联合检测肿瘤标志物在老年人健康体检中的应用

摘要

Objective To evaluate the application of multiple tumor markers detection in health checkup of elderly people.Methods Totally 2 574 subjects undergoing health checkup from Novmber 2012 to November 2013 were divided into elderly group (408 cases) and adult group (2 166 cases).The levels of alphafetoprotein,carcinoembryonic antigen (CEA),carbohydrate antigen 199 (CA199),CA153,CA50,CA724,CA125,neuron-specific enolase (NSE),squamous cell carcinoma antigen,cytokeratin 19 fragment (CYFRA21-1),ferritin (Fer),prostate special antigen were detected.Abnormal increase of above indices was defined as positive result.The positive rates of above indices and diagnosis rate of malignant tumor during 6 months of follow-up were compared between groups and different genders.Results The positive rates of CA199,CA153,CA724,CA125,NSE,CYFRA21-1,Fer and CEA in elderly group were significantly higher than those in adult group [3.43％ (14/408) vs 0.92％ (20/2 166),1.23％ (5/408) vs 0.28％ (6/2 166),2.94％ (12/408) vs0.83％ (18/2 166),1.96％ (8/408) vs0.55％ (12/2 166),5.15％ (21/408) vs 0.37％ (8/2 166),3.92％ (16/408) vs0.60％ (13/2 166),5.88％ (24/408) vs0.42％ (9/2 166),0.98％ (4/408)vs0.18％ (4/2 166)] (P＜0.05).During 6 months of follow-up,there were5 cases (1.23％) in elderly group and 2 cases (0.09％) in adult group having malignant tumor,all with multiple tumor markers positive.The positive rates of tumor markers were not significantly different between male and female in both groups (P ＞0.05).Conclusion Tumor markers including CA199,CA153,CA724,CA125,NSE,CYFRA21-1,Fer and CEA can improve the detection rate of early malignant tumor in health-check-up of elderly people.%目的 评估联合检测肿瘤标志物在老年人健康体检中的应用价值.方法 选取2012年11月至2013年11月在吉林大学中日联谊医院进行体检的人群2 574名,根据年龄分为老年组(408名)及成人对照组(2 166名),检测血清甲胎蛋白、癌胚抗原、糖类抗原199、糖类抗原153、糖类抗原50、糖类抗原724、糖类抗原125、神经元特异性烯醇化酶(NSE)、鳞状细胞癌抗原(SCC)、细胞角蛋白19片段(CYFRA21-1)、铁蛋白、前列腺特异抗原(PSA),以超出正常参考值为阳性结果,并对出现阳性结果的受检者进行随访,以确定有无恶性肿瘤的发生.比较2组上述标志物阳性检出率及恶性肿瘤确诊率,并比较2组男女受检者肿瘤标志物的阳性检出率.结果 老年组糖类抗原199、糖类抗原153、糖类抗原724、糖类抗原125、NSE、CYFRA21-1、铁蛋白、癌胚抗原的阳性检出率明显高于成人对照组[3.43％(14/408)比0.92％ (20/2 166)、1.23％(5/408)比0.28％ (6/2 166)、2.94％(12/408)比0.83％(18/2 166)、1.96％(8/408)比0.55％(12/2 166)、5.15％(21/408)比0.37％ (8/2 166)、3.92％(16/408)比0.60％(13/2 166)、5.88％ (24/408)比0.42％ (9/2 166)、0.98％ (4/408)比0.18％ (4/2 166)],差异有统计学意义(P＜0.05).随访半年发现,老年组有5例(1.23％)患恶性肿瘤,成人对照组有2例(0.09％)患恶性肿瘤,均为多指标联合检测阳性.2组男女受检者肿瘤标志物的阳性检出率差异无统计学意义(P＞0.05).结论 糖类抗原199、糖类抗原153、糖类抗原724、糖类抗原125、NSE、CYFRA21-1、铁蛋白、癌胚抗原用于老年人健康体检,可提高早期恶性肿瘤的检出率.