肿瘤标志物联合检测在胃癌诊断中的应用价值 毕业论文.doc

肿瘤标志物联合检测在胃癌诊断中的应用价值 摘 要 目的：研究血清CEA）199、CA-199)、糖类抗原72-4（CA72-4）CA50)联合检测在胃癌诊治中的临床价值，以筛选理想的血清肿瘤标志物组合，提高临床诊断胃癌的灵敏度、诊断率。 方法：应用放射免疫分析（RIA）法和化学发光免疫分析法测定100例胃癌患者和46例非胃癌患者的血清中CEA、CA199、CA724、CA50四种肿瘤标志物的含量，并分析单个肿瘤标志物和五种标志物联检对胃癌的敏感性和特异性 结果：胃癌组CEA、CA199、CA724、CA50水平明显高于非胃癌组(P0．05)CEA、CA199、CA724、CA50CA199+CA724=58% CA199+CA50=50% CA724+CA50= 51%、CEA+CA199+CA724=88%、CEA+CA724+CA50=86% 、CEA+CA199+CA50= 83%、CA199+CA724+CA50=80% CEA+CA199+CA724+CA50=92%。两者联合检测较单一指标阳性率高，三者联合检测普遍较两者检测阳性率高，四者联合检测普遍较三者联合检测阳性率高(PO．05)。将四种肿瘤标志物联合测定，可使敏感性提高到92.00％，特异性达71.74％， 结果经统计学处理呈显著性差异(P0．05)，联合检测优于单项检测。 结论：血清中癌胚抗原(CEA)、糖类相关抗原50(CA-50)和糖类相关抗原19—9(CAl9-9)、糖类相关抗原72—4(CA72—4)四种血清肿瘤标志物在胃癌诊断中具有较高的辅助诊断价值，四项标志物联合检测有助于提高胃癌诊断的灵敏度及预后判断。 关键词：胃癌肿瘤标志物联合检测诊断THE DIAGNOSTIC VALUE OF COMBINED DETECTION WITH FOUR TUMOR MAKER FOR GASTRIC CANCERABSTRACT Objective:To research the clinical significance of serum tumor markers CEA、CA199、CA724、CA50 in the diagnosis of gastric cancer ,to filter the ideal serum tumor markers combination .SO as to improve the sensitivityand diagnosis ratio for gastric carcinoma． Methods:The serum concentration of tumor makers CEA,CA199,CA724,CA50 in the serum of 100 patients with gastric cancer and 46healthy individuals were measured by radioimmunoassay(RIA) and electrochemiluminescence method Meanwhile，analyzing the difference of a single tumor markers and the combined detection of four tumor markers in sensitivityand specificity for the gastric cancer． Results:The serum levels ofCEA,CA125,CA199,CA724 in patients with gastric cancer were obviously higher than those in the control group It has statistical significance(P0．05). The respective positive expression rates of CEA,CA199,CA724,CA50 52.00％、45.00％、47.00％、34.00％The positive rates of the unite test of index are as follows,CEA+CA199 is 79.00%、CEA+CA724 is 76%、CEA+CA50 is 63% CA199+CA724 is 58.00% CA199+CA50 is 50.00% CA724+CA50 is 51.00%、CEA+CA199+CA724 is 88.00%、CEA+CA724+CA5086.00% 、CEA+CA199+CA5083.00%、CA199+CA724+CA5080.00% CEA+C