胃癌患者手术前后血清CA72-4、CA19-9和CA50的变化及其临床意义

目的 探讨胃癌患者手术前后血清糖链抗原CA72-4、CA19-9和CA50的变化及其临床意义。方法 用免疫放射分析法（IRMA）分别检测了122例胃癌患者手术前后、46例胃良性疾病患者和38例健康献血员血清CA72-4、CA19-9和CA50水平。结果 胃癌组血清CA72-4、CA19-9和CA50水平均明显高于胃良性疾病组（P〈0．005）和正常对照组（P〈0．001）。胃癌患者TNM分期越高，其血清3种肿瘤标志物的水平和阳性率也越高。肿瘤切除后血清3种肿瘤标志物的水平和阳性率均显著降低（P〈0．05），特别是行根治性切除术后，血清CA72-4、CA19-9和CA50水平显著降低（P〈0．05），但姑息性肿瘤切除术后血清3种肿瘤标志物的降低与术前相比差异无显著性（P〉0．05）。结论 CA72-4、CA19-9和CA50是用于胃癌血清学诊断较好的肿瘤标志物，其血清水平与肿瘤的浸润及转移密切相关，动态观察胃癌患者手术前后血清CA72-4、CA19-9和CA50含量的变化对判断病情及有无复发可能等预后有实用的临床价值。

Detection of serum CA72-4, CA19-9, CA50 and their clinical value before or after surgery of gastric cancer

Objective] To investigate the clinical value of serum CA72-4,CA19-9 and CA50 in patients with gastric cancer before or after surgery.Methods] The levels and positive rates of serum CA72-4,CA19-9 and CA50 were determined by immunoradiometric assay(IRMA)in 122 patients with gastric cancer,46 patients with benign diseases and 38 healthy adults.Results] The levels and positive rates of serum CA72-4,CA19-9 and CA50 in gastric cancer group were significantly higher than those in normal subjects group(P <0.001)and in benign lesion group(P <0.005),and became even higher as the malignancy progressed.The serum levels of CA72-4,CA19-9 and CA50 were remarkable decrease after surgery(P <0.05),respectively after a radical cure surgery(P <0.05).But there are no remarkable decrease after appeasement surgery(P >0.05).Conclusions] The CA72-4,CA19-9 and CA50 can be used as very useful and sensitive tumor markers in the diagnosis of gastric cancer.There serum levels are in correspondence with the TNM stage of gastric cancer.There are practical values of continual detection serum CA72-4,CA19-9 and CA50 before or after surgery of gastric cancer for estimate state of an illness or prognosis.