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目的:通过对胃粘膜癌前病变患者胃液CEA、CA19-9、CA72-4的单检及联合检测,探讨其临床意义。方法:采用双抗体夹心法对胃液中CEA、CA19-9、CA72-4进行检测,并对胃粘膜癌前病变患者进行分组,包括萎缩性胃炎伴非典型增生共90例:分轻(B)、中(C)、重度(D)三组,分别各30例,萎缩性胃炎伴肠上皮化生30例(E组),萎缩性胃炎伴肠上皮化生及非典型增生30例(F组),与对照组(A组):慢性浅表性胃炎或正常胃粘膜30例进行对比分析,结果进行统计学处理。结果:萎缩性胃炎伴非典型增生,萎缩性胃炎伴肠上皮化生,萎缩性胃炎伴肠上皮化生及非典型增生各组与浅表性胃炎或正常胃粘膜对照组比较有显著性差异。CEA、CA19-9、CA72-4三种肿瘤标志物单检及联合检测的灵敏度、特异度分别为:CEA:56.32%,61.28%,CA19-9:63.28%,63.20%,CA72-4:69.27%70.32%,CEA+CA19-9:69.90%,70.92%,CEA+CA72-4:72.56%,73.36%,CA19-9+CA72-4:72.98%,73.32%,CEA+CA19-9+CA72-4:75.26%,76.38%。结论:胃液中CEA、CA19-9、CA72-4单检或联合检测均能反映出胃粘膜癌前病变的程度,提示对胃的癌前疾病进行追踪随诊,对早期发现胃癌有重要的临床意义。
Objective: To investigate the clinical significance of single-test and combined detection of gastric juice CEA, CA19-9, and CA72-4 in patients with gastric precancerous lesions. METHODS: CEA, CA19-9, and CA72-4 were detected in gastric juice by double-antibody sandwich method. Patients with gastric precancerous lesions were divided into groups, including 90 cases of atrophic gastritis with atypical hyperplasia: light (B) Three groups (30 cases each), atrophic gastritis with intestinal metaplasia (group E), atrophic gastritis with intestinal metaplasia and atypical hyperplasia (group F) (group F, group C, group D) ), And the control group (A group): chronic superficial gastritis or normal gastric mucosa in 30 cases of comparative analysis, the results of statistical processing. RESULTS: Atrophic gastritis with atypical hyperplasia, atrophic gastritis with intestinal metaplasia, atrophic gastritis with intestinal metaplasia, and atypical hyperplasia were significantly different from the superficial gastritis or normal gastric mucosa control groups. The sensitivity and specificity of CEA, CA19-9, and CA72-4 tumor markers were: CEA: 56.32%, 61.28%, CA19-9: 63.28%, 63.20%, CA72-4: 69.27 %70.32%, CEA+CA19-9: 69.90%, 70.92%, CEA+CA72-4: 72.56%, 73.36%, CA19-9+CA72-4: 72.98%, 73.32%, CEA+CA19-9+CA72- 4: 75.26%, 76.38%. Conclusion: The single or combined detection of CEA, CA19-9, CA72-4 in gastric juice can reflect the degree of precancerous lesions of gastric mucosa, suggesting follow-up of stomach precancerous lesions, and has important clinical significance for early detection of gastric cancer. significance.