血清CEA、CA199、CA125、CA153、AFP联合检测对胃癌的诊断价值

目的 探讨血清癌胚抗原（ CEA） 、糖链抗原199（ CA199） 、糖链抗原125（CA125）、糖链抗原153（CA153）、甲胎蛋白（AFP）单检和联检在胃癌中的诊断价值.方法采用化学发光免疫分析法检测50 例胃癌患者和65 例正常对照组的血清CEA、CA199、CA125、CA153、AFP的含量,分析五种肿瘤标志物单个检测和联合检测的敏感度、特异度.结果 胃癌患者的血清CEA、CA199、CA125的含量明显高于正常对照组（P＜0.05）;采用单项肿瘤标志物诊断胃癌时,灵敏度最高的为CEA和CA199,特异度最高的为CA153,ROC曲线下面积最大的为CEA;采用不同肿瘤标志物的组合诊断胃癌时,灵敏度和特异度均较好的为CEA、CA199与CA125组成的组合.联合检测和单独检测相比,敏感度显著提高,特异度有所下降.结论 联合检测可提高胃癌诊断的敏感度,为早期诊断及早期治疗提供有力的依据.

Diagnostic value of combined CEA,CA199,CA125,CA153 and AFP detection for gastric cancer

Objective To explore the value of combined tumor markers carcinoembryonic antigen （CEA）,carbohy drate antigen 199 （CA199） ,carbohydrate 125 （CA125）,carbohydrate 153 （CA153） and alpha fetoprotein（AFP） in the diagnosis for gastric cancer. Methods Chemiluminesent immunoassay was used to detect the serum level of CEA, CA199 ,CA125 ,CA15a and AFP in 50 patients with gastric cancer and 65 healthy controls. The sensitivity and specifici- ty of the individual marker and the combination of the five tumor markers were analyzed. Results The levels of CEA, CA199 ,CA125 in patients with gastric cancer were significantly higher than those in healthy control（P〈0.05）;When using individual tumor marker to diagnose gastric cancer,the most sensitive is CA199 ,the most specific is CEA,the lar- gest area under ROC curve is CA199 ;When using different combinations of tumor markers to diagnose gastric cancer, the most sensitive and specific is CEA,CA199 and CA125. The sensitivity of combined determination were significantly higher than single assay. Conclusion Joint detection can improve the sensitivity of diagnosis of gastric cancer, provide a strong basis for early diagnosis and early treatment.