探究胃癌肿瘤标志物与中医辨证分型的相关性研究.pdfVIP

提 要 目的：通过观察与胃癌相关的多项肿瘤标志物阳性率和含量的变化，筛选出与胃 癌相关的肿瘤标志物，并探讨其与胃癌的临床分期和中医辨证分型的关系。方法：用 C-12 蛋白芯片检测系统测定 52 例胃癌患者和 30 例正常人血清中 12 项肿瘤标志物 （CA19-9、NSE、CEA、CA242、CA15-3、CA125、Ferritin、AFP、HGH、β-HCG、free-PSA 及PSA）的含量，并进行比较。结果：C-12蛋白芯片检测系统对胃癌有较高的灵敏度； 其中阳性率较高的前 5 种标志物（CA19-9、CA125、CEA、CA242、Ferritin）的阳性 率及含量显著高于对照组；其任何组合方式比单一指标检测胃癌的诊断率有明显的提 高；肿瘤标志物阳性率随着肿瘤临床分期的变晚而逐渐升高；各中医证型组的阳性率 虚证显著高于实证；CA19-9、CA125、CEA、CA242、Ferritin在各中医证型组及对照 组的阳性率和含量呈现出由实证向虚证逐渐升高的趋势，其中CA19-9、CA125、CEA、 CA242 表现为虚证的阳性率和含量均显著高于实证，但各证型之间仅几组有显著性差 异。结论：C-12 蛋白芯片检测系统联合检测多种肿瘤标志物可以明显提高胃癌诊断 的敏感性。CA19-9、CA125、CEA、CA242、Ferritin是经对比筛选出较有价值的标志 物组合。肿瘤标志物阳性率与胃癌临床分期有一定关系，对判断病情及预后有一定的 价值。CA19-9、CA125、CEA、CA242、Ferritin的阳性率和含量与中医辨证分型存在 一定关系，可为临床的辨证论治提供指导。 关键词 胃癌；肿瘤标志物；临床分期；中医辨证分型 Clinical Study on The Relation of Alteration of Tumor Markers Indication Levels of Primary Gastric Cancer With Its Dialectic Classification In Traditional Chinese Medicine Speciality: Internal Medicine of Integrated TCM and Western Medicine Author: Ding Hua Tutor: Professor Qi Yuanfu Abstract Objective: Through observing the alteration of tumor markers indication levels of primary gastric cancer, probe into the relation with dialectic classification in TCM Methods: Detect levels of 12 tumor markers of 30 normal people and 52 patients of primary gastric cancer by C-12.Results: The indication levels of CA19-9 、CA125、CEA、 CA242 、Ferritin among primary gastric cancer group were higher than that of normal(P0.05). The diagnostic rates are improved when we combine the five kinds ; The overall diagnostic rate of TM gets higher as the stage goes on. The differences in diagnostic rates between the four stages reached statisti