明显高于健康对照组,上述差异均有统计学意义(P<0.05);CA72-4水平变化与胃癌患者的临床分期、分化程度有关;多项肿瘤标志物联合检测胃癌其特异性、灵敏度显著高于单项指标检测(P<0.05)。结论血清CEA、CA19-9、CA15-3、CA125、CA72-4对胃癌的诊断具有一定临床价值,多项肿瘤标志物联合检测可大大提高对胃癌的诊断效果。

Objective To investigate the clinical significance of tumor markers detection in patients with gastric cancer. Methods 312 cases of stomach patients served as control group,173 of whom were gastric benign disease and the other 139 were with cancer. 329 cases of healthy people acted as observation group. The concentrations of CEA,CA19-9,CA125,CA72-4,CA15-3,T-PSA,NSE and AFP in three groups were detected by automatic biochemical analyzer,and the results were statistically analyzed. Results Compared with the healthy control group and the benign stomach group,the levels of serum CEA,CA19-9,CA15-3,CA125 and CA72-4 were significantly increased in gastric cancer patients; the levels of serum CEA,CA19-9 and CA72-4 in benign stomach patients were higher than that in healthy control group,with the differences statistically significant（ P〈 0. 05）; the changes of CA72-4 in cancer patients were related to the clinical stage and differentiation of gastric cancer. The specificity and sensitivity of combined several tumor markers in detecting gastric cancer were significantly higher than those of single index. Conclusion Serum CEA,CA19-9,CA15-3,CA125 and CA72-4 exhibit certain value in the diagnosis of gastric cancer,and the combined detection of multiple tumor markers can greatly increase the accuracy of diagnosis on gastric cancer.