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.

Value of the combination detection of alpha fetal protein,carcino embryonic antigen and carbohydrate antigen 19-9 for the diagnosis of malignant tumors of digestive system

Objective To explore the value of the combination detection of alpha fetal protein (AFP), carcino embry-onic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) for the diagnosis of malignant tumors of digestive system. Method The clinical data of 300 patients with malignant tumor in digestive system and 108 patients with benign disease of digestive system were retrospectively analyzed. The levels of serum AFP, CEA and CA19-9 were recorded to evaluate their diagnostic efficiency. Result The serum levels of AFP, CEA and CA19-9 in patients with liver cancer were signifi-cantly higher than those in patients with cirrhosis;and the serum levels of CEA and CA19-9 in patients with gastric can-cer, pancreatic cancer or colorectal cancer were significantly higher than those in patients with gastric ulcer, pancreatitis or ulcerative colitis respectively, and the differences reached statistical significance (P<0.05). In the detection using single tumor marker, AFP had the highest sensitivity (78.5%) for detecting liver cancer, better than CEA and CA19-9 (P<0.05);CA19-9 had the highest sensitivity for detecting pancreatic cancer (78.2%), better than AFP and CEA (P<0.05). The com-bination detection using three tumor markers had higher sensitivity than that of each single marker for the diagnosis of liver cancer, gastric cancer, pancreatic cancer and colorectal cancer (P<0.05). Conclusion The combination detection of serum AFP, CEA and CA19-9 can play an important role in the early diagnosis of malignant tumors of digestive system. The sensitivity of the diagnosis is improved, and the specificity is not reduced.