肿瘤研究与临床
腫瘤研究與臨床
종류연구여림상
CANCER RESEARCH AND CLINIC
2014年
3期
183-186
,共4页
胃肿瘤%肿瘤标志物%预后评估%诊断
胃腫瘤%腫瘤標誌物%預後評估%診斷
위종류%종류표지물%예후평고%진단
Stomach neoplasms%Tumor markers%Prognosis evaluation%Diagnosis
目的 探讨血清癌胚抗原(CEA)、唾液酸化岩藻戊糖(CA199)、胃肠道癌抗原(CA242)、甲胎蛋白(AFP)、胃癌及卵巢癌抗原(CA724)对胃癌的诊断及患者的预后评价价值.方法 回顾性分析诊断为胃癌并接受手术治疗的108例患者,应用电化学发光和酶联免疫法检测外周血清CEA、CA199、CA242、CA724、AFP水平.以108例胃癌患者标本绘制5种标志物受试者工作曲线(ROC);Kaplan-Meier 法分析胃癌患者生存时间;Cox比例风险模型分析影响胃癌患者预后的因素.结果 CEA、CA199、CA242、CA724诊断胃癌的ROC曲线AUC分别为0.735,0.714,0.598,0.576.检测敏感度、特异度、约登指数分别为40.2％、97.7％、0.379;43.0％、91.3％、0.343;35.2％、94.8％、0.300;31.3％、95.3％、0.266.CEA、CA199、CA242、CA724联合诊断胃癌的敏感度、特异度、约登指数分别为76.8％、82.3％、0.585.CEA、CA724与淋巴结转移相关(均P＜ 0.05);血清CEA、CA199、CA242水平与脉栓、远处转移相关及腹腔积液形成有关(均P＜0.05).肿块型和导管型患者血清AFP的水平高于浸润性和溃疡型患者(P＜0.05).肿瘤大小与CEA、AFP、CA724有关.Cox逐步回归分析显示,影响患者3年生存期的因素有术前CEA浓度＞3 μg/ml(P=0.000)、淋巴结转移(P=0.002).随访59例患者中34例死亡,术前CEA阴性与阳性患者中位生存期分别为18.1、10.9个月(P＜0.005).结论 联合检测血清CEA、CA199、CA242、CA724可提高胃癌检出率,同时对预测胃癌患者的复发、转移;术前CEA为胃癌患者唯一不良预后指标.
目的 探討血清癌胚抗原(CEA)、唾液痠化巖藻戊糖(CA199)、胃腸道癌抗原(CA242)、甲胎蛋白(AFP)、胃癌及卵巢癌抗原(CA724)對胃癌的診斷及患者的預後評價價值.方法 迴顧性分析診斷為胃癌併接受手術治療的108例患者,應用電化學髮光和酶聯免疫法檢測外週血清CEA、CA199、CA242、CA724、AFP水平.以108例胃癌患者標本繪製5種標誌物受試者工作麯線(ROC);Kaplan-Meier 法分析胃癌患者生存時間;Cox比例風險模型分析影響胃癌患者預後的因素.結果 CEA、CA199、CA242、CA724診斷胃癌的ROC麯線AUC分彆為0.735,0.714,0.598,0.576.檢測敏感度、特異度、約登指數分彆為40.2％、97.7％、0.379;43.0％、91.3％、0.343;35.2％、94.8％、0.300;31.3％、95.3％、0.266.CEA、CA199、CA242、CA724聯閤診斷胃癌的敏感度、特異度、約登指數分彆為76.8％、82.3％、0.585.CEA、CA724與淋巴結轉移相關(均P＜ 0.05);血清CEA、CA199、CA242水平與脈栓、遠處轉移相關及腹腔積液形成有關(均P＜0.05).腫塊型和導管型患者血清AFP的水平高于浸潤性和潰瘍型患者(P＜0.05).腫瘤大小與CEA、AFP、CA724有關.Cox逐步迴歸分析顯示,影響患者3年生存期的因素有術前CEA濃度＞3 μg/ml(P=0.000)、淋巴結轉移(P=0.002).隨訪59例患者中34例死亡,術前CEA陰性與暘性患者中位生存期分彆為18.1、10.9箇月(P＜0.005).結論 聯閤檢測血清CEA、CA199、CA242、CA724可提高胃癌檢齣率,同時對預測胃癌患者的複髮、轉移;術前CEA為胃癌患者唯一不良預後指標.
목적 탐토혈청암배항원(CEA)、타액산화암조무당(CA199)、위장도암항원(CA242)、갑태단백(AFP)、위암급란소암항원(CA724)대위암적진단급환자적예후평개개치.방법 회고성분석진단위위암병접수수술치료적108례환자,응용전화학발광화매련면역법검측외주혈청CEA、CA199、CA242、CA724、AFP수평.이108례위암환자표본회제5충표지물수시자공작곡선(ROC);Kaplan-Meier 법분석위암환자생존시간;Cox비례풍험모형분석영향위암환자예후적인소.결과 CEA、CA199、CA242、CA724진단위암적ROC곡선AUC분별위0.735,0.714,0.598,0.576.검측민감도、특이도、약등지수분별위40.2％、97.7％、0.379;43.0％、91.3％、0.343;35.2％、94.8％、0.300;31.3％、95.3％、0.266.CEA、CA199、CA242、CA724연합진단위암적민감도、특이도、약등지수분별위76.8％、82.3％、0.585.CEA、CA724여림파결전이상관(균P＜ 0.05);혈청CEA、CA199、CA242수평여맥전、원처전이상관급복강적액형성유관(균P＜0.05).종괴형화도관형환자혈청AFP적수평고우침윤성화궤양형환자(P＜0.05).종류대소여CEA、AFP、CA724유관.Cox축보회귀분석현시,영향환자3년생존기적인소유술전CEA농도＞3 μg/ml(P=0.000)、림파결전이(P=0.002).수방59례환자중34례사망,술전CEA음성여양성환자중위생존기분별위18.1、10.9개월(P＜0.005).결론 연합검측혈청CEA、CA199、CA242、CA724가제고위암검출솔,동시대예측위암환자적복발、전이;술전CEA위위암환자유일불량예후지표.
Objective To investigate the serum CEA,CA199,CA242,CA724,AFP levels as tumor markers for diagnosis and prognosis of gastric cancer.Methods The serum concentrations of CEA,CA199,CA724,AFP were detected in 108 patients with gastric cancer by ECLIA (electrochemiluminescence immunoassay) method.CA242 by ELISA method.The survival analysis was performed by the Kaplan-Meier method,Cox' s proportional hazards model was used for multivariate analysis of prognosis.Results Using healthy subjects group as control,the ROC-AUC of CEA,CA199,CA242,CA724 were 0.735,0.714,0.598,0.576.The sensitivity,specificity and Youden index were 40.2 ％,97.7 ％,0.379; 43.0 ％,91.3 ％,0.343;35.2 ％,94.8 ％,0.300 and 31.3 ％,95.3 ％,0.266,respectively.For combined detection of CEA,CA199,CA242,CA724,the sensitivity,specificity and Youden Index were 76.8 ％,82.3 ％,0.585.The levels of CEA,CA724 were closely related to lymph node status (both P ＜ 0.05).The concentrations of CEA,CA199,CA242 were significantly related to vascular embolization,distant metastases and ascites (all P ＜ 0.05).The patients of lump and catheter had significantly higher of AFP compared with patients of invasion and anabrosis (P ＜ 0.05).In gastric cancer patients,the size of the primary tumors was closely related to the preoperative serum levels of CEA,AFP,CA724 (P ＜ 0.05).During follow-up,there were 34 cases of death in 59 patients,and the median survival time were 18.1,10.9 months for the patients with CEA negative and positive (P ＜ 0.005).Conclusions Combing detection of CEA,CA199,CA242,CA72 can improve sensitivity of gastric cancer,and play an important role in forecasting the recurrence,metastasis,curing and prognosis evaluation.CEA is an important predictor of recurrence and prognosis of gastric cancer.
