Prognostic value of preoperative serum tumor markers in gastric cancer

AIM: To evaluate the prognostic value of preoperative carcinoembryonic antigen (CEA), carbohydrate antigen (CA)19-9, and CA50 in patients undergoing D2 resection.METHODS: We evaluated 363 patients with gastric cancer who underwent gastrectomy at our hospital from January 2006 to December 2009. Blood samples were obtained from each patient within 1 wk before surgery. The cut-off values for serum CEA, CA19-9, and CA50 were 5 ng/mL, 37 U/mL, and 20 U/mL, respectively. The correlation between preoperative tumor marker levels and prognosis was studied by means of univariate and multivariate analyses.RESULTS: The preoperative serum positive rates of CEA, CA19-9 and CA50 were 24.0%, 18.9% and 24.5%, respectively. The positivity rate of serum CEA was significantly correlated with age (P < 0.001), sex (P = 0.022), tumor size (P = 0.007) and depth of invasion (P = 0.018); CA19-9 with tumor size (P = 0.042) and lymph node metastasis (P < 0.001); and CA50 only with lymph node metastasis (P = 0.001). In multivariate analysis, tumor size, T category, N category, vascular or neural invasion, and adjuvant chemotherapy were independent prognostic factors for overall survival. CA19-9 had an independent prognostic significance in patients without adjuvant chemotherapy (P = 0.027).CONCLUSION: Preoperative serum CEA, CA19-9 and CA50 are prognostic in patients with gastric cancer. Only CA19-9 is an independent prognostic factor after surgery without adjuvant chemotherapy.     

The prognostic significance of gastric juice CA 19-9 and CEA levels in gastric carcinoma patients

AIM: The usefulness of gastric juice CA 19-9 and carcinoembryonic antigen (CEA) levels in the diagnosis of gastric carcinoma is controversial. There is only one study related with their prognostic value. In this study the clinical significance of gastric juice CA 19-9 and CEA levels in patients with gastric carcinoma was investigated. METHODS: Preoperative serum and gastric juice CA 19-9 and CEA concentrations were measured in 139 patients with gastric carcinoma, 54 patients with benign gastroduodenal disease and as the 'healthy' control group 46 patients with inguinal hernia and with no other pathology. RESULTS: In all groups the mean gastric juice levels of CA 19-9 and CEA were significantly higher than the serum levels. The gastric juice CA 19-9 levels were not different between groups. Gastric juice CEA levels of the gastric carcinoma group were significantly higher than those of the benign gastroduodenal disease group (P=0.007) and had a tendency to increase when compared to those of the control group (P=0.064) whereas there was no significant difference between the benign gastroduodenal disease and the control group. The cut-off values of gastric juice CA 19-9 and CEA were 440U/ml and 320ng/ml and the positivity ratios of these markers in gastric carcinoma patients were 16.5 and 27.3%, respectively. There was no significant relationship between the histopathological features and the gastric juice CA 19-9 or CEA positivities. Neither univariate analysis nor the multivariate Cox proportional hazards model analysis showed prognostic value for gastric juice CA 19-9 and CEA positivities. CONCLUSIONS: The gastric juice CA 19-9 and CEA levels have no diagnostic and prognostic significance in gastric carcinoma patients.     

A clinical evaluation of carbohydrate antigen 19-9 and carcinoembryonic antigen in patients with pancreatic carcinoma

We have studied serum carbohydrate antigen 19-9 (CA 19-9) and carcinoembryonic antigen (CEA) in 221 persons to assess their usefulness in the diagnosis of pancreatic carcinoma. Although serum CA 19-9 and CEA in all healthy controls were within normal limits, the positive ratings of serum CA 19-9 and CEA in all benign disease were 9.8% and 18.1%, respectively. Sensitivity of serum CA 19-9 for pancreatic carcinoma was 70.5%, which was higher than that found in healthy controls, benign disease, and other malignant disease except biliary carcinoma; but sensitivity of serum CEA levels (67.7%) was not different from that seen in malignant disease. Three of 34 patients (8.8%) with pancreatic carcinoma who had a above-normal levels of serum CA 19-9 but not serum CEA were resectable. Although there was no correlation between serum CA 19-9 and CEA, advanced stages of pancreatic, gastric, and colorectal carcinoma tend to show high serum CA 19-9 and CEA, but no statistical differences were observed in relation to the stages of these carcinomas. Comparative studies of serum CA 19-9 and CEA for sensitivity and the predictive value of true positive and negative results for detecting pancreatic, gastric, and colorectal carcinoma showed that serum CA 19-9 has significantly higher sensitivity and predictive value of true positive results for pancreatic carcinoma than for gastric and colorectal carcinoma (P less than 0.05). However, serum CEA measurements did not show any difference between these carcinomas, and the highest predictive value of a true negative result for excluding pancreatic carcinoma was also observed in serum CA 19-9. These results indicate that although the CA 19-9 assay is not specific for pancreatic carcinoma, it is more useful adjunct method for diagnosing pancreatic carcinoma, possibly in resectable stages.     

Prognostic significance of CEA, CA 19-9 and CA 72-4 preoperative serum levels in gastric carcinoma.

The prognostic value of preoperative serum levels of CEA, CA 19-9 and CA 72-4 tumor markers was investigated in 153 patients resected for gastric cancer. The positivity rates for CEA, CA 19-9 and CA 72-4 were 20.9, 34.6 and 28.1%, respectively. Multiple logistic regression analysis for positive levels of tumor markers indicates that CEA positivity is significantly related to the depth of invasion (p < 0.005) and the presence of distant metastasis (p < 0. 05), CA 19-9 positivity is related to nodal involvement (p < 0.05) and the depth of invasion (p < 0.05), whereas CA 72-4 positivity is influenced by tumor size (p < 0.005) and noncurative surgery (p < 0. 05). Positive levels of each tumor marker were associated with a worse prognosis if compared with negative cases using univariate analysis. Multivariate analysis of curatively resected cases identified depth in gastric wall (p < 0.0001), nodal status (p < 0. 0005), and tumor location in the upper third (p < 0.05) as significant prognostic variables; CEA, CA 19-9 and CA 72-4 serum positivity did not reach statistical significance. However, when the positivity of the three markers was associated, a p value < 0.05 was observed. The analysis of survival curves stratified by tumor stage revealed that marker positivity significantly affects survival in stages I, II and IV (p < 0.05). The combined assay of CEA, CA 19-9 and CA 72-4 preoperative serum levels provides additional prognostic information in patients resected for gastric cancer; patients with preoperative positivity for one of these tumor markers should be considered at high risk of recurrence even in early stages of gastric carcinoma.     

Evaluation of seven tumor markers (CA 50, CA 19-9, CA 19-9 TruQuant, CA 72-4, CA 195, carcinoembryonic antigen, and tissue polypeptide antigen) in the pretreatment sera of patients with gastric carcinoma.

Preoperative serum levels of the tumor markers CA 50, CA 19-9, CA 19-9 TruQuant, CA 72-4, CA 195, carcinoembryonic antigen (CEA), and tissue polypeptide antigen (TPA) were measured in 94 patients with well-staged adenocarcinoma of the stomach and in 15 patients with benign gastric diseases. In all patients with carcinoma, a laparotomy was done. The serum levels were correlated with the stage of disease, the location of the primary tumor, and the resectability and grade of differentiation. The marker CA 50 was the best, with an overall positivity of 59.5%. For CA 19-9, this figure was 34%; for CA 19-9 TruQuant, 22%; for CA 72-4, 34%; for CA 195, 29%; for CEA, 33%; and for TPA, 50%. The best combination of two markers was CA 50 and TPA; this combination gave a positivity of 81%. There was no evident correlation with stage of disease and the percentage of positive serum levels or the median serum levels. The marker CA 50 gave the widest range of elevated serum levels between the cutoff level and the 90th percentile (54%). Patients with carcinoma of the cardia had higher preoperative serum levels than those with a tumor in other parts of the stomach. There was no correlation with the resectability of the tumor and the preoperative serum level. Patients with an undifferentiated tumors did not have significantly lower serum levels than those with more differentiated tumors. Currently, preoperative determination of serum tumor marker levels in patients with gastric carcinoma has no significant in clinical practice.     

Preoperative Serum CEA and CA19-9 in Gastric Cancer - a Single Tertiary Hospital Study of 1,075 Cases

To evaluate the clinical impact of preoperative serum CEA and CA19-9 on resectable gastric cancer (GC),a total of 1,075 consecutive cases with gastric adenocarcinoma were obtained retrospectively from January2012 and December 2013 in a single tertiary hospital, and the relationships between serum CEA, CA19-9 andclinicopathologic features were investigated. Positive preoperative serum rates of CEA and CA19-9 were 22.4%and 12.3% respectively, levels significantly correlating with each other and depth of invasion, lymph nodeinvolvement, pTNM and stage. The CEA level also presented a remarkable association with lymphovascularinvasion. Both CEA and CA19-9 positivity significantly and positively correlated with depth of invasion, nodalinvolvement, pTNM stage, lymphovascular invasion, tumor size and tumor location. Stratified analyses accordingto gender or tumor location showed preoperative CEA or CA19-9 had different associations with clinicopathologicfeatures in different gender subgroups or location subgroups. Preoperative serum CA19-9 positivity may bemore meaningful for tumor size rather than CEA. In conclusion, preoperative serum CEA and CA19-9 correlatewith disease progression of GC, and may have applications in aiding more accurate estimation of tumor stage,decision of treatment choice and prognosis evaluation.     

Prognostic value of carcinoembryonic antigen, CA 19-9 and CA 72-4 in gastric carcinoma.

The prognostic value of preoperative serum levels of carcinoembryonic antigen (CEA), CA 19-9 and CA 72-4 tumor markers was investigated in patients with gastric cancer. Eighty-two patients who underwent surgical resection of gastric cancer were entered in the study. Correlation analyses showed that CA 72-4 was more frequently positive in patients with advanced tumors (p = 0.04), lymph node invasion (p = 0.02), liver metastasis (p = 0.02) and peritoneal involvement (p = 0.03). CA 19-9 was more frequently positive in patients with advanced tumors (p = 0.01) and with serosal (p = 0.04), lymph node (p = 0.008) and peritoneal involvement (p = 0.02). CEA was more frequently positive in patients with liver metastasis (p = 0.03). Low 3-year cumulative survival was significantly associated with elevated serum levels of CA 72-4 (p = 0.004), CA 19-9 (p = 0.001) and CEA (p < 0.001). Age, tumor stage and CA 72-4 provided prognostic information in the multivariate analysis. Patients with elevated serum levels of CA 72-4 showed a 4.2 times higher risk of death than patients with low levels of the marker. Our results suggest that CA 72-4 has prognostic value in gastric cancer, and patients with a high preoperative serum level of CA 72-4 have a greater risk of death due to gastric cancer.     

Pre-operative serum levels of sialyl Tn antigen predict liver metastasis and poor prognosis in patients with gastric cancer

AIMS: To clarify the prognostic value of preoperative serum levels of sialyl Tn antigen (STN) for survival of gastric cancer patients. METHODS: Pre-operative serum levels of STN, sialyl Lewis(a)antigen (CA19-9) and carcinoembryonic antigen (CEA) were examined in 180 patients who underwent resection of gastric cancer. Patients were divided into high and low antigen groups on the basis of a selected diagnostic-based cut-off value. Correlation between high antigen serum levels, established clinicopathologic factors and prognosis was examined by univariate and multivariate analysis. RESULTS: Twenty-eight patients (15.6%) were classified as high STN; 37 (20.6%) as high CA19-9; and 33 (18.3%) as high CEA. The survival time of the high STN, CA19-9 or CEA group was shorter than that of the respective low-antigen group (P<0.0001, P=0.0008 or P=0.0002, respectively). Patients with stage III/IV tumours with high STN had a shorter survival time that those with low STN (P=0.0004). Cox's regression with multiple covariates showed that high serum STN is an independent factor predicting a worse outcome in gastric cancer patients. Multiple logistic regression analysis revealed that high serum STN is an independent predictor for the development of liver metastasis. CONCLUSIONS: Pre-operative high serum levels of STN predict both liver metastasis and poor prognosis after resection for gastric cancer.     

Combined Detection of CEA,CA 19-9, CA 242 and CA 50 in the Diagnosis and Prognosis of Resectable Gastric Cancer

Our aim was to investigate the value of combined detection of serum  carcinoembryonic antigen (CEA), carbohydrate antigen (CA) 19-9, CA 242 and CA 50 in diagnosis and assessment of prognosis in consecutive gastric cancer patients. Clinical data including preoperative serum CEA, CA 19-9, CA 242, and CA 50 values and information on clinical pathological factors were collected and analyzed retrospectively. Univariate and multivariate survival analyses were used to explore the relationship between tumor markers and survival. Positive rates of tumor markers CEA, CA 19-9, CA 242 and CA 50 in the diagnosis of gastric cancer were 17.7, 17.1, 20.4 and 13.8%, respectively, and the positive rate for all four markers combined was 36.6%. Patients with elevated preoperative serum concentrations of CEA, CA 19-9, CA 242 and CA 50, had late clinical tumor stageand significantly poorer overall survival. Five-year survival rates in patients with elevated CEA, CA 19-9, CA 242 and CA 50 were 28.1, 25.8, 27.0 and 24.1%, respectively, compared with 55.0, 55.4, 56.4 and 54.5% in patients with these markers at normal levels (p<0.01). In multivariate Cox proportional hazards analyses, an elevated CA 242 level was determined to be an independent prognostic marker in gastric cancer patients. Combined detection of four tumor markers increased the positive rate for gastric cancer diagnosis. CA 242 showed higher diagnostic value and CA 50 showed lower diagnostic value. In resectable gastric carcinoma, preoperative CA 242 level was associated with disease stage, and was found to be a significant independent prognostic marker in gastric cancer patients.     

Serum tumor markers in skeletal metastasis

BACKGROUND: There have been no well-documented reports detailing the relationship between skeletal metastasis and tumor markers in a large series of patients. The purpose of our study was to assess the relationship between the clinical features of skeletal metastasis and serum tumor markers and to determine whether tumor markers are a useful modality in the differential diagnosis of skeletal metastasis. METHODS: We retrospectively reviewed consecutive 458 patients with skeletal metastasis and divided the patients into two groups according to six clinical presenting factors. We assessed whether these groups influenced the level of the tumor markers in univariate and multivariate analysis. RESULTS: Patients with skeletal metastasis of carcinoma had a higher level of markers CEA (P < 0.0001) and CA19-9 (P = 0.0008) than patients with primary bone tumors and hematological malignancies. Univariate analysis of clinical variables revealed that metastasis on axial skeleton, multiple skeletal metastases and visceral metastasis were associated with the serum CEA and CA19-9 levels. By multivariate analysis, metastasis on axial skeleton, multiple skeletal metastases and visceral metastasis were found to be associated with the serum CEA and CA19-9 levels. At least one of the tumor markers was elevated in 73% of all patients. CONCLUSIONS: The higher tumor marker level (CEA, CA19-9) is predictive of metastasis on the axial skeleton, multiple skeletal metastases and visceral metastasis. Tumor markers are useful as a screening test to distinguish skeletal metastases of carcinoma from primary bone tumors or hematological malignancy from primary bone tumor and hematological malignancy.     

血清肿瘤标志物CEA、CA19-9和CA72-4在胃癌术后监测中的意义

目的研究血清肿瘤标志物CEA、CA19—9和CA72—4在胃癌术后复发、转移监测中的意义。方法采用电化学发光法检测228例手术后胃癌患者血清CEA、CA19—9和CA72—4含量;并结合临床及随访资料进行分析。结果胃癌术后复发、转移患者CEA、CA19—9和CA72—4的含量和阳性率均显著高于未发生复发、转移患者。术后复发、转移的胃癌患者血清CEA、CA19—9和CA72—4检测灵敏度和特异度分别为46．2％和94．7％,52．3％和97．4％,47．1％和90．6％。结论血清CEA、CA19—9和CA72-4升高与胃癌复发、转移密切相关,在术后随访过程中检测血清肿瘤标志物有助于早期诊断胃癌复发、转移。     

血清肿瘤标志物CEA、CA19-9和CA72-4在胃癌术后监测中的意义

目的 研究血清肿瘤标志物CEA、CA19-9和CA72-4在胃癌术后复发、转移监测中的意义.方法 采用电化学发光法检测228例手术后胃癌患者血清CEA、CA19-9和CA72-4含量;并结合临床及随访资料进行分析.结果 胃癌术后复发、转移患者CEA、CA19-9和CA72-4的含量和阳性率均显著高于未发生复发、转移患者.术后复发、转移的胃癌患者血清CEA、CA19-9和CA72-4检测灵敏度和特异度分别为46.2%和94.7%,52.3%和97.4%,47.1%和90.6%.结论 血清CEA、CA19-9和CA72-4升高与胃癌复发、转移密切相关,在术后随访过程中检测血清肿瘤标志物有助于早期诊断胃癌复发、转移.     

血清碱性磷酸酶、癌胚抗原、糖类抗原19-9联合检测对胃癌骨转移的诊断价值

目的探讨碱性磷酸酶(ALP)、癌胚抗原(CEA)、糖类抗原19-9(CA19-9)单独与联合检测对胃癌骨转移的诊断价值,为胃癌骨转移的早期诊断提供依据。方法收集522例胃癌患者的临床资料及血清标志物(ALP、CEA、CA19-9)检测结果,根据有无骨转移将入组患者分为骨转移组(n=91)和无骨转移组(n=431)。参照Soloway分级标准将骨转移分为3级,进一步分析ALP、CEA、CA19-9三者单独与联合检测在胃癌骨转移中的诊断价值及其与骨转移分级之间的关系。结果骨转移组患者ALP、CEA、CA19-9水平均明显高于无骨转移组,差异均有统计学意义(P﹤0.01)。ALP、CEA、CA19-9均是胃癌发生骨转移的影响因素(P﹤0.05)。3种血清标志物联合检测的曲线下面积(AUC)大于任何指标单独检测,但ALP单独检测与三者联合检测的AUC值差异不明显;3种血清标志物联合检测诊断效能优于单独检测。ALP与CA19-9水平随着骨转移分级升高呈上升趋势。经Spearman相关分析显示,ALP、CA19-9与骨转移分级均呈正相关(r=0.436、0.391,P﹤0.05),且ALP在评价胃癌骨转移严重程度方面优于CA19-9。结论ALP、CEA、CA19-9联合检测对胃癌骨转移的诊断价值优于单项检测,为胃癌骨转移的早期诊断以及监测提供参考。但考虑到患者的经济因素,对于临床上怀疑胃癌骨转移的患者,ALP是首选的检测指标,且该指标可作为评价胃癌骨转移严重程度的生物学标志物。     

CA 72-4 measurement of tumor-associated glycoprotein 72 (TAG-72) as a serum marker in the management of gastric carcinoma.

The presence of three distinct serum markers of carcinoma, tumor-associated glycoprotein 72 (TAG-72; as measured by the CA 72-4 assay), CA 19-9, and carcinoembryonic antigen (CEA), was evaluated in 194 patients diagnosed with either malignant (n = 94) or benign (n = 100) gastric disease. Of the 94 patients diagnosed with gastric carcinoma, the percentage of patients whose serum samples were positive for TAG-72, CA 19-9, or CEA was 42.6, 31.9, and 20.2%, respectively. Furthermore, fewer false positive samples were observed for TAG-72 than either CA 19-9 or CEA. The analysis of serum TAG-72, CA 19-9, and CEA levels in patients diagnosed with early (stage I and II) versus advanced (stage III and IV) disease revealed a significantly higher level of TAG-72 and CA 19-9 in the serum of patients with advanced stage gastric carcinoma. The serum samples were also analyzed to determine whether any advantage might be gained by simultaneously measuring two or more of the tumor markers. The data clearly indicate that the measurement of TAG-72 with CA 19-9 significantly increased the percentage of gastric carcinoma patients with positive serum levels of either antigen. This advantage was achieved with no significant increase in the number of false positives. Twenty-one patients were followed postsurgically for up to 3 years to determine whether the appearance or reappearance of TAG-72, CA 19-9, or CEA accurately predicted disease recurrence. Positive serum TAG-72 levels correlated with disease recurrence in 7 of 10 patients, compared with 5 and 2 patients for CA 19-9 and CEA, respectively. The findings suggest that serum TAG-72 as measured by the CA 72-4 assay may be a useful marker for late stage gastric carcinoma and its measurement alone or in combination with CA 19-9 may have utility in the clinical management of gastric carcinoma.     

可切除肝门部胆管癌患者临床病理特征及预后影响因素分析

目的:探讨可切除肝门部胆管癌（hilar cholangiocarcinoma,HC）患者术前血清CEA、CA19-9水平与临床病理因素的相关性,并进一步分析上述各因素与HC患者行根治术后预后的相关性。方法:回顾性分析2012年1月至2018年1月中国医科大学附属盛京医院收治的109例行根治性切除的HC患者的临床病理资料,研究术前血清CEA、CA19-9水平与各临床病理特征的相关性,并进一步分析上述各因素与HC患者行根治性切除术后预后的相关性。结果:术前血清CEA水平与HC各临床病理特征无关（P＞0.05）。术前黄疸越重,血清CA19-9水平越高（P＜0.05）。肿瘤侵犯血管的HC患者,术前血清CA19-9水平较高（P＜0.05）。HC患者TNM分期越晚,术前血清CA19-9水平越高（P＜0.05）。门静脉侵犯、淋巴结转移、TNM分期以及术前血清CA19-9水平是影响HC患者术后1年生存率的危险因素（P＜0.05）,其中淋巴结转移、门静脉侵犯、CA19-9是影响患者术后1年生存率的独立危险因素（P＜0.05）。结论:可切除HC患者术前血清CA19-9水平与临床分期及血管侵犯情况存在一定相关性;早期 HC患者行根治性切除术后预后较好,提高HC早期诊断率有助于进一步改善HC患者的生存预后;结合术前血清CA19-9水平、门静脉侵犯及淋巴结转移等多种因素可预测HC患者行根治性切除术后的生存率。     

CEA, CA 19-9, and CA 125 in the differential diagnosis of benign and malignant pancreatic diseases with or without jaundice

BACKGROUND AND OBJECTIVES: In this study, the value of the serum tumor markers carcinoembryonic antigen (CEA), CA 19-9, and CA 125 was assessed in the differential diagnosis of benign and malignant pancreatic diseases with and without obstructive jaundice. METHODS: Serum levels of CEA, CA 19-9, and CA 125 were measured by immunoradiometric assay before the treatment in 123 patients with pancreatic carcinoma and 58 patients with a benign pancreatic disease. RESULTS: The sensitivity of CEA, CA 19-9, and CA 125 in the diagnosis of pancreatic carcinoma was 39.0%, 81.3%, and 56.9%; and specificity was 91.4%, 75.9%, and 77.6%, respectively. Although there was no significant difference between the CA 19-9 positivity ratios of the jaundiced (84.3%) and nonjaundiced (73.5%) patient subgroups of the pancreatic carcinoma, this ratio was significantly higher in the jaundiced subgroup (64.7%) than the nonjaundiced subgroup (7.3%) of the benign pancreatic diseases (P < 0.001). The CEA and CA 125 positivity ratios of jaundiced and nonjaundiced subgroups of patients with benign and malignant pancreatic diseases were not significantly different. CONCLUSIONS: In the differential diagnosis of pancreatic carcinoma from benign pancreatic diseases, CA 19-9 can be useful in the nonjaundiced patients, whereas CA 125 provides a limited contribution in jaundiced patients.     

血清CEA、CA19-9、CA724检测对老年胃癌病理、临床分期的意义

目的:探讨血清CEA、CA19-9、CA724对老年胃癌的临床应用价值.方法:采用ELISA方法对87例老年胃癌患者进行回顾性分析.结果:老年胃癌患者CEA、CA19-9、CA724阳性率分别为25%、21%、21%,联合检测阳性率为41%,其中TNM Ⅳ期患者CA19-9、CA724、联合检测阳性率明显高于TNM Ⅰ+Ⅱ期患者.TNM Ⅲ+Ⅳ期患者CA19-9、CA724检测值明显高于Ⅰ+Ⅱ期患者.CEA、CA19-9、CA724阳性率、其值大小与胃癌病理类型、分化无关.结论:CEA、CA19-9、CA724可用于老年胃癌的诊断、病情判断,联合检测可提高诊断效率,但早期诊断价值有限.     

胃癌患者血清CA72-4、CEA及CA19-9水平及其与临床病理特征的相关性

目的:探讨血清CA72-4、CEA及CA19-9水平与胃癌患者病理特征的相关性。方法:选择2011年6月-2013年3月收治的86例胃癌患者,56例胃良性肿瘤患者,60例普通胃病患者,比较三组患者CA72-4、CA19-9和CEA水平;CA72-4、CA19-9和CEA单项检测及联合检测胃癌患者的阳性率;CA72-4、CA19-9和CEA水平与胃癌病理特征的关系。结果:胃癌组患者血清CA72-4、CA19-9和CEA水平均高于胃良性肿瘤组患者（P＜0.05),胃癌良性组患者均高于对照组（P＜0.05);三种胃癌肿瘤标志物中CA72-4诊断胃癌的阳性率最高,肿瘤3项标志物的阳性检测率要显著高于单项CA72-4、CA19-9、CEA的阳性检出率（P＜0.05）;肿瘤越大、TNM分期越高,CA72-4、CA19-9和CEA水平越高。结论:采用CA72-4、CA19-9和CEA联合检测是诊断胃癌比较理想的组合。CA72-4、CA19-9和CEA水平的变化可以反应胃癌患者的病理特征。     

甲胎蛋白、癌胚抗原和糖链抗原19-9联合检测诊断消化系统恶性肿瘤的价值分析

目的 探讨甲胎蛋白(AFP)、癌胚抗原(CEA)和糖链抗原19-9(CA19-9)联合检测对消化系统恶性肿瘤的诊断价值.方法 回顾性分析300例消化系统恶性肿瘤患者和108例消化系统良性病变患者的临床资料,记录患者的血清AFP、CEA和CA19-9水平,评价其诊断效能.结果 肝癌患者的血清AFP、CEA和CA19-9水平均高于肝硬化患者,胃癌、胰腺癌和结直肠癌患者的血清CEA和CA19-9水平分别高于胃溃疡、胰腺炎和溃疡性结肠炎患者,差异均有统计学意义(P<0.05).单项检测中,AFP对肝癌的诊断敏感度(78.5%)高于CEA和CA19-9(P<0.05);CA19-9对胰腺癌的诊断敏感度(78.2%)高于AFP和CEA(P<0.05).对于肝癌、胃癌、胰腺癌和结直肠癌,3项联合检测的敏感度均高于单项检测(P<0.05).结论 血清AFP、CEA和CA19-9联合检测对消化系统恶性肿瘤的早期诊断具有重要意义,可提高诊断的敏感度,且不会降低特异度.     

血清CEA、CA19—9、CA724检测对老年胃癌病理、临床分期的意义

目的：探讨血清CEA、CA19—9、CA724对老年胃癌的临床应用价值。方法：采用ELISA方法对87例老年胃癌患者进行回顾性分析。结果：老年胃癌患者CEA、CA19—9、CA724阳性率分别为25％、21％、21％,联合检测阳性率为41％,其中TNMIV期患者CA19—9、CA724、联合检测阳性率明显高于TNMⅠ＋Ⅱ期患者。TNMⅢ＋Ⅳ期患者CA19—9、CA724检测值明显高于Ⅰ＋Ⅱ期患者。CEA、CA19—9、CA724阳性率、其值大小与胃癌病理类型、分化无关。结论：CEA、CA19—9、CA724可用于老年胃癌的诊断、病情判断,联合检测可提高诊断效率,但早期诊断价值有限。