三种血清肿瘤标志物在胃癌诊断中的应用

Three Tumor Markers for Diagnosis Stomach Cancer

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、手术效果评价中的应用价值 ,并将它们联合检测 ,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 6 0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 7) μg/L ,CA19- 9为 (2 2 8± 9 9)KU/L ,CA72 - 4为 (2 1± 0 8)KU/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。结果 :三种血清肿瘤标志物联合检测可提高胃癌诊断的灵敏度、特异性及有效诊断率 ,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 in diagnosis of stomach can cer and combined use may raise the sensitivity and arruracy in detecting the can cer.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 determined in 58 cases of stomach cancer and 60 patients suffered from stomach begnign diseases.Resluts:In control group,CEA,CA19-9 and CA72-4 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 stomach cancer patients were significantly higher than those in control group( P <0 01).If serum CEA,CA19-9 and CA72-4 were detected simultaneously,the sensitivity and accuracy of diagnosis for stomach cancerr could be improved.Serum CEA,CA19-9 and CA72-4 levels in cancer patients before operation were much higher than those after operation( P <0 01).Conculsion:Serum CEA,CA19-9 and CA72-4 detected simultaneously could improve the sensitivity and accuracy in diagnosis of stomach cancer.The changes of serum CEA,CA19-9 and CA72-4 level have significant value in clinical pratice for diagnosis and commenting therapeutic effect.