摘要
目的:探讨胃癌患者血清CA72-4的参比值,进一步探明其临床意义。方法:应用电化学发光法(ECL)检测62例手术前胃癌患者血清CA72-4的含量,并与78例胃良性病变患者和96例健康人的结果作比较。选择根治术后的胃癌患者21例,于术后3周、2个月、6个月分别进行CA72-4检测,确立胃癌患者的血清CA72-4参比值。结果:胃癌组血清CA72-4水平显著高于健康对照组及良性病变组(P均<0.001),进展期胃癌患者的血清CA72-4水平及阳性检出率显著高于早期(P<0.01)。术后追踪显示,未复发组患者16例,术后血清CA72-4水平显著下降(P1<0.01,P2<0.001),术后2个月血清CA72-4含量均恢复正常(P>0.05)。复发组患者5例,术后3周,血清CA72-4水平虽明显下降(P<0.05),但术后2个月和6个月血清CA72-4浓度呈直线回升,其均值分别为健康对照组的9.2倍和12.8倍。与同期未复发组比较,差异有极显著性意义(P<0.01)。临床评价显示,当截止值CA72-4值抬高至≥16.5U/ml时,其阳性预示值和特异度分别为94.4%和97.4%,敏感度可达54.8%,提供鉴别诊断价值。结论:血清CA72-4是一项较敏感、较特异的胃癌血清肿瘤标志物之一。进行血清CA72-4含量的动态追踪,不仅有助于提高胃癌的检出率,而且对于评价治疗效果、监视病情发展、判断预后均有重要的临床意义。在胃癌的治疗中,血清CA72-4的浓度选择≥16.5U/ml作为参比值较为合理并认可。
Objective To explore the clinical significance of reference value of serum CA72-4 in gastric cancer patients. Methods 62 cases of application with ECL detection before surgery in patients with gastric cancer on serum CA724 content. Compared to 78 cases of gastric benign lesion patients and 96 cases of healthy individuals. Choice 21 cases of patients with gastric cancer after radical surgery to establish the reference value of serum CA72-4. In the first 3 weeks, 2 months and 6 months respectively. Results Gastric cancer group of serum CA72-4 level significantly higher than that of healthy controls and benign lesions group（ P 〈 0. 1 ）, ad vanced gastric cancer patients serum CA72-4 level and positive detection rate showed markedly higher than the early （P 〈0.01 ）. Follow-up shows, not in a group of patients with recurrence, 16 cases of postoperative serum CA72-4 level dropped significantly （P1 〈 0.01 ,P2 〈0.001 ）, after two months, serum CA72-4 content all returned to normal （ P 〉0.05）. A group of patients with recurrence in 5 cases, the first 3 weeks, serum CA72-4 level decreased obviously（P 〈 0.05）, but after two months and 6 months serum level of CA72-4 elevated dramatically, the mean average for health groups, expressed 9.2times and 12.8 times respectively, Compared with the rot relapsed group, the difference indicat very remarkable significance （ P 〈 0.01 ）. Clinical evaluation showed that cutting point CA72-4 value was up to 16.5 U/ml, its positive predic value and specificity indicated 94.3% and 97.4% respectively, the sensitivity up to 54.8%. Provides differential diagnostic value. Gonolusion Serum CA72-4 is a more sensitive and specific tumor markers of gastric cancer. In the serum CA72-4 levels of dynamic tracking, not only help to improve the detection rate of gastric cancer, but also to evaluate the efficacy of the treatment, monitoring the progress and prognosis possess important value clinically. In the treatment of gastric cancer, the concentration of serum CA72-4 or choose 16.5 U/ml as reference value might be reasonable and acceptable.
出处
《放射免疫学杂志》
CAS
2013年第3期333-336,共4页
Journal of Radioimmanology
