肿瘤标志物在霉菌性胃溃疡及溃疡型胃癌鉴别诊断中的应用价值  

Clinical value of tumor markers in the differential diagnosis of mycotic gastric ulcer and ulcerated gastric carcinoma

作　　者：阳长清[1] 

机构地区：[1]四川省邻水县人民医院检验科,638500

出　　处：《国际检验医学杂志》2009年第2期116-119,共4页International Journal of Laboratory Medicine

摘　　要：目的分析几种典型的血清肿瘤标志物在霉菌性胃溃疡与溃疡型胃癌中的变化,以探讨其临床鉴别诊断价值。方法根据手术后病理结果,122例胃溃疡患者分为溃疡型胃癌组(n=75)、胃癌合并霉菌组(n=4)及霉菌性胃溃疡组(n=43),55例健康成人设为健康对照组。采集静脉血,分离血清。采用电化学发光法检测血清癌抗原72-4(CA72-4)、癌抗原19-9(CA19-9)、癌抗原24-2(CA24-2)、癌胚抗原(CEA)。日立7170全自动生化分析仪上进行血清唾液酸(SA)值和甘氨酰脯氨酸二肽氨基肽酶(GPDA)活力测定。结果1)溃疡型胃癌组血清CA72-4、CA19-9、CA24-2、CEA、SA水平分别为(49.85±10.36)U/L、(59.31±3.89)U/L、(38.77±12.56)U/L、(5.33±2.94)μg/L及(85.12±10.86)mg/dL,胃癌合并霉菌组分别为(48.98±11.22)U/L、(60.13±4.72)U/L、(36.92±9.97)U/L、(5.38±7.22)μg/L及(85.16±9.96)mg/dL,均显著高于健康对照组和霉菌性胃溃疡组;溃疡型胃癌组与胃癌合并霉菌组GPDA水平分别为(48.09±15.02)U/L及(48.22±13.51)U/L,显著低于健康对照组和霉菌性胃溃疡组,差异均有统计学意义(P<0.01)。2)溃疡型胃癌组血清CA72-4、CA19-9、CA24-2、CEA、SA及GPDA阳性检出率分别为24.00%、29.33%、20.00%、41.33%、65.33%及72.00%,均分别显著高于健康对照组和霉菌性胃溃疡组,差异均有统计学意义(P<0.01),SA+GPDA联合检测阳性检出率达到78.67%。结论CA72-4、CA19-9、CA24-2、CEA、SA和GPDA等6种血清肿瘤标志物检测对霉菌性胃溃疡、溃疡型胃癌具有鉴别诊断价值,在胃溃疡病因难以确定、选择治疗方案时,检测具有高度特异性及敏感性的血清肿瘤标志物,特别是血清肿瘤标志物联合检测对疾病的临床处理及预后转归具有重要的参考意义。Objective To investigate the changes of several typical serum tumor markers in patients with mycotic gastric ulcer and ulcerated gastric carcinoma, so as to explore their clinical value in the differential diagnosis of mycotic gastric ulcer and ulcerated gastric carcinoma. Methods According to the post operation pathological results, 122 patients with gastric ulcer were divided into ulcerated gastric carcinoma group （n=75）, gastric carcinoma complicated with fungal infection group （n=4） and mycotic gastric ulcer group （n=43）. Fifty-five heahhy adults were set as normal control group （n = 55）. Venous blood was collected and sera were separated for all subjects. Electrogenerated chemilu-minescence analysis was performed to measure serum CA72-4, CA19-9, CA24-2 and carcinoembryonic antigen （CEA）. Serum sialic acid （SA） level and glycylproline dipeptidyl aminopeptidase （GPDA） activity were determined by applying Hitachi 7170 fully automatic biochemical analyzer. Results The level of CA72-4, CA19-9, CA24-2, CEA and SA was 49.85±10.36 U/L, 59.31±3.89 U/L, 38.77 ±12.56 U/L, 5.33±2.94 μg/L and 85.12±10.86 mg/dL respectively in ulcerated gastric carcinoma group; 48.98±11.22 U/L, 60.13±4.72 U/L, 36.92±9.97 U/L, 5.38±7.22 μg/L and 85.16± 9.96 mg/dL respectively in gastric carcinoma complicated with fungal infection group, significantly higher than that of normal control group and mycotic gastric ulcer group. The GPDA activity was 48.09±15.02 U/L and 48.22 ±13.51 U/I. in ulcerated gastric carcinoma group and gastric carcinoma complicated with fungal infection group, significantly lower than that of normal control group and my- cotic gastric ulcer group. The differences were statistical significant （P〈0.01）. （2） The positive detection rate of CA72 4, CA19-9, CA24-2, CEA, SA and GPDA was 24.00%, 29. 33%, 20.00%, 41. 33%, 65.33% and 72.00% respectively in ulcerated gastric carcinoma group, significantly higher than that of normal control group and mycotic gastric ulcer group. T

关 键 词：肿瘤标记 生物学的 抗原 胃溃疡 胃肿瘤 诊断 鉴别 

分 类 号：R573.1[医药卫生—消化系统] R735.2[医药卫生—内科学] R446.1[医药卫生—临床医学]