血清胃蛋白酶原及CA199、CA242、CEA联合检测在胃癌早期诊断中的价值

目的 研究联合检测血清胃蛋白酶原(PGⅠ、PGⅠ/PGⅡ)及糖蛋白抗原199(CA199)、糖脂类抗原242(CA242)、癌胚抗原(CEA)在胃癌早期诊断中的临床应用价值。 方法 血清中的胃蛋白酶原PG用乳胶增强免疫比浊法，CA199、CA242、CEA用化学发光微粒子免疫法，分别检测130例胃癌患者(均有病理学诊断明确为胃癌患者)、30例胃部良性疾病患者、120例正常健康体检人群的水平，统计学分析3组间的差异；并比较上述各单一肿瘤指标与联合肿瘤指标检测的灵敏度、特异度的差异。 结果 相较于胃部良性疾病患者组和正常健康体检对照组，胃癌组血清中各肿瘤标志物PGⅠ及PGⅠ/PGⅡ和CA199、CA242、CEA含量水平差异均有统计学意义(P＜0.01)。与所有单项肿瘤标志物检测的灵敏度相比较，联合检测5项肿瘤标志物的灵敏度为86.1%，差异均有统计学意义(P＜0.01)，而特异度降低差异无统计学意义(P＞0.05)。 结论 胃癌患者血清PGⅠ及PGⅠ/PGⅡ和CA199、CA242、CEA联合检测的灵敏度远远高于单一肿瘤标志物项目检测的灵敏度，血清的PGⅠ及PGⅠ/PGⅡ和CA199、CA242、CEA的联合检测有助于胃癌的早期诊断。联合检测对提高早期胃癌患者的检出率具有临床实用价值。 

Study on the application of serum pepsinogen and CA199,CA242,CEA joint detection in the diagnosis of earlier gastric cancer

Objective To explore the joint determination of the serum pepsinogen PGⅠ,PGⅠ/PGⅡ and carbohydrate antigen 199(CA199),carbohydrate antigen 242 (CA242),carcino-embryonic antigen (CEA) on the clinical significance of early diagnosis of gastric cancer. Methods In the serum pepsinogen PG(PGⅠ,PGⅠ/PGⅡ) latex-enhancedimmunoturbidimetic,the tumor markers CA199,CA242,CEA with chemiluminescent particles immune method,130 cases of gastric cancer patients was detected for gastric cancer patients are pathological diagnosis clear,30 patients with gastric benign disease,120 cases of normal healthy check-up crowd,statistical analysis of the differences between three groups.Compare the sensitivity and specificity of single and joint index to see whether there is significant difference. Results The serum levels of five tumor markers(CEA,CA199,CA242,PGⅠ and PGⅠ/PGⅡ) in gastric malignant tumor were significantly different from those in benign gastric disease and control group(P<0.01).The sensitivity of the joint detections of the five tumor markers(86.1%) were significantly higher than that of the respective detection(P<0.01).However,there was no difference in specificity(P>0.05). Conclusion The positive rate of the joint detection of serum PGⅠ and PGⅠ/PGⅡ,CA199,CA242,CEA in gastric cancer patients is far higher than that of any single biomarker detection.Joint detection to improve detection rate early gastric cancer patients has clinical practical value.