血清肿瘤标志物联合检测对胃癌的诊断价值

Diagnostic value of combined detection of serum tumor markers for gastric cancer

目的应用受试者工作特征(ROC)曲线评价几种血清肿瘤标志物联合检测对胃癌患者的诊断价值。方法选取2016年1月~2017年12月我院收治的57例胃癌患者(A组)、50例胃良性病变患者(B组)、50例胃黏膜正常健康体检者(C组)作为研究对象,采用电化学发光法检测三组研究对象的血清癌胚抗原(CEA)、糖类抗原72-4(CA72-4)、糖类抗原50(CA50)、糖类抗原19-9(CA19-9)、糖类抗原242(CA242)水平并进行ROC分析。结果A组的血清CEA、CA72-4、CA50、CA19-9、CA242表达水平均高于B组与C组,差异有统计学意义(P<0.05);随着胃癌分期的进展,胃癌患者血清中CEA、CA72-4、CA50、CA19-9、CA242的阳性检出率呈增长趋势。肿瘤标志物单独检测时,CA19-9的AUC最大,为0.777,CA72-4的检测敏感度最高,为77.7%;肿瘤标志物联合检测的诊断准确性提高,尤其是CA50、CA72-4、CA19-9和CA242联合检测时,AUC为0.925,敏感度提高至78.7%。结论CA50、CA72-4、CA19-9和CA242联合检测能够有效提高胃癌患者诊断的准确性、敏感度,具有重要的临床诊断和应用价值。

Objective To evaluate the diagnostic value of several serum tumor markers in patients with gastric cancer by using receiver operating characteristic(ROC)curve.Methods A total of 57 patients with gastric cancer(group A),50 patients with benign gastric lesions(group B)and 50 healthy patients with normal gastric mucosa(group C)from January 2016 to December 2017 in our hospital were selected as the research objects.Expression levels of carcino embryonic antigen(CEA),carbohydrate antigen 72-4(CA72-4),carbohydrate antigen 50(CA50),carbohydrate antigen 19-9(CA19-9)and carbohydrate antigen 242(CA242)in serum for the three groups were detected by electrochemiluminescence.ROC curve was carried for analysis.Results The expression levels of CEA,CA72-4,CA50,CA19-9 and CA242 in group A patients were higher than those in group B and group C,the differences were statistically significant(P<0.05).With the progress of gastric cancer staging,the positive detection rate of CEA,CA72-4,CA50,CA19-9 and CA242 in the serum of gastric cancer patients showed an increasing trend.When the tumor markers were detected individually,the AUC of CA19-9 was 0.777,and the sensitivity of CA72-4 was the highest,which was up to 77.7%.The diagnostic accuracy of combined detection of tumor markers was improved.The AUC of the combined detection of CA50,CA72-4,CA19-9 and CA242 was 0.925,and the sensitivity increased to 78.7%.Conclusion The combined detection of CA50,CA72-4,CA19-9 and CA242 can effectively improve the accuracy and sensitivity of diagnosis of gastric cancer patients,and has important clinical diagnosis and application value.