胃癌和大肠癌患者血清肿瘤标志物联合检测的临床意义

目的评价血清肿瘤标记物联合检测对胃癌和大肠癌诊断和监测的价值.方法用PC-12多种肿瘤标志物蛋白芯片检测系统检测179例胃癌和大肠癌患者、82例胃和结直肠良性疾病患者及160例健康人血清中12种常见肿瘤标志物CA19-9、NSE、CEA、CA242、铁蛋白（Ferritin）、Beta-HCG、AFP、free-PSA、PSA、CA125、HGH、CA153的水平.结果肿瘤组的肿瘤标志物水平显著高于良性疾病组及健康组（P＜0.01）,其中CA19-9、CEA、CA242、CA125和CA153 5项在胃癌和大肠癌患者中水平较两对照组明显升高,差异有统计学意义（P＜0.01）.采用平行检测法,可以提高检测的敏感度（72.07%）和阴性预测值（79.25%）;采用系列检测,可提高检测的特异度（92.15%）和阳性预测值（84.67%）.肿瘤根治术后,肿瘤标记物水平显著下降.术后未降至正常者,复发或转移率为68.89%,而术后再升高者复发或转移率为77.78%.结论多种肿瘤标记物对胃癌和大肠癌的诊断、监测肿瘤复发和转移有一定的价值.

Clinical significance of combined assay of serum tumor markers in patients with gastrocolonic carcinoma

Objective To evaluate the clinical significance of combined serum tumor markers assay in patients with gastric or colorectal carcinoma. Methods Serum level of 12 common tumor markers, including CA19-9,NSE,CEA,CA242 Jerritin,Beta-HCG,AFP,free-PSA,PSA,CA125,HGH and CA153, was measured with multi-tumor markers protein biochip detective system in 179 cases of gastric and colorectal carcinoma, 82 patients with benign digestive disease and 160 healthy volunteers. Results Cancer patients had significantly higher positive rates than that of two other controls (P < 0. 01) . The levels of 5 serum tumor markers (CA19-9,CEA,CA242,CA125 and CA153) were significantly higher in gastric cancer and colorectal carcinoma than that of two other controls ( P < 0. 01). The simultaneously combined assay raised sensitivity (72.07%%) and negative predictive rate (79.25%); the serial combined assay raised specificity (92. 15%) and positive predictive rate (84.67%). The recurrence or metastasis rate was 68. 89% in patients whose serum tumor markers failed to decrease to normal after operation. The recurrence or metastasis rate was 77. 78% in patients whose serum tumor markers reelevated after operation. Conclusion Combined serum tumor markers assay is of value for the diagnosis and postoperative follow up of gastric and colorectal carcinoma.