从粪便及胃液中检测癌相关抗原GP87,CEA,S-Tn及尿激酶进行胃癌普查方法的研究  

A methodological study on mass screening of gastric cancer by detection of the GP87, CEA, S Tn and UPA in feces and gastric juice

作　　者：张晓平[1,2] 袁玫[1,2] 乔士兴 李力[1,2] 

机构地区：[1]解放军总医院肿瘤生物学研究室 [2]白求恩医科大学第二附属医院普通外科

出　　处：《细胞与分子免疫学杂志》1998年第4期268-271,共4页Chinese Journal of Cellular and Molecular Immunology

摘　　要：为寻找胃癌普查的简便方法，以抗消化道肿瘤单克隆抗体（ｍＡｂ）Ａｄｎａｂ－９，组合ＣＬ－３，ＧＳ－２和抗尿激酶（ＵＰＡ）多克隆抗体，用ＥＬＩＳＡ直接法和酶免疫电泳法，检测了粪便标本１４４例和胃液标本１５３例中癌相关抗原ＧＰ８７，ＣＥＡ，Ｓ－Ｔｎ及ＵＰＡ。结果表明，以抗ＧＰ８７ｍＡｂＡｄｎａｂ－９检测时，粪便组的阳性率：胃癌为８７．９％，萎缩性胃炎（ＣＡＧ）为７４．１％，ＣＡＧ伴不典型增生（ＡＴＰ）为８７．５％，ＣＡＧ伴肠化生（ＩＭ）为８０．０％，浅表性胃炎（ＣＳＧ）为１６．６％，正常人为６．６％。胃液组的阳性率：胃癌为８６．３％，ＣＡＧ为７０．０％，ＣＡＧ伴ＡＴＰ为７５．０％，ＣＡＧ伴ＩＭ为７２．７％，ＣＳＧ为２６．１％，正常人为３．３％，具有对癌及癌前病变诊断的价值。以抗Ｓ－Ｔｎ，ＣＥＡ的ｍＡｂＣＬ－３和ＧＳ－２联合检测时，粪便组的阳性率：胃癌为７２．７％，明显高于ＣＳＧ（２４．１％），正常人为８．７％，也有一定的诊断胃癌的价值；而胃液组中胃癌的检出率则较低为５４．５％。从胃液及粪便标本中均可检出ＵＰＡ，其中胃癌的阳性率（５９．０％及５４．５％）高于正常人及ＣＳＧ组，阳性率分别为１３．３％，２０．０％及１８?To study the methods for the mass screening and diagnosis of gastric cancer, we detected the tumor associated antigens GP87, CEA, S Tn and urokinase type plasminogen(UPA) in feces(F) and in gastric juice(GJ) by ELISA and electrophoresis enzyme assays using monoclonal and polyclonal antibodies to gastrointestinal tumors. 144 samples of feces and 153 of GJ were obtained from patients. The results : ① The positive rate of GP87 in patients with gastric cancer was 87.9%(F) and 86.3%(GJ), in chronic atrophic gastritis(CAG) was 74.1%(F) and 71.6%(GJ), in CAG accompanied with atypical dysplasia (ATP) was 87.5%(F) and 75.0%(GJ), in CAG accompanied with intestinal metaplasia(MI) was 80.0%(F) and 72.7%(GJ), while in chronic superficial gastritis(CSG) was 16.6%(F) and 26.1%(GJ), and in healthy controls was 6.6%(F) and 3 3%(GJ). The accurate diagnostic value of gastric cancer and pre malignant lesions are higher than 70%; ② when CEA and S Tn were detected with mAbs CL 3 and GS 2, for gastric cancer group, the positive rate was 72.7% in feces, higher than that in GJ(54.5%), and these were significantly higher than those in healthy controls. UPA could be detected in both feces and gastric juice, and the positive rates of gastric cancer group were 54.5% and 59.0% while those of CSG group were 22.2% and 17.6%, and those of healthy controls were 20.0% and 13.3%. Our preliminary results indicated that detection of GP87 in feces is promising for gastric cancer mass screening, and combination of detection of CEA, S Tn and UPA may improve the diagnostic efficiency of gastric cancer.

关 键 词：胃癌 癌相关抗原 单克隆抗体 粪便 胃液 普查 

分 类 号：R735.204[医药卫生—肿瘤]