癌胚抗原、糖类抗原125、糖类抗原199结合血清甲胎蛋白诊断消化系统肿瘤良恶性的准确性  

Accuracy of CEA,CA125,CA19-9 Combined with AFP in the Diagnosis of Benign and Malignant Tumors of Digestive System

作　　者：陆晓辉 扎西普赤 LU Xiaohui;Zhaxipuchi(Department of Laboratory Medicine,Shigatse People’s hospital,Shigatse,Tibet 857000,China)

机构地区：[1]日喀则市人民医院检验科,西藏日喀则857000

出　　处：《中国医药指南》2025年第8期101-104,共4页Guide of China Medicine

摘　　要：目的 分析癌胚抗原(CEA)、糖类抗原125(CA125)、糖类抗原199(CA19-9)结合血清甲胎蛋白(AFP)诊断消化系统肿瘤良恶性的准确性。方法 选取日喀则市人民医院2024年1月—7月收治的疑似消化系统恶性肿瘤患者样本472例作为试验组,将同一时间到院内体检的健康受试者244例作为对照组。以病理诊断结果为金标准,将试验组患者分为恶性病变为试验A组(n=248)、良性病变为试验B组(n=224),评估单一及联合指标检测对消化系统肿瘤良恶性的准确度,对比三组受试者CEA、CA125、CA19-9以及AFP水平,根据恶性肿瘤患者发病位置划分不同组别,对比不同发病位置的消化系统恶性肿瘤上述指标水平。通过绘制受试者工作(ROC)曲线,分析CEA、CA125、CA19-9结合AFP在消化系统肿瘤良恶性鉴别中的诊断价值。结果 经病理诊断明确,472例患者中恶性病变248(52.54%)、良性病变224例(47.46%)。联合检测对恶性肿瘤的诊断准确度高于单一诊断。其中,试验A组患者的CA125、CA19-9、CEA以及AFP水平均高于试验B组、对照组(F=721.841、735.069、46 676.575、15 572.567,P <0.05)。与单一指标检测相比,联合检测在消化系统良恶性肿瘤中的曲线下面积(AUC)为0.917(P <0.05)。CEA在肠道恶性肿瘤中的表达水平高于其他指标,CA125在胃恶性肿瘤中的表达水平高于其他指标,AFP在肝脏中的表达水平高于其他指标,CA19-9在胰腺恶性肿瘤中的表达水平高于其他指标(均P <0.05)。结论 与单一血清肿瘤标志物检测相比,联合CEA、CA125、CA19-9以及AFP在消化系统恶性肿瘤中的诊断价值更高,且不同指标在不同发病位置的消化系统恶性肿瘤中均呈现不同表达,对临床鉴别诊断具有较高的参考价值。Objective Analysis of Carcino embryonic antigen(CEA),Carbohydrate antigen 125(CA125),Carbohydrate antigen 199(CA19-9)in combination with serum Alpha-FetoProtein(AFP)was used to diagnose benign and malignant tumours of the digestive system.FetoProtein(AFP)in combination with serum Alpha-FetoProtein(AFP)for diagnosis of benign and malignant digestive tumours.Methods A total of 472 patients with suspected malignant digestive system tumors admitted to Shigatse People’s Hospital from January 2024 to July 2024 were selected as the trail group,and 244 healthy subjects who underwent physical examinations in the hospital during the same period were selected as the control group.Based on pathological diagnosis as the gold standard,patients in the trail group were divided into the trail subgroup A(n=248)with malignant lesions and the trail subgroup B(n=22)4 with benign lesions.The accuracy of single and combined indicator tests in differentiating the benignity and malignancy of digestive system tumors was evaluated.Levels of CEA,CA125,CA19-9,and AFP were compared among the three groups of subjects.Patients with malignant tumors were further divided into different subgroups according to the location of the tumor,and levels of the above indicators were compared among digestive system tumors with different locations.Receiver operating characteristic(ROC)curves were plotted to analyze the diagnostic value of CEA,CA125,CA19-9,and AFP in differentiating the benignity and malignancy of digestive system tumors.Results Pathological diagnosis confirmed that among the 472 patients,248(52.54%)had malignant lesions and 224(47.46%)had benign lesions.Combined detection had a higher diagnostic accuracy for malignant tumors than single detection.The levels of CA125,CA19-9,CEA,and AFP in patients of the trail subgroup A were higher than those in the trail subgroup B and the control group(F=721.841,735.069,46676.575,15572.567,P<0.05).Compared with single indicator detection,combined detection had an area under the curve(AUC)of 0.917 for dif

关 键 词：消化系统肿瘤 鉴别诊断 癌胚抗原 糖类抗原 血清甲胎蛋白 准确性 

分 类 号：R735[医药卫生—肿瘤]