CEA联合CA242检测对胃癌诊断及预后判断的效果

Effect of CEA and CA242 on the Diagnosis and Prognosis of Gastric Cancer

目的探究癌胚抗原(CEA)联合糖类抗原242(CA242)检测对胃癌患者预后判断的效果。方法选择98例各期胃癌患者为胃癌组,另选取80例良性病变患者为良性病变组,选取同期接受体格检查的100例健康个体为对照组,对比3组个体血清CEA及CA242水平,对比不同TNM分期胃癌患者血清CEA及CA242水平,分析CEA、CA242单独及联合检测对胃癌的诊断效率。对胃癌患者进行为期3年的随访,对比死亡及存活患者CEA、CA242水平,最后分析CEA、CA242阳性及阴性患者生存情况。结果(1)胃癌组患者CEA及CA242水平明显高于良性病变组(P<0.05),良性病变组明显高于对照组(P<0.05)。(2)胃癌Ⅰ期、Ⅱ期患者CEA及CA242水平对比差异不具有统计学意义(P>0.05),Ⅲ~Ⅳ期患者血清CEA及CA242水平明显高于Ⅰ~Ⅱ期,同时Ⅲ期与Ⅳ期对比差异具有统计学意义(P<0.05)。(3)分析显示,CEA及CA242联合检测对胃癌诊断灵敏性、特异性、阳性预测值明显高于任一单独检测(P<0.05)。(4)根据随访结果发现,死亡患者血清CEA、CA242水平明显高于存活组患者(P<0.05)。(5)单因素分析显示,CEA、CA242阴性患者生存情况明显优于阳性患者,对比差异具有统计学意义(P<0.05)。结论CEA联合CA242检测能够较好地判断胃癌患者病情,在胃癌患者的诊断及预后评估中具有重要价值。

Objective To explore the prognostic effect of carcinoembryonic antigen(CEA)combined with carbohydrate antigen 242(CA242)on gastric cancer patients.Methods 98 patients with gastric cancer in each stage were selected as the gastric cancer group,and 80 patients with benign lesions were selected as the benign lesion group.100 healthy individuals who underwent physical examination during the same period were selected as the control group.The serum levels of CEA and CA242 were compared among the 3 groups.The serum CEA and CA242 of different TNM patients with gastric cancer were compared.Patients with gastric cancer were followed up for 3 years,and CEA and CA242 levels of dead(38 cases)and surviving patients(60 cases)were compared.Finally,the survival of CEA,CA242 positive and negative patients was analyzed.Results The levels of in the gastric cancer group were significantly higher than those in the benign lesion group(P<0.05),and the benign lesion group were significantly higher than those of the control group(P<0.05).The levels of CEA and CA242 in patients with stageⅠandⅡof gastric cancer were not statistically significant(P>0.05).The levels of serum CEA and CA242 in patients with stageⅢandⅣwere significantly higher than those in stageⅠandⅡ.At the same time,the difference between stageⅢand stageⅣwere statistically significant(P<0.05).The analysis showed that CEA and CA242 combined detection had significantly higher sensitivity,specificity and positive predictive value for gastric cancer than any single test(P<0.05).According to the follow-up results,the serum CEA and CA242 levels in the patients were significantly higher than those in the survival group(P<0.05).Univariate analysis showed that the CEA and CA242 negative patients were significantly better than the patients.In the positive patients,the median survival time of CEA-negative patients was(23.65±2.68)months,while the median survival time of positive patients was(16.98±3.61)months,and the median survival time of CA242-negative patients was(30.65±2.65)months.The median survival time of positive patients was(17.23±2.65)months,and the difference was statistically significant(P<0.05).ConclusionCEA combined with CA242 can better judge the condition of gastric cancer patients,and has important value in the diagnosis and prognosis evaluation of gastric cancer patients.