多项肿瘤标志物联检对胃恶性肿瘤诊断的临床价值

目的:本文报告CEA、CA19-9、CA72-4三项肿瘤标志物,单项与联检诊断胃恶性肿瘤的临床价值.方法:应用免疫放射分析(IRMA).结果:本文单项检测阳性率在70%以上,但以CA72-4阳性率最高(84.21%),次为CA19-9(75.43%).作为单项应用首选CA72-4,次为CA19-9.全文仅4例三项均阴性(假阴性率为1.75%),故三项联检可使阳性率提高到98.25%.本文分三组双项组合检测,按双阳性分析,结果显示A组阳性率最高(61.84%),次为B组(51.31%),C组(48.24%).结论:单项筛选检测,首选CA72-4,双项组合检测仍以CA72-4 CA19-9为宜,随访可按组织学类型选用.

Clinical Value of Multi-tumor Markers Detection with (CEA, CA19-9, CA72-4) for Diagnosis of Gastric Malignancy

Objective To assess the clinical value of multi-tumor markers detection with(CEA,CA19-9,CA72-4) for diagnosis of gastric malignancy.Methods Serum CEA,CA19-9,CA72-4 contents were measured with IRMA in 228 patients with gastric malignancies,152 patients with benign gastric disorders and 200 controls.Results The positive rates of single marker detection were all above 70% and that of CA724 was the highest(84.21%),next was CA19-9(75.43%).Three tumor markers were all negative in only 4 cases(false negative rate was 1.75%).So combined detection of 3 tumor markers could improve the positive rate to 98.25%.With combined determination of two markers,double positive rate for different sets of combinations was: 61.84% for CA72-4+CA19-9,51.31% for CA72-4+CEA and 48.24% for CEA+CA19-9.Conclusion It was suggested that for screeing,CA724 was the first choice in single marker detections,and CA72-4+CA19-9 was the first choice for combined detections of two markers.For follow-up,a combination of 2 markers with highest positive rate for the specific histo-pathologic type(i.e.carcinoma,leiomyosarcoma or lymphosarcoma) should be used throughout the study.