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目的:探讨CEA、CA19-9以及CA72-4诊断老年胃癌的临床价值。方法:对192例经活检确诊为老年胃癌患者的血清CEA、CA19-9以及CA72-4水平进行分析,比较不同TNM分期老年胃癌患者的血清CEA、CA19-9以及CA72-4阳性率,并评价血清CEA、CA19-9以及CA72-4水平诊断老年胃癌的敏感性和特异性。结果:TNM 3期及4期的胃癌患者CEA以及CA19-9阳性率明显高于1期及2期胃癌患者,而TNM1-4期的胃癌患者CA72-4的阳性率都明显高于CEA以及CA19-9。以6.5 ng/m L、30U/m L以及4 ng/m L分别作为CEA、CA19-9以及CA72-4的上限临界值,其诊断老年患者的胃癌的敏感性分别为15.6%、19.3%以及29.2%,特异性分别为98.9%、97.2%以及98.0%,曲线下面积分别为0.59、0.62以及0.66。结论:CEA、CA19-9以及CA72-4对于诊断老年胃癌都有较好的特异性,但敏感性一般,尤其对于早期胃癌,CEA及CA19-9敏感性较差,CA72-4敏感性要优于二者。
Objective: To investigate the clinical value of CEA, CA19-9 and CA72-4 in the diagnosis of elderly gastric cancer. Methods: The serum levels of CEA, CA19-9 and CA72-4 in 192 elderly patients with gastric cancer diagnosed by biopsy were analyzed. The positive rates of serum CEA, CA19-9 and CA72-4 in patients with different stages of gastric cancer were compared and evaluated Serum CEA, CA19-9 and CA72-4 levels in the diagnosis of gastric cancer sensitivity and specificity. Results: The positive rates of CEA and CA19-9 in stage 3 and stage 4 TNM patients were significantly higher than those in stage 1 and stage 2 gastric cancer patients, while the positive rates of CA72-4 in stage TNM1-4 gastric cancer patients were significantly higher than those in CEA and CA19 -9. The sensitivity of 6.5 ng / mL, 30 U / mL and 4 ng / mL for CEA, CA19-9 and CA72-4 were 15.6% and 19.3% respectively in elderly patients with gastric cancer 29.2% with specificity of 98.9%, 97.2% and 98.0%, respectively. The areas under the curve were 0.59, 0.62 and 0.66, respectively. Conclusion: CEA, CA19-9 and CA72-4 have good specificity for the diagnosis of elderly patients with gastric cancer, but the sensitivity is general, especially for early gastric cancer, CEA and CA19-9 are less sensitive and CA72-4 is more sensitive In both.