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目的:评价外周血糖类抗原72-4(CA72-4)、糖类抗原19-9(CA19-9)、癌胚抗原(CEA)和肿瘤特异性生长因子(TSGF)联合检测对胃癌的诊断价值。方法:CA72-4、CA19-9和CEA采用电化学发光免疫分析法,TSGF采用免疫比浊法测定484例胃癌患者、62例良性胃部疾病患者和56名健康体检者的外周血。t检验和χ2检验进行数据统计分析。结果:胃癌组CA72-4、CA19-9、CEA和TSGF的水平及阳性率〔(36.3±32.6)U/mL与43.2%、(216.2±184.6)U/mL与32.6%、(47.2±43.4)ng/mL与23.1%及(72.4±9.3)U/mL与86.4%〕明显高于良性胃部疾病组〔(3.8±1.8)U/mL与6.5%、(21.6±14.8)U/mL与3.2%、(3.3±1.8)ng/mL与4.8%和(53.6±10.6)U/mL与3.2%〕和健康对照组〔(3.6±1.9)U/mL与1.8%、(18.2±12.4)U/mL与0、(3.1±2.0)ng/mL与3.6%和(50.4±13.7)U/mL与1.8%〕,P<0.01。随着临床分期递增,血清CA72-4、CA19-9、CEA和TS-GF的水平和阳性率也呈正相关。4项肿瘤标志联合检测的灵敏度可达到96.1%(465/484),诊断符合率可达到94.7%(458/484),阳性预测值为0.961,阴性预测值为0.881。结论:外周血CA72-4、CA19-9、CEA和TSGF联合检测可提高胃癌的检出率。
Objective: To evaluate the diagnostic value of combined detection of peripheral blood carbohydrate antigen 72-4 (CA72-4), carbohydrate antigen 19-9 (CA19-9), carcinoembryonic antigen (CEA) and tumor specific growth factor (TSGF) in gastric cancer . Methods: Electrochemiluminescence immunoassay was used for CA72-4, CA19-9 and CEA. Peripheral blood of 484 patients with gastric cancer, 62 patients with benign gastric diseases and 56 healthy controls were detected by immune turbidimetry. t test and χ2 test for statistical analysis of data. Results: The positive rates of CA72-4, CA19-9, CEA and TSGF in gastric cancer group were (36.3 ± 32.6) U / mL and 43.2%, (216.2 ± 184.6) U / mL and 32.6%, (47.2 ± 43.4) (3.8 ± 1.8) U / mL and 6.5%, (21.6 ± 14.8) U / mL vs 3.2 (3.2 ± 1.8) U / mL and 86.4% for patients with benign gastric diseases (3.6 ± 1.9) U / mL and 1.8%, (18.2 ± 12.4) U / mL and (18 ± 12.4) U / mL and 3.2% mL and 0, (3.1 ± 2.0) ng / mL vs 3.6% and (50.4 ± 13.7) U / mL vs 1.8%, respectively), P <0.01. With the increasing of clinical stage, the levels and positive rates of serum CA72-4, CA19-9, CEA and TS-GF were also positively correlated. The sensitivity of the four tumor markers combined detection was 96.1% (465/484), the diagnostic coincidence rate was 94.7% (458/484), the positive predictive value was 0.961 and the negative predictive value was 0.881. Conclusion: The combined detection of peripheral blood CA72-4, CA19-9, CEA and TSGF can improve the detection rate of gastric cancer.