血清CA72-4、CA19-9及CEA免疫放射量度分析在胃癌诊治中的意义

目的　研究血清肿瘤标志物诊治胃癌的敏感度、特异度及其意义。方法　采用免疫放射量度分析 (IR MA)法测定 136例胃癌患者及 73例消化道良性疾病患者中血清CA72 4、CA19 9及CEA的水平。结果　血清CA72 4、CA19 9及CEA在胃癌诊断中的敏感度分别为 39.7%、30 .9%、及 14.7% ,特异度分别为 98.6 %、82 .2 %和 98.6 %。CA72 4联合CA19 9检测的敏感度为 5 4.4% ,特异度为 80 .8%。血清CA72 4的阳性率在早期胃癌与消化道良性疾病组间存在显著差异。三者阳性率均随肿瘤期别的增高而显著上升 ,随胃癌淋巴结转移、远处转移而显著升高。血清CA72 4与CA19 9水平在胃癌根治术后显著降低。结论　血清CA72 4水平能较好地反映胃癌的临床病程和病理特征 ,与CA19 9联合检测有助于胃癌的术前期别预测以及术后的随访与监测。

Immunoradiometric Assay for Serum Levels of Tumor Markers: CA72-4,CA19-9 and CEA in Gastric Cancer

Purpose To investigate the sensitivity and specificity of single or different combined tumor markers to value of the markers in diagnosing and treatment in patients with gastric cancer. Methods The IRMA were used to measure the serum levels of three tumor markers: carbohydrate antigen 72-4 (CA72-4), carbohydrate antigen 19-9 (CA19-9) and carcinoembryonic antigen (CEA) in 136 patients with gastric cancer and 73 patients with benign digestive tract disease. Results In patients with gastric cancer, the sensitivity of serum CA72-4 was 39.7% ,CA19-9 30.9% and CEA 14.7%. The specificity were 98.6%, 82.2%, 98.6% respectively. Combined measuring of serum CA72-4 and CA19-9 in gastric cancer patients, the sensitivity was 54.4 % and the specificity was 80.8%. Upon comparison of cancer with early stages and benign digestive tract disease, significant difference was observed only for CA72-4. The sensitivity of these markers was corresponded to the stage of the gastric cancer, significant difference between the stages Ⅰ-Ⅱ andⅢ-Ⅳ was observed for all markers. The sensitivity of all markers was also related to the lymph node metastasis or distant metastasis. In the patients undergone radical surgery, the serum level of CA72-4 and CA19-9 decreased significantly, vise versa in those whose tumor was unresectable, the serum level of the two markers increased. Conclusions The serum level of CA72-4 can indicate the gastric cancer's clinical and pathological characteristics better. The combined use of serum CA72-4 and CA19-9 measurements in gastric cancer may be useful in the preoperative staging and postsurgical follow-up, detection of recurrence.