多种肿瘤标志物联合监测胃癌术后复发

目的：探讨联合检测血清肿瘤标志物癌胚抗原（CEA）、糖类抗原19-9（CA19-9）、糖类抗原153（CA153）和糖类抗原125（CA125）在胃癌复发患者诊断中的临床价值.方法：应用美国Abbott公司AXSYM全自动免疫分析仪测定40例胃癌术后复发患者血清中的CEA、CA19-9、CA153和CA125的含量,同时进行胃镜检查和活体组织病理检查以明确诊断,并进行腹部B超或CT等检查.结果：复发病例多项肿瘤标志物水平明显上升,甚至高于术前水平,复诊时未复发病例各项肿瘤标志物均未见明显上升;腹腔种植、局部复发病例肿瘤标志物水平均明显高于未复发者（P＜0.05）,而局部复发病例与腹腔多脏器转移者肿瘤标志物水平无明显差异（P＞0.05）;CA153于胃癌根治术前、术后、复发比较无明显差异（P＞0.05）;CEA与CA19-9均为阳性者70.1 %确诊为胃癌复发;CEA、CA19-9与CA125均为阳性者75.6%确诊为胃癌复发.结论：联合多项肿瘤血清免疫标志物检测诊断胃癌术后复发是一个较有价值、值得推荐的随访检查手段.

Detection Value of Combined Four Tumor Markers in the Diagnosis of Gastric Cancer of Postoperative Recurrence

Objective:To investigate the clinical value in patients with recurrent gastric cancer diagnosis by combined detection of tumor markers in serum CEA,CA153,CA19-9,and CA125.Methods:Detection 40 cases of postoperative recurrence of gastric cancer patients with serum levels of CEA, CA19-9, CA153 and CA125, abdominal ultrasound or CT check,gastroscopy and diagnosis by pathological if necessary.Results:Multiple tumor marker levels of gastric cancer recurrence patients were significantly higher,even higher than the preoperative level, no recurrence of the tumor markers were not seen a significant increase. Abdominal cavity, and local recurrence of Tumor Marker levels were significantly higher than those who did not relapse.But there was no significantly difference of tumor Marker levels between abdominal cavity cases and local recurrence, so as CA153 in gastric cancer before and after curative resection, recurrence.Combined detection of CEA and CA19-9 were 70.1% confirmed as positive for recurrence of gastric cancer, and combined detection of CEA,CA19-9 and CA125 were 75.6% confirmed as positive for recurrence of gastric cancer.Conclusions:Combined detection of multiple immune serum tumor markers is a effective way for diagnosis of postoperative recurrence of gastric cancer.