癌胚抗原糖类抗原72-4和糖类抗原19-9对胃癌的诊断价值

目的 探讨检测血清肿瘤标志物癌胚抗原(CEA)、糖类抗原72-4(CA72-4)和糖类抗原19-9(CA19-9) 在胃癌诊断中的价值.方法 应用化学发光和电化学发光技术检测经病理检查确诊为胃癌患者104例,胃良性疾病患者43例及健康对照组51例的血清CEA、CA72-4和CA19-9的水平.结果胃癌组患者CEA,CA72-4和CA19-9水平均高于胃良性疾病组和健康对照组(P<0.05),而胃良性疾病组和健康对照组3种肿瘤标志物水平差异无统计学意义(P>0.05).ROC曲线分析显示,CEA、CA19-9、CA72-4曲线下面积分别为0.778、0.670、0.715.CEA取cut off 值为4.7 ng/mL时,灵敏度和特异度分别为51.2%和95.7%.CA19-9取cut off 值为28 U/mL时,灵敏度和特异度分别为43.0%和95.7%.CA72-4取cut off 值为6.3 U/mL时,灵敏度和特异度分别为29.1%和94.7%.若联合检测3种肿瘤标志物,灵敏度可提高到61.5%,特异度为84.7%.结论 CEA、CA72-4和CA19-9对胃癌有较好诊断价值;CEA是诊断胃癌最有价值的指标;3项指标联合检测可提高对胃癌诊断的敏感度.

Diagnostic value of CEA,CA72-4 and CA19-9 in gastric cancer

Objective To discuss the diagnostic value of serum tumor markers carcinoma embryonic antigen（CEA）,CA72-4 and CA19-9 in the patients with gastric cancer.Methods The serum levels of CEA,CA72-4and CA19-9 were measured by chemiluminescence immunoassay（CLIA） and electrochemiluminescence immunoassay（ECLIA） in 104 patients with gastric cancer,43 patients with benign gastric diseases and 51 healthy persons.Results Serum levels of four tumor markers in the patients with gastric cancer were higher than those in benign gastric disease group and healthy control group（P0.05）.There was no significant difference between the benign gastric disease group and healthy control group（P0.05）.The areas under the curve（AUC） of CEA,CA19-9 and CA72-4 were 0.778,0.670 and 0.715 respectively by application of ROC curve.The cut off value of CEA was 4.7 ng/mL,which resulted in 51.2% sensitivity and 95.7% specificity.The cut off value of CA19-9 was 28 U/mL,which resulted in 43.0% sensitivity and 95.7%specificity.The cut off value of CA72-4 was 6.3 U/mL,which resulted in 29.1% sensitivity and 94.7% specificity.Compared to single detection,the sensitivity detection of the three tumor markers were improved significantly.Conclusion CEA,CA19-9 and CA72-4 have the good diagnostic value to gastric cancer.CEA is the most effective tumor marker of gastric cancer.Combined detection of serum tumor markers CEA,CA72-4 and CA19-9 can improve the sensitivity of gastric cancer.