三种血清肿瘤标志物在胃癌诊断中的应用

Application of Three Tumor Markers for the Diagnosis of Gastric Carcinoma

目的 :探讨癌胚抗原 (CEA)和糖类相关抗原CA19 9、CA72 4三种肿瘤标志物在胃癌诊断、疗效监测评价中的应用价值 ,并将它们联合用于检测 ,以提高临床诊断胃癌的灵敏度、有效诊断率。方法 :应用放射免疫分析 (RIA)法和生物素—链霉亲和素双抗夹心法 ,测定 60例患有不同良性胃部疾病病人和 5 8例胃癌患者血清中CEA、CA19 9及CA72 4的含量 ,并对癌症患者进行术后 3个月到 1年的动态随访监测。结果 :良性疾病组CEA为11 8± 3 7μg/L ,CA19 9为 2 2 8± 9 9KU/L ,CA72 42 1+ 0 8KU/L。胃癌患者血清中这三种肿瘤标志物的含量明显高于良性疾病组 ,差异均具有显著性意义 (P <0 0 1)。患者术后血清中CEA、CA19 9及CA72 4水平较术前明显下降 (P <0 0 1)。将CEA、CA19 9及CA72 4三者联合检测较单测任何一项其灵敏度和有效诊断率均有提高。结论 :三种血清肿瘤标志物联合检测可提高胃癌诊断的灵敏度、特异性 ,胃癌患者血清中三种标志物含量变化对胃癌的诊断。

Objective: To evaluate the application of three tumor markers for the diagnosis of stomach cancer and to use their combination to improve their sensitivity and specificity in detecting the gastic carcinoma.Methods:CEA and CA19-9 were detected by radioimmunoassay(RIA),CA72-4 was detected by sandwich assay using streptavidin technology.Serum levels of CEA,CA19-9 and CA72-4 were dtermined in 58 cases with a astric carcinoma and in 60 patients suffered from begnign diseases of stomach as the control group.Results:In control group,their CEA,CA19-9 and CA72-4 serum levels were (11.8±3.7)μg/L,(22.8±9.9)KU/L,(2.1±0.8)KU/L,respectively.Serum CEA,CA19-9 and CA72-4 levels in gastric cancer Patients were significantly higher than those of in control group(P<0.01).If all these serum CEA CA19-9 and CA72-4 were detected,their sensitivity and specifieity in the diagnosis of gastlic caranome could be remarkably improved.Serum CEA,CA19-9 and CA72-4 levels in gastric carcinoma patients before operation were much higher than those of after operation(P<0.01).Conclusion:Serum CEA,CA19-9 and CA72-4 examinations could improve the sensitivity and specificity in the diagnosis of gastric carcinoma.The changes of serum CEA,CA19-9 and CA72-4 levels also have significant value in moritoring the outcome of gastric carcinoma patierts after surgical treatment.