关合检测CEA、CA19-9、CA72-4对胃癌淋巴结转移及临床分期的诊断价值

目的通过对胃癌患者外周血癌胚抗原（CEA）、糖链抗原19—9（CA19—9），糖链抗原72—4（CA72—4）的单项检测和联合检测，探讨三种肿瘤标志物（TM）在胃癌淋巴结转移及分期中的敏感度。方法应用Elecsys2010电化学发光全自动免疫分析系统检测63例胃癌患者外周血CEA、CA19—9、CA72—4水平。结果淋巴结转移组的血清CEA、CA19—9、CA72—4阳性率高于无淋巴结转移组，差异有统计学意义（P〈0．05）。胃癌患者的TNM分期总阳性率是52-38％，Ⅰ、Ⅱ、Ⅲ、Ⅳ期患者的阳性率分别是27．27％、43．75％、50．00％和77．78％，TM阳性率在不同分期中比较差异有统计学意义（P〈0．05）；CEA、CA19—9和CA72—4单项检测和联合检测各组间Ⅰ期与Ⅳ期相比。差异有统计学意义（P〈0．05）；CA72—4的阳性率Ⅰ期＋Ⅱ期与Ⅲ期＋Ⅳ期相比差异无统计学意义（P〉0．05），其余各组间Ⅰ期＋Ⅱ期与Ⅲ期＋Ⅳ期相比，差异有统计学意义（P〈0．05）。TNM分期中CEA＋CA19—9＋CA72—4联合检测阳性率均高于单项检测，差异有统计学意义（P〈0．05）。结论外周血CEA、CA19—9和CA72—4的联合检测可提高胃癌的检出率，淋巴结转移组阳性率明显增高，胃癌TNM分期的TM联合检测最佳组合为CEA＋CA19—9＋CA72—4。

The diagnostic value of combined detection of CEA,CA19-9 and CA72-4 on gastric cancer lymph node metastasis and clinical staging

Objective To discuss the sensitivity of three tumor markers（TM）in lymph node metastasis and clinical staging of gastric cancer by detecting carcinoembryonic antigen （CEA）,carbohydrate antigen 19-9 （CA19-9）,carbohydrate antigen 72-4（CA72-4）in the peripheral blood of patients. Methods CEA,CA19-9,CA72-4 of the peripheral blood in 63 cases of gastric cancer were detected by Elecsys 2010 electrochemiluminescence automatic immune analytic system. Results Positive rate of CEA,CAI9-9,CA72-4 in lymph node metastasis group was higher than that in without lymph node metastasis group respectively,with statistical difference（P〈0.05）.An overall positive rate of TNM staging in patients of gastric cancer was 52.38%,positive rate of Ⅰ, Ⅱ, Ⅲ,Ⅳ stages patients was respectively 27.27%,43.75%,50.00% and 77.78%.There was statistical difference in the positive rate of TM of different clinical stages respectively（P〈0.05）.There was statistical difference in single detection and combining detection of CEA,CA19-9 and CA72-4 between the Ⅳ stage and Ⅰ stage（P〈0.05）.There was no statistical difference in positive rate of CA72-4 between Ⅰ ＋ Ⅱ stage and Ⅲ ＋ Ⅳ stage（P〉0.05）,there was statistical difference between the Ⅰ ＋ Ⅱ stage and Ⅲ＋Ⅳ stage in other groups respectively （P〈0.05）.Positive rate in combined detection was higher than that in single detection of CEA,CA19-9,CA72-4 respectively,with statistical difference （P〈0.05）. Conclusion The combined detection of CEA,CA19-9 and CA72-4 in peripheral blood may improve the detecting rate of gastric cancer,lymph node metastasis group of gastric cancer is higher.The combined detection of CEA＋CA19-9＋CA72-d is the best combination.