多肿瘤标记物蛋白芯片在胃癌术前诊断中的价值

目的 探讨多肿瘤标记物蛋白芯片(C-12)在胃癌术前诊断中的价值.方法 应用C-12同时检测12种肿瘤标记物在45例胃癌、38例良性胃病初治患者和65例正常对照血清中的表达水平,寻找与胃癌相关性最强的肿瘤标记物及肿瘤标记物最佳联合检测组合.结果 ①胃癌组中糖链抗原(CA)199、癌胚抗原(CEA)、CA242、CA125和甲胎蛋白的检测阳性率和表达水平显著高于良性胃病组和正常对照组,此外胃癌组中绒毛膜促性腺激素和人生长激素的表达水平也显著高于良性胃病组和正常对照组(P＜0.05).②与胃癌相关性较强的肿瘤标记物是CEA、CA125、CA242和CA199,其中CEA的敏感性、准确性和阴性预测值最高,分别为57.8%、81.8%和77.1%,而CA242检测胃癌的特异性和阳性预测值最高.③胃癌的最佳2项、3项和4项检测组合分别是CEA+CA125、CEA+CA125+CA199和CEA+CA242+CA125+CA199.最佳2项、3项和4项检测组合的敏感性、特异性和准确性与C-12和最佳单项肿瘤标记物相比,差异均无统计学意义(P＞0.05).结论 C-12对胃癌具有较高的术前诊断价值,CEA+CA125、CEA+CA125+CA199和CEA+CA242+CA125+CA199对胃癌的诊断价值足以替代12项肿瘤标记物联合检测.

Potential role of multiple tumor markers chip in preoperative diagnosis of gastric cancer

Objective To explore the potential value of multiple tumor markers chip( C- 12) in preoperative diagnosis of gastric cancer. Methods The serum levels of 12 rumor markers were measured in 45 gastric cancer patients, 38 benign gastrosis patients and 65 normal controls by use of C-12 in order to find out the most levels of CA199, CEA, CA242, AFP and CA125 in the gastric cancer patients were significantly higher than those of the benign gastrosis patients and normal controls. Moreover, the serum levels of β- HCG and HGH were also significantly higher in gastric cancer group than benign gastric disease group and control group ( P ＜sis of gastric cancer. CEA is the TM with the highest sensitivity, validity and negative predictive value of 57.8% ,81.8% and 77.1% ,respectively whereas CA242 is the TM with the highest specificity and positive CEA + CA125 + CA199 and CEA + CA242 + CA199 + CA125, respectively. The sensitivity, specificity and validity of the best combination of 2 TMs, 3 TMs and 4TMs for gastric cancer were not statistically significantly different from those of C-12 and the best TM ( P ＞ 0.05 ). Conclusion The multiple tumor markers chip ( C-12 ) has a relatively high value in the preoperative diagnosis of gastric cancer. The best combinations of 2 TMs ( CEA + CA125) ,3 TMs ( CEA + CA125 + CA199 ) and 4TMs ( CEA + CA242 + CA199 + CA125 ) for gastric cancer diagnosis could be sufficient to replace the combination of 12 TMs.