血清肿瘤标志物联合胆汁酸检测在胃癌诊断中的价值  

The Value of Serum Tumor Markers Combined with Bile Acid Detection in the Di-agnosis of Gastric Cancer

作　　者：李芃萌 慈向男 修辉 张珊[1] 姜娜[1] 王荣玉 张海燕[1] 刘希双[1] 

机构地区：[1]青岛大学附属医院消化内科,山东 青岛

出　　处：《临床医学进展》2023年第3期3163-3172,共10页Advances in Clinical Medicine

摘　　要：目的:探讨血清肿瘤标志物(CEA、CA19-9、CA72-4)及胆汁酸(TBA)在胃癌诊断中的价值。方法:收集842例临床资料完整的胃癌患者的数据,采用秩和检验、受试者工作特征曲线分析CEA、CA19-9、CA72-4与TBA单独及联合检测在胃癌诊断中的价值。结果:胃癌组血清CEA、CA72-4、TBA水平明显高于健康对照组(Z = −7.013~−3.387, P 0.05)。血清CEA、CA19-9、CA72-4、TBA联合检测的灵敏度高于单独检测,且四项指标联合检测灵敏度最高。ROC曲线中,CEA、CA72-4、TBA联合检测曲线下面积(AUC)最大为0.616。结论:血清CEA、CA19-9、CA72-4、TBA对胃癌的诊断价值不高,仅当其升高大于4倍时意义较大。只有当血清CEA、CA19-9水平升高大于4倍时,对胃癌是否有淋巴结转移预测价值较大。Objective: To investigate the value of serum tumor markers (CEA, CA19-9, CA72-4) and bile acid (TBA) in the diagnosis of gastric cancer. Methods: The data of 842 gastric cancer patients with com-plete clinical data were collected, and the value of single and combined detection of CEA, CA19-9, CA72-4 and TBA in the diagnosis of gastric cancer was analyzed by Kruskal-Wallis test and receiver operating characteristic curve. Results: The levels of serum CEA, CA72-4 and TBA in gastric cancer group were significantly higher than those in healthy control group (Z = −7.013~−3.387, P 0.05). The sensitivity of combined detection of serum CEA, CA19-9, CA72-4 and TBA was higher than that of single detection, and the sensitivity of combined detection of four indexes was the highest. In the ROC curve, the maximum area under the curve (AUC) of CEA, CA72-4 and TBA joint detection is 0.616. Conclusion: The value of serum CEA, CA19-9, CA72-4 and TBA in the diagnosis of gastric cancer is not high, but it is of great significance only when it increases more than 4 times. Only when the serum levels of CEA and CA19-9 increase more than 4 times, it is of great value in predicting whether there is lymph node metastasis in gastric cancer.

关 键 词：胃癌 肿瘤标志物 胆汁酸 

分 类 号：R73[医药卫生—肿瘤]