肿瘤标志物对胃癌诊断及预后的评估价值

目的探讨肿瘤标志物水平变化对胃癌诊断及预后评估的价值。方法经手术与病理学确诊的198例胃癌患者作为病例组，同时选择198例于我院体检均为健康者为对照组。采用电化学发光法检测2组患者血清中肿瘤标志物CEA、CA724、CA199的水平，并评价3种肿瘤标志物的灵敏度、特异度。结果病例组3种肿瘤标志物的含量均高于对照组，且差异均有统计学意义。同时术后该3种肿瘤标志物的水平均低于术前，差异均有统计学意义。同时（Ⅲ＋Ⅳ）期患者肿瘤标志物水平明显高于（Ⅰ＋Ⅱ）期，差异均有统计学意义。病例组患者CEA、CA724、CA199的灵敏度分别为50．9％，51．3％，47．8％；特异度分别为92．1％，91．4％，89．5％；三者联合检测的灵敏度和特异度分别达90．1％，73．4％。结论血清CEA、CA724、CA199对于胃癌的诊断有一定的辅助诊断价值，同时三者联合检测可以提高其诊断的敏感度，对于预后胃癌患者的预后有较高的评估价值。

Assessment Value of Tumor Markers in Diagnosis and Prognosis of Patients with Gastric Cancer

Objective To study the assessment value of tumor markers in diagnosis and prognosis of patients with gastric cancer. Methods 198 gastric cancer patients confirmed by surgery and pathology were selected as the case group, and 198 healthy subjects who received physical examination were selected as the control group. Electrochemical luminescence method was used to measure level of tumor markers CA724, CEA and CA199 in the serum of the 2 groups, and the sensitivity and specificity of these tumor markers were evaluated. Results The level of 3 kinds of tumor markers in the case group were higher than that of the control group, and the difference had statistical significance. The level of 3 kinds of tumor markers droped after operation, the difference had statistical significance. The level of tumor markers in stage（ Ⅲ＋Ⅳ ） patients was significantly higher than that of stage （ Ⅰ＋Ⅱ）patients, the difference had statistical significance. Sensitivity of CEA, CA724 and CA199 in the case group were 50.9% ,51.3% ,47.8% ,respectively;Specificity of CEA,CA724 and CA199 in the case group were 92.1% ,91.4% ,92.1%, respectively ; Combined detection of sensitivity and specificity were 90. 1%, 73.4%, respectively. Conclusion Serum CEA, CA724, CA199 have certain auxiliary diagnostic value for the diagnosis of gastric cancer, and joint detection of the 3 markers can improve the sensitivity of the diagnosis, it has higher assessment value for the prognosis of gastric cancer.