肿瘤标志物在胃肠道间质瘤辅助诊断中的应用价值

Application value of tumor markers in the auxiliary diagnosis of gastrointestinal stromal tumor

目的探讨肿瘤标志物癌胚抗原(CEA)、糖类抗原19-9(CA19-9)、糖类抗原242(CA242)、糖类抗原125(CA125)及细胞角质蛋白19片段抗原21-1(CYFRA21-1)在胃肠道间质瘤(GIST)辅助诊断中的应用价值。方法选择40例GIST患者和40例健康志愿者,分别作为GIST组和健康对照组。检测并比较两组研究对象的血清CEA、CA19-9、CA242、CA125、CYFRA21-1水平和阳性率。分析CEA、CA19-9、CA242、CA125、CYFRA21-1诊断GIST的灵敏度、特异度、阳性预测值和阴性预测值。结果GIST组患者的血清CEA、CA19-9、CA242、CA125、CYFRA21-1水平均明显高于健康对照组,差异均有统计学意义(P﹤0.01)。GIST组患者的血清CEA、CA19-9、CA242、CA125、CYFRA21-1阳性率均明显高于健康对照组,差异均有统计学意义(P﹤0.01)。CEA、CA19-9、CA242、CA125、CYFRA21-1诊断GIST的灵敏度、特异度、阳性预测值、阴性预测值比较,差异均无统计学意义(P﹥0.05),5项指标联合诊断GIST的灵敏度和阴性预测值均高于任一指标单独诊断的结果,差异均有统计学意义(P﹤0.05)。结论GIST患者的血清CEA、CA19-9、CA242、CA125、CYFRA21-1水平均较高,5项指标联合检测有助于GIST的早期诊断,值得应用与推广。

Objective To explore the value of carcinoembryonic antigen(CEA),carbohydrate antigen 19-9(CA19-9),carbohydrate antigen 242(CA242),carbohydrate antigen 125(CA125)and cyto-keratin 19 fragment antigen 21-1(CYFRA21-1)in the diagnosis of gastrointestinal stromal tumor(GIST).Method A sum of 40 subjects with GIST and another 40 healthy volunteers were enrolled in the analysis as GIST group and healthy control group,respectively.The level and positive rates of serum CEA,CA19-9,CA242,CA125 and CYFRA21-1 were analyzed and compared between the two groups.The sensitivity,specificity,positive predictive value and negative predictive value of CEA,CA19-9,CA242,CA125 and CYFRA21-1 in diagnosing GIST were analyzed.Result Compared with the healthy control group,the level of serum CEA,CA19-9,CA242,CA125 and CYFRA21-1 in the GIST group were significantly higher(P<0.01).The positive rates of serum CEA,CA19-9,CA242,CA125 and CYFRA21-1 in the GIST group were significantly higher than those in the healthy control group(P<0.01).There were no notable difference for CEA,CA19-9,CA242,CA125 and CYFRA21-1 in regards of sensitivity,specificity,positive predictive value and negative predictive value when diagnosing GIST(P>0.05).The sensitivity and negative predictive value of the combined detection of the five markers were significantly higher than those of the indicator used alone(P<0.05).Conclusion The levels of serum CEA,CA19-9,CA242,CA125 and CYFRA21-1 in patients with GIST are significantly higher,the combined detection of the five markers is helpful for early diagnosis of GIST.