血清肿瘤标志物的联合检测在胃癌诊断中的价值

目的探讨癌胚抗原（CEA）、癌相关糖抗原（CA19—9、CA242、CA72—4）4种血清肿瘤标志物在胃癌诊断中的应用价值，通过联检筛选出一种检测最佳组合，以提高胃癌的诊断率。方法应用罗氏2010电化学发光仪检测80例健康者及217例胃癌患者中的血清癌胚抗原（CEA）、癌相关糖抗原（CA19—9、CA24—2、CA724）的含量。结果胃癌组4种血清肿瘤标志物含量明显高于健康对照组（P〈0．001），单个检测在胃癌中的灵敏度和特异性分别为50．6％、42％、35．3％、56．0％和85．1％、92．6％、94．3％、96．2％。3组肿瘤标志物联合检测（CEA＋CA19—9＋CA72-4、CEA＋CA24—2、CEA＋CA24—2＋CA72—4）的灵敏度和特异性分别为86．0％、76．0％、80．7％和90．3％、94．0％、92．5％。联合检测组灵敏度明显优于肿瘤标志物单项测定。结论4种肿瘤标志物能为胃癌的诊断提供可靠依据，建议临床工作中采用CEA＋CA199＋CA72—4联合检测。

Clinical value of tumor markers combined detection in diagnosis of grastric cancer

Objective To explor the clinical value of tumor markerscarcinoembryonic antigen(CEA),CA19-9,CA24-2 and CA72-4)]in the diagnosis of gastric cancer,screen the best combination of tumor markers,so as to improve the diagnostic rate of gastric cancer.Methods Roche 2010 eleetrochemiluminescence detector was applited to measuring the serum levels of CEA,CA19-9,CA24-2 and CA72-4 in 80 healthy subjects(healthy control group)and 217 patients with gastric cancer(gastric cancer group).Results The serum levels of four tumor markers(CEA,CA19-9,CA24-2 and CA72-4)were significantly higher in gastric cancer group than that in healthy control group.The sensitivity and specificity of single marker detection was respectively as follows;CEA(50.6%,85.1 %),CA19-9(42.0%,92.6%),CA24-2(35.3%,94.3%)and CA72-4(56.0%,96.2%).For diffeent combination of tumor markers(CEA+CA19-9 + CA72-4,CEA + CA24-2,CEA+CA24-2 + CA72-4),the sensitivity was respectively 86.0%,76.0% and 80.7%;while the specificity was respectively 90.3%,94.0% and 92.5%.The sensitivity of combined detection was superior to that of single detection.Conclusion Four tumor markers may provide reliable evidence for the diagnosis of gastric cancer.It suggests that CEA + CA19-9 + CA24-2 combination be adopted in the clinical test.