摘要
目的探讨CEA、CA19-9、CA72-4、CA242、CA50和PGⅠ、PGR（PGⅠ／PGⅡ）7项血清标志物在胃癌术前术后检测的临床价值。方法回顾性研究。选择2013年10月至2015年7月郑州人民医院诊治的41例胃癌初诊和手术治疗的患者（胃癌组），所有病例均经胃镜及病理组织学检查确诊；另选择健康对照者60名作为对照组。采用AutoLumo A2000化学发光仪检测41例胃癌术前术后患者和60例健康对照者血清中的CEA、CA72-4、CA50、CA19-9、CA242和胃蛋白酶原PGⅠ、PGⅡ的水平并进行比较。采用SPSS17．0秩和检验进行统计分析。结果胃癌组术前CEA、CA19-9、CA72-4、CA242、CA50、PGI、PGⅡ、PGR中位数分别为：3．79ng／ml、17．85U／ml、3．50U／ml、14．52U／ml、17．62U／ml、32．81ng／ml、11．48ng／ml、3．35；胃癌组术后分别为：1．67ng／ml、7．76U／ml、1．73U／ml、6．30U／ml、7．57U／ml、20．56ng／ml、5．71ng／ml、2．94；对照组：1．53ng／ml、7．59U／ml、1．47U／ml、6．08U／ml、5．68U／ml、90．86ng／ml、14．85ng／ml、6．67；不同组间的血清CEA、CA19-9、CA72-4、CA242、CA50、PGⅠ、PGⅡ、PGR水平比较，差异均有统计学意义（Х^2分别为79．108、20．678、20．374、7．252、56．73、131．212、20．38、86．37，P〈0．05），进一步经Mann-Whitney秩和检验两两比较可知，胃癌术前亚组血清中的CEA、CA19-9、CA72-4、CA242和CA50水平显著高于对照组（Z值分别为-8．598、-4．425、-4．365、-2．000、-7．420，P〈0．05），胃癌术后亚组水平均显著低于术前亚组（Z值分别为-4．641、-2．383、-2．459、-2．399、-2．903，P〈0．05）；胃癌术前亚组血清中的PGⅠ、PGⅡ和PGR水平显著低于对照组（Z值分别为-10．309、-2．695、8．637，P〈0．05），术后亚组患者的PGⅠ水平显著低于术前亚组，差异有统计学意义（Z值为-2．109，P〈0．05）；术后亚组的PGⅡ、PGR水平虽然比术前亚组有所降低，但差异无统计学意义（Z值分别为-1．506、-0．838；P值分别为0．132、0．402）。结论7项血清标志物的检测有助于胃癌的术前诊断和术后监测。
Objective To investigate the clinical significance of serum CEA, CA19-9, CA724, CA242, CASO, PG Ⅰ and PGR （ PG Ⅰ/PG Ⅱ） in the Diagnosis of preoperative and postoperative gastric cancer. Methods Retrospective study. The levels of CEA, CA19-9, CA72-4, CA242, CA50, PC Ⅰ and PG Ⅱ in serum of 41 patients with gastrie cancer preoperative and postoperative and 60 healthy people were detected by AutoLumo A2000 chemiluminescence immunoassay and compared. Statistical analysis was performed using Rank-sum test by SPSS 17.0. Results The median of CEA, CA19-9, CA72-4, CA242, CA50, PGⅠ, PGⅡ and PGR in postoperative gastric cancer group were 3.79 ng/ml, 17.85 U/ml, 3.50 U/ml, 14. 52 U/ml, 17.62 U/ml, 32.81 ng/ml, 11.48 ng/ml, 3.35. The postoperative gastric cancer group were 1.67 ng/ml, 7. 76 U ml, 1.73 U/ml, 6. 30 U/ ml, 7.57 U/ml, 20. 56 ng/ml, 5.71 ng/ml, 2. 94. The healthy group were 1.53 ng / ml, 7.59 U/ ml, 1.47 U/ml, 6. 08 U/ml, 5.68 U/ml, 90. 86 ng/ml, 14. 85 ng/ml, 6. 67. There were statistical differences in the serum levels of CEA, CA19-9, CA72- 4, CA242, CAS0, PGⅠ , PGⅡ and PGR among different groups（chi-squared values were 79. 108, 20. 678, 20. 374, 7. 252, 56. 73, 131. 212, 20. 38, 86. 37, P 〈 0.05）. By the Mann-Whitney rank sum test, the serum levels of CEA, CA19-9, CA724, CA242 and CA50 in patients with preoperative gastric cancer were significantly higher than those in healthy controls （Z values were - 8. 598, - 4. 425, - 4. 365, - 2. 000, - 7. 420, P 〈 0.05 ）. The level of postoperative group was significantly lower than that of preoperative group （Z value were -4. 641, - 2. 383, - 2. 459, - 2. 399, - 2. 903, P 〈 0. 05）. The serum PG Ⅰ , PG Ⅱ and PGR levels in patients with preoperative gastric cancer were significantly lower than those in healthy controls （Z values were - 10. 309, - 2. 695, 8. 637, P 〈 0. 05）. The PG Ⅰ level in the postoperative group was significantly lower than that in the preoperative group （Z value was -2. 109, P 〈 0. 05 ）. PG Ⅱ , PGR levels of postoperative group were lower than those of preoperative group, but the difference were not statistically significant. （Z values were - 1. 506, -0. 838, P values were 0. 132,0. 402）. Conclusion The detection of the seven serum markers can help to preoperative diagnosis and postoperative monitoring of gastric cancer.
作者
康运凯
吴学炜
史小芹
苗拥军
鲁清月
渠海
付光宇
王敏
Kang Yunkai Wu Xuewei Shi Xiaoqin Miao Yongjun Lu Qingyue Qu Hai Fu Guangyu Wang Min(Department of Laboratory Medicine, People＇s Hospital of Zhengzhou, Zhengzhou 450053, Chin)
出处
《中华检验医学杂志》
CAS
CSCD
北大核心
2017年第1期60-63,共4页
Chinese Journal of Laboratory Medicine
基金
国家高技术研究发展计划（863计划）（2011AA02A101）
关键词
胃癌
血清标志物
术后监测
Gastric Cancer
Serum markers
Postoperative monitoring
