胃癌及胃癌前疾病患者血清及组织癌胚抗原检测的意义

目的 检测胃癌、胃癌前疾病患者血清与胃组织癌胚抗原(CEA),为胃癌及胃癌前疾病的诊断、监测提供参考指标.方法 采用放射免疫法测定胃癌(111例)、胃癌前疾病(167例,其中慢性萎缩性胃炎104例,胃溃疡31例,胃黏膜肠上皮化生32例)患者血清CEA,免疫组化SP法测定胃组织CEA,并与浅表性胃炎(31例)对照.结果 胃癌组织中CEA阳性率(89.2%,99/111)明显高于胃癌前疾病[慢性萎缩性胃炎52.9%(55/104),胃黏膜肠上皮化生53.1%(17,32),胃溃疡48.4%(15/31)]及浅表性胃炎组织(19.4%,6/31),P＜0.01;胃癌与胃癌前疾病及浅表性胃炎的血清CEA阳性率比较差异有统计学意义(分别为19.8%、1.9%、0),P＜0.01;胃癌前疾病与浅表性胃炎的血清CEA阳性率比较差异无统计学意义,P＞0.05.结论 胃组织中CEA阳性有助于胃癌的诊断.并可作为监测胃癌前疾病的指标之一;血清CEA水平对胃癌有一定的诊断价值,对胃癌前疾病的诊断价值不大.

Significance of examing carcinoembryonic antigen levels of serum and gastric tissue in patients with precancerous lesions and gastric cancer

Objective To meagure the serum eareinoembryonic antigen(CEA)value and tissue CEA stainingin patients with gastric carcinoma and precancerous lesions,in order to apply the index for the diagnosis and monitoring on gastric carcinoma and precancerous lesions.Methods The gemm CEA level of patients with gastric carcinoma(111 cases),precancerous lesions(167 cases,including chronic atrophic gastritis 104 cases,gastric ulcer 31 cases,mucosa intestinal metaplasia 32 cases)was measured by radioimmunoassay,gastric tissue CEA was measured by immunohistochemical SP staining,and 31 cases with superticial gastritis were admired as controls.Results(1)In patients with gastric carcinoma,the positive rate of tissue CEA(89.2%,99/111)Was higher than that in patients with precancerous lesions[chronic atrophic gastritis 52.9%(55/104),mucosa intestinal metaplasia 53.1%(17/32),gastric ulcer 48.4%(15/31)]and superficial gastritis(19.4%,6/31)(P＜0.01).(2)The positive rate of tissue CEA increased significantly than that of the serum levels in patients with gastric carcinoma and precancerous lesions.(3)The serum CEA level in precancerous lesions showed no significant differences compared with that of superficial gastritis(P＞0.05).Conclusions The tissue CEA could be useful diagnostic and monitoring indicators in patients with gastric carcinoma and precancerous lesions.The serum CEA levels in patients with gastric carcinoma may have value in the diagnosis of gastric carcinoma,but have little value for the precancerous lesions.