血清肿瘤标志物CEA、CA19-9及CA724联合检测在胃癌诊断中的价值分析

目的分析血清肿瘤标志物癌胚抗原(CEA)、糖类抗原(CA) 19-9及CA724联合检测在胃癌诊断中的价值。方法采用回顾性研究方法,选取2016年1月至2018年12月辽宁省健康产业集团阜新矿总医院收治的500例胃癌患者(胃癌组)、632例胃部良性疾病患者(良性组)及体检中心的671例健康人群(对照组),比较三组研究对象的血清CEA、CA19-9、CA724表达情况,采用Pearson法进行相关性分析,组间比较进行单因素分析,再以Logistic多元回归方程分析影响胃癌发生的危险因素,采用受试者操作特征(ROC)曲线及ROC下面积(AUC)分析各指标诊断胃癌的价值。结果胃癌组患者血清CEA、CA19-9、CA724水平明显高于良性组和对照组,差异有显著性(P <0. 05)。CEA、CA19-9、CA724均与分化程度呈负相关(r=-0. 417、-0. 393、-0. 404,P <0. 001),均与临床分期呈正相关(r=0. 531、0. 528、0. 530,P <0. 001);喜饮烫茶、喜食腌制菜、喜食熏制食物、幽门螺杆菌感染及血清CEA、CA19-9、CA724高表达是胃癌发生的相关危险因素(P <0. 05);诊断胃癌的AUC:CEA+CA19-9+CA724> CEA> CA724> CA19-9。结论血清肿瘤标志物CEA、CA19-9、CA724均与胃癌分化程度呈负相关,均与临床分期呈正相关,三者联合检测可提高对胃癌的诊断价值。

Value of combined detection of serum tumor markers CEA,CA19-9 and CA724 in the diagnosis of gastric cancer

Objective To analyze the value of combined detection of serum tumor markers carcinoembryonic antigen( CEA),carbohydrate antigen( CA) 19-9 and CA724 in the diagnosis of gastric cancer. Methods A retrospective study was performed,enrolled 500 patients with gastric cancer( gastric cancer group),632 patients with benign gastric diseases( benign group) and 671 healthy people( control group) from January 2016 to December 2018. The serum CEA,CA19-9,and CA724 expressions of the three groups were compared,and the correlation analysis was performed using the Pearson method. Univariate analysis was performed between the groups,and then logistic multiple regression was used to analyze the risk factors affecting gastric cancer. The receiver operator characteristic( ROC) curve and the area under the area( AUC) were used to analyze the value of each tumor markers in the diagnosis of gastric cancer. Results The serum CEA,CA19-9,CA724 levels in gastric cancer group were significantly higher than those in benign group and control group( P < 0. 05). CEA,CA19-9,and CA724 were all negatively correlated with the degree of differentiation( r =-0. 417,-0. 393,-0. 404,P < 0. 001),and positively correlated with clinical stage( r =0. 531,0. 528,0. 530,P < 0. 001);Like drinking hot tea,eating pickled or smoked foods,Helicobacter pylori infection and high expression of serum CEA,CA19-9,CA724 are related risk factors for gastric cancer( P < 0. 05). AUC for diagnosis of gastric cancer was: CEA + CA19-9 + CA724 > CEA > CA724 > CA19-9. Conclusion Serum tumor markers CEA,CA19-9 and CA724 are negatively correlated with the degree of differentiation of gastric cancer,and positively correlated with clinical stage. The combined detection of the three markers can improve the diagnostic value of gastric cancer.