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目的:通过测定血清中甲胎蛋白(AFP)、糖链抗原125(CA125)、糖链抗原19-9(CA19-9)、糖链抗原72-4(CA72-4)、癌胚抗原(CEA)的水平,对其性能进行评价,探讨这几种肿瘤标志物(TM)单独与联用时对胃癌诊断的临床应用价值。方法:使用直接化学发光法测定65例胃部良性疾病患者和38例胃部恶性肿瘤患者血清中TM的水平,计算各指标的平均水平并比较不同TM单独及联合使用时的灵敏度和特异度。结果:胃癌组CA125、CA19-9、CA72-4、CEA水平明显高于良性胃病组(P<0.05);采用单项TM诊断胃癌时,灵敏度最高的为CA19-9,特异度最高的为CEA,ROC曲线下面积最大的为CA19-9;采用不同TM的组合诊断胃癌时,灵敏度和特异度均较好的为CA19-9与CEA组成的组合。结论:血清TM的检测对胃癌的诊断具有较高的辅助价值,选择适当的TM进行联合检测有助于提高诊断的灵敏度。
OBJECTIVE: To determine the serum levels of AFP, CA125, CA19-9, CA72-4, carcinoembryonic antigen (CEA) ), Evaluate their performance and discuss the clinical value of these tumor markers (TM) alone and in combination for the diagnosis of gastric cancer. Methods: The serum levels of TM in 65 patients with benign gastric diseases and 38 patients with gastric malignancies were determined by direct chemiluminescence. The average level of each index was calculated and the sensitivity and specificity of different TM alone and in combination were compared. Results: The levels of CA125, CA19-9, CA72-4 and CEA in gastric cancer group were significantly higher than those in benign gastric disease group (P <0.05). When using single TM to diagnose gastric cancer, the highest sensitivity was CA19-9, the highest specificity was CEA, The area under the ROC curve was CA19-9. When the combination of different TM was used to diagnose gastric cancer, the combination of CA19-9 and CEA was the best in sensitivity and specificity. Conclusion: The detection of serum TM has a higher auxiliary value in the diagnosis of gastric cancer. Choosing the appropriate TM for joint detection can improve the diagnostic sensitivity.