胃癌患者血清肿瘤标志CA50和CEA的意义

目的比较胃恶性和良性病变血清人类结肠癌抗原 CA50和 CEA 的变化。方法用放射免疫法测定33例健康对照和86例胃部疾病(胃癌34例,胃溃疡27例和慢性萎缩性胃炎25例)患者血清 CA50和 CEA 含量,胃癌包括窦部27例,体部3例和底部9例,组织学类型包括腺癌21例,上皮癌4例和未分类9例;胃溃疡包括窦部18例,体部3例和底部9例;萎缩性胃炎均伴有肠上皮化生。结果与正常人比较,胃癌血清 CA50(112.67±38.36 kU/L vs 16.26±6.14 kU/L,P<0.01)和 CEA(10.28±3.76μg/L vs 3.12±1.03 μg/L,P<0.01)明显升高;CA50(>22 kU/L)阳性率在胃癌是53.0%(18/34),CEA(>5 μg/L)阳性率是55.8%(19/34);CA50和 CEA 升高呈正相关(r=0.648,P<0.01)。胃癌手术后(n=21),血清 CA50(46.4±25.9 kU/L,P<0.01)和 CEA(6.85±2.43μg/L,P<0.01)有明显下降。胃溃疡和萎缩性胃炎血清 CAS0(P<0.05)轻度升高,而 CEA 无明显变化(P>0.05)。结论血清 CAS0和 CEA 升高可作为诊断晚期胃癌的指标,胃癌手术后血清 CA50和 CEA 明显降低,提示联合测定血清CA50和 CEA 对晚期胃癌的诊治有一定临床意义。

Significance of serum tumor markers CA50 and CEA in gastric cancer

AIM: Cancer antigen 50 (CA50) and Carcinoembryonic antigen (CEA) are well-described human tumor-associated antigens, utilized clinically in management of gastrointestinal cancer cases. In this study, we compared these markers in sera from patients with malignant and benign digestive tract diseases. METHODS: Using a side-phase radioimmunoassay, CA50 and CEA serum levels were measured in 33 control subjects and 86 patients with either gastric cancer (n = 34), gastric ulcer (n = 27) or chronic atrophic gastritis (n = 25). Carcinoma of the stomach was found in the antrum (n = 22), the body (n = 3) and the fundus (n = 9), and according to histopathological findings was divided into adenocarcinoma (n = 21), squamous cancer (n = 4) and undetermined (n = 9). Gastric ulcer, when present, appeared in the antrum (n = 18), the body (n = 3) and the fundus (n = 9). Chronicatrophic Gastritis cases were all associated with intestinal metaplasia. RESULTS: The normal ranges established for CA50 and CEA in the control group were 16.26-6.14 kU/L and 3.12-1.03 μg/L respectively. In patients with gastric cancer, serum levels of CA50 (112.67 ± 38.36 kU/L) and CEA (10.28 ± 3.76 μg/L) were elevated significantly (P < 0.01), the former being < 22 kU/L in 18 of 34 patients (53%; range: 5-550 kU/L) and the latter being < 5 μg/L in 19 of 34 patients (55.8%; range: 0.5-17.4 μg/L). A statistically significant correlation was found between the levels of CA50 and CEA (r = 0.648, P < 0.01). The serum levels of CA50 (46.4 kU/L vs 25.9 kU/L, P < 0.01) and CEA (6.85 μg/L vs 2.43 μg/L, P < 0.01) were much lower in patients with gastric ulcer or chronic atrophic gastritis (P < 0.05). CONCLUSION: CA50 and CEA are indicators for advanced gastric cancer, and postoperatively their serum levels may decrease considerably. Overall, there is such a close correlation between these two factors that in clinical practice they might be of great value for the diagnosis of gastric cancer.