血浆中四种肿瘤标志物和13C-尿素呼气试验对胃癌诊断的对比研究  

Clinical application of four plasma tumor markers and 13C-urea breath test in diagnosis of patients with gastric carcinoma

作　　者：濮伟刚[1] 谭纪伏[1] 朱建华[1] 杨永青[2] 

机构地区：[1]南京医科大学附属苏州医院普外科,苏州215002 [2]南京医科大学附属苏州医院核医学科,苏州215002

出　　处：《国际放射医学核医学杂志》2010年第2期94-96,104,共4页International Journal of Radiation Medicine and Nuclear Medicine

摘　　要：目的 探讨胃癌患者血浆中胃泌素、瘦素、糖类抗原125（CA125）、糖类抗原72-4（CA72-4）水平和13C-尿素呼气试验（13C-UBT）对胃癌诊断的对比研究.方法 采用放射免疫分析法、酶免疫吸附测定法测定126例胃癌患者（其中Ⅰ～Ⅱ期32例、Ⅲ期57例和Ⅳ期37例）和60名正常对照者血浆中胃泌素、瘦素、CAi25和CA72-4水平;用13C-UBT测定幽门螺旋杆菌（HP）感染的阳性率并进行比较性分析.结果 126例胃癌患者血浆中的胃泌素、CA125和CA72-4水平较60名正常对照者均明显升高（t分别为3.125、3.519、3.788,P均＜0.01）,并随疾病的严重程度而增加;血浆瘦素水平较60名正常对照者明显降低（t=3.524,P＜0.01）,并随疾病的严重程度不断减少.与正常对照组相比,4种肿瘤标志物中CA72-4水平变化最明显.126例胃癌患者HP感染的阳性率为84.9%,其中,Ⅰ～Ⅱ期、Ⅲ期和Ⅳ期胃癌患者HP感染的阳性率分别为46.9%、89.5%和89.2%;60名正常对照者HP感染的阳性率为15.0%.结论 通过对126例胃癌患者血浆中胃泌素、瘦素、CA125和CA72-4水平的分析表明,血浆中的CA72-4水平诊断胃癌为最佳,其次为瘦素、CA125及胃泌素.因胃癌与HP的关系密切,故尽早使用13C-UBT测定HP感染和治疗HP感染者甚为重要.Objective To investigate clinical value of plasma gastrin, leptin,carbohydrate antigen 125（ CA 125 ）, carbohydrate antigen 72-4 （ CA72-4 ） and 13C-urea breath test（13C-UBT） in diagnosis of patients with gastric carcinoma. Methods Radioimmunoassay and enzyme immunosorbent assay were used to determine the plasma gastrin, leptin, CA125 and CA72-4 levels, and helicobacter pylori （ HP ） infection rate was determined by 13C-UBT. Compared all the determined results from 126 patients with gastric carcinoma （ including 32 cases Ⅰ - Ⅱ stage gastric carcinoma, 57 cases Ⅲ stage gastric carcinoma and 37 cases Ⅳ stage gastric carcinoma ） and 60 normal controls. Results The plasma gastrin, CA125 and CA72-4 levels in 126 patients with gastric carcinoma were significantly higher （t=3.125, t=3.519, t=3.788, P〈0.01 ） but plasma level was significantly lower （t=3.524, P〈0.01 ） than those in 60 normal controls. Compared with normel controls, the result of CA72-4 was signeficantly changed. The plasma gastrin, CA125 and CA72-4 levels in 126 patients with gastric carcinoma were increased with the severity of gastric carcinoma, but plasma leptin was decreased.The HP infection rate in 126 patients with gastric carcinoma （84.9%） were significantly higher than those in 60 normal controls（15%）. The HP infection rate in 32 Ⅰ - Ⅱ,57 Ⅲ and 37 Ⅳ stage gastric carcinoma were 46.9%,89.5% and 89.2% respectively and were increased with severity of gastric carcinoma. Conclusion The determination of plasma CA72-4 was the best item for diagnosis of gastric carcinoma in four tumor markers, leptin,CA 125 and gastrin followed. The determination of HP infection rate in gastric carcinoma by 13C-UBT played a considerable role for diagnosis and therapy.

关 键 词：胃肿瘤 胃泌素类 瘦素 CA-125抗原 抗原 肿瘤相关 碳水化合物 螺杆菌  幽门 放射免疫测定 

分 类 号：R735.2[医药卫生—肿瘤]