胃癌肿瘤标志物与中医辨证分型的关系研究

目的对胃癌相关的多项肿瘤标志物的阳性率以及含量变化进行观察,进而筛选出胃癌肿瘤标志物,并对该标志物与中医辨证分型的相关性进行探究。方法 35例胃癌患者作为观察组,同期27例健康人作为对照组。利用蛋白芯片检测系统测定两组血清中多种肿瘤标志物。比较两组12种肿瘤标志物[糖类抗原(CA)125、甲胎蛋白(AFP)、铁蛋白(Ferritin)、CA15-3、前列腺特异性抗原(PSA)、游离前列腺特异性抗原(f-PSA)、癌胚抗原(CEA)、CA242、CA19-9、神经元特异性烯醇化酶(NSE)、人绒毛膜促性腺激素β亚单位(β-HCG)、生长激素(HGH)]的阳性情况;CEA、CA19-9、Ferritin、CA242、CA125肿瘤标志物含量;中医辨证分型阳性情况。结果观察组的CA125、Ferritin、CEA、CA242、CA19-9阳性率分别为42.86%、25.71%、45.71%、34.29%、42.86%,均高于对照组的18.52%、3.70%、18.52%、0、0,差异均具有统计学意义(P<0.05);两组的AFP、CA15-3、PSA、f-PSA、NSE、β-HCG、HGH阳性率比较,差异均无统计学意义(P>0.05)。观察组的CEA、CA19-9、Ferritin、CA242、CA125肿瘤标志物含量均高于对照组,差异均具有统计学意义(P<0.05)。观察组患者中医辨证分型阳性率与对照组相比较均显著升高,总体上实证(肝胃不和型、痰湿凝结型)阳性率显著低于虚证(胃热伤阴型、脾胃虚寒型、气血双亏型)阳性率。结论蛋白芯片检测与胃癌肿瘤标志物结合诊断胃癌具有高度的敏感性, CEA、CA19-9、Ferritin、CA242、CA125为5种价值型相对较高的标志物,并且其表达量与阳性率与中医辨证分型具有高度相关性,可为临床胃癌诊断提供参考依据。

Study on correlation between tumor markers and traditional Chinese medicine syndrome differentiation in gastric cancer

Objective To observe the positive rate and content change of multiple tumor markers related to gastric cancer, and then to screen out the tumor markers of gastric cancer, and to explore the correlation between the markers and traditional Chinese medicine syndrome differentiation. Methods There were 35 gastric cancer patients selected as the observation group, and 27 healthy people at the same time as the control group. The protein chip detection system was used to detect multiple tumor markers in the serum of the two groups. The positive results of 12 tumor markers [carbohydrate antigen(CA) 125, alpha fetoprotein(AFP), Ferritin, CA15-3, prostate specific antigen(PSA), free prostate specific antigen(f-PSA), carcinoembryonic antigen(CEA), CA242, CA19-9, neuron specific enolase(NSE), human chorionic gonadotropin β subunit(β-hCG), human growth hormone(HGH)], content of CEA, CA19-9, Ferritin, CA242, and CA125 tumor markers, and positive situation of traditional Chinese medicine syndrome differentiation were compared between the two groups. Results The positive rate of CA125, Ferritin, CEA, CA242 and CA19-9 were 42.86%, 25.71%, 45.71%, 34.29% and 42.86% respectively in the observation group, which were higher than 18.52%, 3.70%, 18.52%, 0 and 0 in the control group, and the difference was statistically significant(P<0.05). There was no statistically significant difference in positive rate of AFP, CA15-3, PSA, f-PSA, NSE, β-HCG and HGH between the two groups(P>0.05). The content of CEA, CA19-9, Ferritin, CA242, and CA125 tumor markers in the observation group were higher than those in the control group, and their difference was statistically significant(P<0.05). Compared with the control group, the positive rate of traditional Chinese medicine syndrome differentiation in the observation group was significantly higher, and the positive rate of excess syndrome(liver-stomach disharmony type, phlegm-dampness coagulation type) was significantly lower than that of deficiency syndrome(deficiency yin by stomach heat type, spleen stomach deficiency cold type, Qi and blood deficiency type). Conclusion Protein chip detection combined with gastric cancer tumor markers is highly sensitive in the diagnosis of gastric cancer. CEA, CA19-9, ferritin, CA242 and CA125 are relatively high value markers, and their expression and positive rate are highly correlated with traditional Chinese medicine syndrome differentiation, which can provide reference for clinical diagnosis of gastric cancer.