血清肿瘤标志物癌胚抗原和糖类抗原在胃癌腹膜转移中的诊断价值  

Diagnostic value of combined detection of serum carcinoembryonic antigen and carbohydrate antigen in gastric cancer peritoneal metastasis

作　　者：彭忠[1] 郑成军[1] 江培[1] 陈雷[1] 宋桂芹[2] PENG Zhong;ZHENG Chengjun;JIANG Pei;CHEN Lei;SONG Guiqin(Gastrointestinal Surgery,Leshan People's Hospital,Leshan 614000,Sichuan,China;Department of Medical Biology,North Sichuan Medical College,Nanchong 637000,Sichuan,China)

机构地区：[1]乐山市人民医院胃肠外科,四川乐山614000 [2]川北医学院医学生物学教研室,四川南充637000

出　　处：《西部医学》2019年第5期782-785,共4页Medical Journal of West China

基　　金：四川省卫生厅科研课题(120457)

摘　　要：目的探讨血清肿瘤标志物癌胚抗原和糖类抗原在胃癌腹膜转移中的诊断价值,为胃癌腹膜转移的诊断提供理论依据。方法纳入2014年6月～2017年6月于乐山市人民医院肿瘤科诊治的68例胃癌患者,根据是否发生腹膜转移分为转移组(20例)与非转移组(48例);手术或化疗前采用全自动免疫分析仪检测血清肿瘤标志物癌胚抗原(Carcinoembryonic antigen,CEA)、糖类抗原CA724、CA242、CA211、CA19-9、CA125水平,比较两组各检测指标血清水平、阳性率。进行Logistic回归分析,绘制受试者特征ROC曲线,比较联合检测以及各指标单独检测的诊断效能。结果转移组血清CEA、CA724、CA242、CA211、CA19-9、CA125水平均显著高于非转移组,差异均有统计学意义(P<0.05);转移组血清CA724、CA125、CA211阳性率显著高于非转移组,差异均有统计学意义(P<0.05),血清CEA、CA242、CA19-9阳性率差异无统计学意义(P>0.05);CA724、CA125、CA211联合诊断(Y1)与所有检测指标联合诊断(Y2)ROC曲线下面积(area under the cure,AUC)值均大于单项指标诊断(P<0.05)。结论单项指标中CA125诊断胃癌腹膜转移效能最高,其与CA724、CA211联合诊断可作为胃癌腹膜转移的有效诊断方式。Objective To investigate the diagnostic value of combined detection of serum carcinoembryonic antigen and carbohydrate antigen in gastric cancer peritoneal metastasis.Methods 68 patients with gastric cancer treated in Oncology Department of our hospital from June 2014 to June 2017 were divided into metastasis group (20 cases) and non-metastasis group (48 cases),according to the pathological or cytological examination.The levels of carcinoembryonic antigen (CEA),carbohydrate antigen CA724,CA242,CA211,CA19-9 and CA125 were detected by automatic immunoassay analyzer before operation or chemotherapy.The serum level and positive rate of the two groups were compared.The diagnostic efficiencies of the single and combined detection of these tumor markers were evaluated through establishing Logistic regression model,drawing ROC curves and calculating the areas under the curve (AUC).Results The serum levels of CEA,CA724,CA242,CA211,CA19-9 and CA125 in the metastasis group were significantly higher than those in the non metastasis group,and the difference was statistically significant ( P <0.05).The positive rates of serum CA724,CA125 and CA211 in metastasis group were significantly higher than those in non-metastasis group ( P <0.05),while no difference was found in the positive rate of the serum CEA,CA242,CA19-9 of the two groups ( P >0.05).The AUC of combined detection (Y1) of CA125,CA724 and CA211 or combined detection (Y2) of the all tumor markers was significantly greater than that of any single detection.Conclusion CA125 can be as a predictor for peritoneal metastasis of gastric cancer,and its detection in combination with CA724 and CA211 can provide effective information for clinical identification of gastric cancer peritoneal metastasis.

关 键 词：血清肿瘤标志物 癌胚抗原 糖类抗原 胃癌腹膜转移 诊断价值 

分 类 号：R735.2[医药卫生—肿瘤] R730.43[医药卫生—临床医学]