联合检测血清CEA、CA199、TGFα和TGFβ_1在胃癌诊断中的价值  

Combined detection of serum CEA,CA199,TGFα and TGFβ_1 for diagnosis of gastric cancer

作　　者：李健[1] 乔世铭[1] 史枫[1] 叶朕雄[1] 李奇[1] 王世伟[1] 

机构地区：[1]同济大学附属杨浦医院普外科,上海200090

出　　处：《同济大学学报（医学版）》2015年第3期21-26,共6页Journal of Tongji University(Medical Science)

基　　金：上海市卫生局项目(2010168)

摘　　要：目的检测血清CEA、CA199、TGFα和TGFβ1在胃癌患者血清中的水平,探讨其在胃癌诊断中的临床价值。方法采用化学发光免疫法和酶联免疫吸附法测定60例胃癌患者血清CEA、CA199、TGFα和TGFβ1水平,选择同期的20例健康体检者作为对照。分别于术前、术后对患者血清CEA、CA199、TGFα和TGFβ1进行检测,对比胃癌患者手术前、后CEA、CA199、TGFα和TGFβ1血清水平及术后变化规律。研究CEA、CA199、TGFα和TGFβ1血清水平与临床因素(性别、年龄)和胃癌肿瘤特性(肿瘤大小、淋巴转移、远处转移、临床分期)的关系,观察其在不同TNM分期的变化。结果与正常对照组相比,胃癌患者血清CEA、CA199、TGFα和TGFβ1含量均显著升高(P<0.05)。胃癌组患者术后血清CEA、CA199、TGFα和TGFβ1水平均显著低于术前,差异有统计学意义(P<0.05)。术后7、14、28、56 d,各血清指标逐渐下降,趋近正常水平。CEA、CA199、TGFα和TGFβ1四项血清指标联合检测的阳性检出率(85.00%)显著高于单项检测的阳性检出率(38.33%,46.67%,53.33%,51.67%),差异有统计学意义(P<0.05)。各血清指标CEA、CA199、TGFα和TGFβ1的表达水平在胃癌患者的年龄、性别、肿瘤大小各因素方面无统计学差异,而TGFβ1在有无淋巴结转移,有无淋巴结远处转移方面有显著性差异。各血清指标水平升高与胃癌的临床病理分期有密切的关系。结论血清CEA、CA199、TGFα和TGFβ1水平与胃癌的发展程度相关,联合检测CEA、CA199、TGFα和TGFβ1,有助于胃癌的早期诊断,提高胃癌的检出率。Objective To investigate serum levels of CEA, CA199, TGFα and TGFβ1 in patients with gastric cancer and the diagnostic value of combination of these 4 markers. Methods Serum CEA, CA199, TGFα and TGFβ1 levels were measured by electric chemilluminescent assay or enzyme-linked immunosorbent assay in 60 patients with gastric cancer and 20 healthy subjects（ control group）. The serum markers were measured before and after operation in patients with gastric cancer. The relationship of serum tumor marker levels with gender, age, tumor size, lymph node metastasis, distant metastasis and clinical stages were analyzed. Results Compared with the control group, serum CEA, CA199, TGFα and TGFβ1 levels of gastric cancer patients were significantly increased （P 〈 0. 05）. The average levels of these markers of patients were significantly decreased at d7, d14, d28 and d56 after surgery （ P 〈 0. 05 ） and gradually returned to normal levels. The positive rate of combined detection of CEA, CA199, TGFα and TGFβ1 （85.0%） was significantly higher than that of single detection （ 38.3 % ,46.7 %, 53.3 % and 51.7 % ）, the difference was statistically significant （ P 〈 0.05 ）. Serum CEA, CA199, TGFα and TGFβ1 levels were not correlated with age, gender and tumor size of patients, while correlated with clinicopathologic staging of gastric cancer; and serum TGFβ1 level was correlated with lymph node metastasis and distant metastasis. Conclusion The levels of serum markers are related to gastric cancer development. Combined detection of CEA, CA199, TGFα and TGFβ1 might be helpful to early diagnosis of gastric cancer.

关 键 词：胃肿瘤 血清 糖类抗原199 癌胚抗原 转化生长因子Α 转化生长因子β1 

分 类 号：R735[医药卫生—肿瘤]