应用恶性肿瘤相关物质(TSGF)进行3年防癌普查的临床研究

Study on Result of Three Years' Cancer Screening by TSGF

目的:应用TSGF对固定人群连续3年进行防癌普查,以期提高恶性肿瘤的早期诊断率。方法:对铁四院5710名职工连续3年作防癌普查,筛选可疑人群进行排查:①通过相关检查确诊为恶性肿瘤者,进行专科治疗;②根据病史治疗慢性炎症,然后复查排除假阳性人员;③对无法排除的TSGF阳性人员进行定期复查,每3个月1次。结果:5710名成年人连续3年普查,TSGF阳性总数616人次,平均阳性率为3.6％(616/17130人次)。经过排查和定期复查,确诊恶性肿瘤15例,确诊率2.4％,其中肺癌6例,胃癌5例,结肠癌2例,皮肤癌2例;Ⅰ期11例,Ⅱa期4例。结论:TSGF对于检测早期恶性肿瘤是一种比较灵敏的方法,操作简单,无须特殊设备,便于推广;不足之处:①假阳性问题。可能存在两方面的原因,一方面可能处于特早期的病人一时难以定位,另一方面是受到慢性疾病的干扰,因此,需要临床医生认真甄别。②定位问题。TSGF只有恶性肿瘤的特异性,而没有瘤种的特异性,因此,定位比较困难,需要根据临床症状逐一排查。

Objective: To enhance the early diagnostic rate of malignant tumor by three year's continual cancer screening. Methods: 5710 staff and workers from the Forth Railway Survey and Designing Institute were examined for 3 years.The following three kind of people ①The people who were diagnosed as cancer by associated methods and were treated as cancer. ②The people who were treated for chronic inflammation and the false-positive of whom was excluded by re-examination of TSGF.③The people the cancer of whom was impossible to be excluded by TSGF and should be re-exammed every three months.Result: It amounted to 616 positive cases in the total of 5710 adults for three year's screen.The average positive rate was 3.6%(616/17130) ,15 cases proved to have cancer in the re-examination, the diagnostic rate was 2.4% .It consisted of 6 cases of lung cancer,5 cases of gastric cancer,2 cases of dermal cancer and 2 cases of colon cancer; 11 cases were in Ⅰ phase cancer and 4 cases in Ⅱa phase. Conclusion: TSGF-examining is a sensitive and simple method of preceding diagnosis of cancer,But it has following Shortcomings:①False positive. It mainly owes to two reasons,i.e. it is difficult to locate the tumor in early patients and it is disturbed by chronic diseases.②Location problems TSGF has the specificity for malignant tumor, but has no specificity to it define what kind of cancer it is. So it is difficult to locate and it needs to screen by clinic characteristics.