联合检测血清肿瘤标志物对胃癌的诊疗意义

目的 探讨联合检测血清癌胚抗原（CEA）、糖类抗原724（CA724）对胃癌的诊疗意义。方法 用放射免疫分析法检测50例胃炎或胃溃疡患者和58例胃癌患者及其术后3个月、术后1年的患者的血清CEA含量，同时用化学发光法检测其血清CA724含量。结果 胃癌患者术前血清CEA、CA724含量及阳性率均比胃炎、胃溃疡患者高（P〈0．05）；手术后3个月其血清CEA、CA724含量及阳性率均比手术前低（P〈0．05）；术前联合检测血清CEA与CA724的阳性率为74．5％，较单项标志物高；TNM临床分期患者Ⅰ、Ⅱ、Ⅲ、Ⅳ期其血清CA724含量呈逐级递增的趋势（P〈0．05）；术后1年临床证实的复发者血清CEA、CA724含量及阳性率较未复发者明显增高（P〈0．05）。结论 血清CEA、CA724均有助于胃癌诊断、疗效监测和预后判断，二者联合检测可提高其临床应用价值。

Clinical significance of combined detection of serum tumor markers in the diagnosis and treatment of gastric cancer

Objective To explore the clinical significance of combined detection of serum carcinoembryonic antigen （CEA） and CA724 in the diagnosis and treatment of gastric cancer. Methods Serum level of CEA in patients with gastric canner （n= 58）, gastritis （n= 50） or gastric ulcer （n= 50） was detected with radioimmunoassay （RIA）. Serum CA724 was detected by using chemiluminescent immunoassay （CLIA）. Results The levels and positive rate of serum CEA, CA724 in patients with gastric cancer were significantly higher than those in patients with gastritis or gastric ulcer （P〈0.05）. The levels and positive rate of serum CEA, CA724 in patients with gastric cancer 3 mouths after operation were significantly lower than those of pre-operation gastric cancer patients （P〈0.05）. The positive rate during pre-operation with combined detection of CEA and CA724 was more elevated than that by single marker detection. The serum level of CA724 kept increasing with TNM clinical stages. The serum contents of CEA and CA724 were significantly higher in relapsing patients than those of non-relapsing patients at one year after operation （P〈0.05）. Conclusion Detection of serum CEA and CA724 is useful for the diagnosis, curative effect monitoring and prognosis evaluation of gastric cancer. Combined detection of serum CEA and CA724 can increase their clinical value.