体检人员常见肿瘤标志物异常的临床意义  

Clinical Significance of Tumor Marker Elevation in Screened Person

作　　者：刘炬[1] 徐志坚[1] 张凯[1] 左京华[1] 邹杰[1] 李槐[1] 

机构地区：[1]中国医学科学院,北京协和医学院肿瘤医院/肿瘤研究所,北京100021

出　　处：《中国肿瘤》2013年第12期1029-1032,共4页China Cancer

基　　金：北京希望马拉松专项基金(N2009YF51)

摘　　要：[目的]探讨体检发现肿瘤标志物异常对诊断肿瘤的临床意义。[方法]129例常规体检发现的肿瘤标志物（CEA、CA199、CA724、CA125、CA242、SCC、NSE、CYFRA211）升高人员,对其进行颈胸部、腹盆部CT、内窥镜检查,女性进行妇科检查,未明确诊断者进行长期随访（大于6个月）。[结果]经过随访,共发现肿瘤患者22例,其中发现肿瘤标志物升高6个月内诊断为恶性肿瘤15例（68.2%）,6个月至1年诊断3例（13.9%）,1年至2年诊断2例（9.1%）,2年至3年诊断2例（9.1%）。COX分析显示肿瘤标志物升高的程度（RR=1.154,95%CI：1.078~1.237,P〈0.001）、肿瘤标志物逐渐升高（RR=3.863,95%CI：1.504~9.919,P〈0.005）和有相关临床症状（RR=3.935,95%CI：1.178~13.14,P〈0.05）是体检肿瘤标志物升高人员患肿瘤的危险因素。[结论]对于体检发现的肿瘤标志物升高人员,应进行全面的临床检查并进行长期随访。[Purpose] To investigate the clinical significance of tumor marker elevation during physical examination in diagnosis for tumor. [Methods] One hundred and twenty-nine screened person with elevated tumor marker（CEA,CA199,CA724,CA125,CA242,SCC,NSE,CYFRA211） were collected. Cervical,thorax,abdominal and pelvic CT,gastric endoscopy and colonoscopy were carried out for them. TCT and HPV were also performed for female. Uncerating persons were followed up for a long term（more than 6 months）.[Results] After follow up,there were 22 cancer patients was found. Among them,15 cases（68.2%） were diagnosed within 6 months from the elevation of tumor markers, 3 cases（13.9%） within one year,2 cases（9.1%） within two years,and 2 cases（9.1%） within three years. COX analysis showed that degree elevated tumor markers（RR=1.154,95%CI：1.078~1.237,P 0.001）,tumor markers increased gradually（RR=3.863,95%CI：1.504~9.919,P0.005） and relevant symptoms（RR=3.935,95%CI：1.178~13.14,P0.05） were the cancer risk factors of screened person. [Conclusions] Systemic clinical examination and long-term follow up should be carried out for person with elevated tumor marker.

关 键 词：恶性肿瘤 早期诊断 肿瘤标志物 体检 

分 类 号：R730.4[医药卫生—肿瘤]