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目的 探讨血清癌胚抗原（ＣＥＡ）、糖链抗原（ＣＡ５０）和转化生长因子－α（ＴＧＦ－α）的水平对胃癌的诊断价值。方法 采用放射免疫法和微粒子化学发光免疫法测定 ７８例胃癌，１０例重度胃影膜不典型增生患者及３０例健康人血清ＣＥＡ，ＣＡ５０，ＴＧＦ－α水平。结果 各期胃癌血清ＣＥＡ，ＣＡ５０，ＴＧＦ－α值均明显高于正常对照组（Ｐ＜０．０１），Ⅲ，Ⅳ期胃癌的ＣＥＡ，ＣＡ５０水平及阳性检出率显著高于Ⅰ，Ⅱ期胃癌组（Ｐ＜０．０５），Ⅲ，Ⅳ期胃癌的ＴＧＦ－α水平与Ⅰ，Ⅱ期组差异无显著性（Ｐ＞０．０５），重度胃黏膜不典型增生组的ＣＥＡ，ＣＡ５０与正常对照组差异无显著性，其ＴＧＦ－α值明显高于对照组（Ｐ＜０．０１），几乎接近胃癌水平。三项指标联合检测在Ⅲ，Ⅳ期胃癌阳性率可高达８６％。结论ＣＥＡ，ＣＡ５０，ＴＧＦ－α联合检测可提高胃癌诊断的阳性率，其中ＴＧＦ－α可能是检测癌前病变的一项有意义指标之一。
Objective To investigate the diagnostic value of serum carcinoembryonic antigen (CEA), carbohydrate antigen (CA50) and transforming growth factor-α (TGF-α) in gastric cancer. Methods Serum levels of CEA, CA50 and TGF-α were measured in 78 patients with gastric cancer, 10 patients with severe gastric atypical hyperplasia and 30 healthy controls by radioimmunoassay and microparticle chemiluminescence immunoassay. Results The serum levels of CEA, CA50 and TGF-α in all stages of gastric cancer were significantly higher than those in normal control group (P <0.01). The levels of CEA and CA50 and the positive rates of stage Ⅲ and Ⅳ gastric cancer were significantly higher than those in stage Ⅰ and Ⅱ (P <0.05). The levels of TGF-α in stage Ⅲ and Ⅳ gastric cancer tissues were not significantly different from those in stage Ⅰ and stage Ⅱ (P> 0.05). CEA and CA50 in patients with severe gastric mucosal dysplasia There was no significant difference between the normal control group and the TGF-α level (P <0.01), which was close to the level of gastric cancer. Joint detection of three indicators in Ⅲ, Ⅳ gastric cancer positive rate can be as high as 86%. Conclusions The combined detection of CEA, CA50 and TGF-α can increase the positive rate of gastric cancer diagnosis, and TGF-α may be one of the significant indexes for detecting precancerous lesions.