肿瘤标志物在胃癌浸润深度评估及治疗决策中的价值

摘要

目的 探讨胃癌患者术前血清肿瘤标志物癌胚抗原、癌抗原125、癌抗原19-9和甲胎蛋白水平与胃癌病变浸润深度的相关性及判断患者是否符合内镜下黏膜下剥离术(endoscopic submucosal dissection,ESD)适应证的临床价值.方法 采用电化学发光免疫分析法检测107例胃癌患者术前血清肿瘤标志物癌胚抗原、癌抗原125、癌抗原19-9和甲胎蛋白水平,并应用受试者工作特性曲线及其曲线下面积分析各指标在判断胃癌病变浸润深度中的价值.结果 B组术前血清肿瘤标志物癌胚抗原、癌抗原125、癌抗原19-9水平均较A组明显升高(P<0.05);术前血清肿瘤标志物癌胚抗原、癌抗原125、癌抗原19-9联合检测在预测胃癌患者是否可行ESD治疗的准确度达75.70％.结论 术前血清肿瘤标志物癌胚抗原、癌抗原125、癌抗原19-9联合检测对于预测胃癌患者病变浸润深度具有较高的敏感度,对于判断该类患者是否可行ESD治疗具有一定的参考价值.%Objective To investigate the correlation between serum levels of carcinoembryonic antigen (CEA), carbohydrate antigen 125, carbohydrate antigen 19-9 and alphafetoprotein (AFP) in patients with gastric cancer and the depth of invasion of gastric cancer, and to evaluate the clinical value of endoscopic submucosal dissection (ESD) in patients with gastric cancer. Methods The serum levels of carcinoembryonic antigen, carbohydrate antigen 125, carbohydrate antigen 19-9 and AFP in 107 patients with gastric cancer before operation were detected by electrochemiluminescent immunoassay. The value of each index in judging the depth of invasion of gastric cancer was retrospectively analyzed by using the working characteristic curve and the area under the curve. Results The levels of serum tumor markers CEA, carbohydrate antigen 125, carbohydrate antigen 19-9 AFP in group B were significantly higher than those in group A (P<0. 05). The accuracy of combined detection of serum tumor markers CEA, carbohydrate antigen 125 and carbohydrate antigen 19-9 in predicting the feasibility of ESD treatment in patients with gastric cancer was 75. 70％. Conclusion Combined detection of serum tumor markers CEA, carbohydrate antigen 125 and carbohydrate antigen 19-9 has a high sensitivity for predicting the depth of invasion of gastric cancer patients, and has a certain reference value for judging whether ESD treatment is feasible for such patients.