超声联合血清肿瘤标志物CEA、CA199对胃肠道腺癌腹膜转移的诊断价值  

Diagnostic value of ultrasound combined with serum tumor markers CEA and CA199 for peritoneal metastasis of gastrointestinal adenocarcinoma

作　　者：张波[1] 苗润琴[1] 原韶玲[1] 郭荣荣[1] 唐瑾 Zhang Bo;Miao Runqin;Yuan Shaoling;Guo Rongrong;Tang Jin(Department of Ultrasound,Shanxi Province Cancer Hospital,Shanxi Hospital Affiliated to Cancer Hospital,Chinese Academy of Medical Sciences,Cancer Hospital Affiliated to Shanxi Medical University,Taiyuan 030013,China)

机构地区：[1]山西省肿瘤医院、中国医学科学院肿瘤医院山西医院、山西医科大学附属肿瘤医院超声科,太原030013

出　　处：《肿瘤研究与临床》2024年第12期938-941,共4页Cancer Research and Clinic

摘　　要：目的探讨超声联合血清肿瘤标志物癌胚抗原(CEA)、糖类抗原199(CA199)对胃肠道腺癌腹膜转移的诊断价值。方法回顾性病例系列研究。选取山西省肿瘤医院2021年8月至2023年1月收治的140例胃肠道腺癌患者,采用血清肿瘤标志物CEA、CA199(肿瘤标志物法)及超声联合CEA、CA199(联合法)对患者腹膜转移进行术前诊断。以术后病理结果为金标准,比较两种方法对患者腹膜转移的检出率及诊断效能。结果140例患者中,男性78例,女性62例;年龄(59±5)岁;胃癌40例,结直肠癌100例;病理分期Ⅰ期4例,Ⅱ期36例,Ⅲ期52例,Ⅳ期48例。所有患者均行根治性切除手术,术后病理结果显示32例(22.86%)患者发生腹膜转移。联合法对胃肠道腺癌腹膜转移的检出率高于肿瘤标志物法[96.88%(31/32)比78.13%(25/32)],但差异无统计学意义(χ^(2)=5.14,P=0.059)。肿瘤标志物法诊断胃肠道腺癌腹膜转移的灵敏度为64.00%,特异度为86.09%,阳性预测值为50.00%,阴性预测值为91.67%,Kappa值为0.379,曲线下面积(AUC)为0.793。联合法诊断胃肠道腺癌腹膜转移的灵敏度为77.42%,特异度为92.66%,阳性预测值为75.00%,阴性预测值为93.52%,Kappa值为0.905,AUC为0.985。联合法诊断胃肠道腺癌腹膜转移的灵敏度、阳性预测值均高于肿瘤标志物法,差异均有统计学意义(χ^(2)值分别为4.06、13.33,均P<0.05)。结论超声联合血清肿瘤标志物CEA、CA199对胃肠道腺癌腹膜转移具有较高的诊断价值。Objective To explore the diagnostic value of ultrasound combined with tumor markers carcinoembryonic antigen(CEA)and carbohydrate antigen 199(CA199)for peritoneal metastasis of gastrointestinal adenocarcinoma.Methods A retrospective case series study was conducted.A total of 140 patients with gastrointestinal adenocarcinoma who were admitted to Shanxi Province Cancer Hospital from August 2021 to January 2023 were collected.Preoperative diagnosis of peritoneal metastasis was performed using tumor markers CEA and CA199(tumor marker method)and ultrasound combined with CEA and CA199(combined method).Using postoperative pathological results as the gold standard,the detection rate and diagnostic efficacy of the two methods for peritoneal metastasis in patients were compared.Results Among 140 patients,there were 78 males and 62 females;the age was(59±5)years old;there were 40 cases of gastric cancer and 100 cases of colorectal cancer;pathological staging:4 cases in stageⅠ,36 cases in stageⅡ,52 cases in stageⅢ,and 48 cases in stageⅣ.All patients underwent radical resection surgery,and postoperative pathological results showed that 32 cases(22.86%)had peritoneal metastasis.The detection rate of combined method for peritoneal metastasis of gastrointestinal adenocarcinoma was higher than that of tumor marker method[96.88%(31/32)vs.78.13%(25/32)],but the difference was not statistically significant(χ^(2)=5.14,P=0.059).The sensitivity of tumor marker method for diagnosing peritoneal metastasis of gastrointestinal adenocarcinoma was 64.00%,the specificity was 86.09%,the positive predictive value was 50.00%,the negative predictive value was 91.67%,the Kappa value was 0.379,and the area under the curve(AUC)was 0.793.The sensitivity of combined method for diagnosing peritoneal metastasis of gastrointestinal adenocarcinoma was 77.42%,the specificity was 92.66%,the positive predictive value was 75.00%,the negative predictive value was 93.52%,the Kappa value was 0.905,and the AUC was 0.985.The sensitivity and positive pred

关 键 词：胃肠肿瘤 腺癌 超声检查 肿瘤转移 腹膜 癌胚抗原 糖类抗原199 

分 类 号：R73[医药卫生—肿瘤]