多肿瘤标志物蛋白芯片对食管癌诊断的临床评价

摘要

Objective : To evaluate the clinical value of multiple tumor markers protein biochip (C-12)in the diagnosis of esophageal carcinoma. Methods : The serum levels of 12 tumor markers (TMs) , including CA199, NSE, CEA, CA242, Ferritin, β-HCG, AFP, f-PSA, PSA, CA125, CAl53 and HGH, were measured in 37 esophageal carcinoma patients, 52 benign disease patients of digestive system and 65 normal controls. The most relevant TM and the combinations of TMs to the improvement of diagnosis were determined. Results : The positive rates of CA199, CEA, Ferritin, AFP, CA125 and C-12 in the esophageal carcinoma patients had significant difference compared with the benign disease patients and normal controls. The serum levels of CEA ,Ferritin, β-HCG, CA125 and HGH in the esophageal carcinoma patients had significantly higher than those in the benign disease patients and normal controls. Among all the 12 TMs, CEA was the single best TM and gave the sensitivity, specificity and validity of 40. 5 ％ , 98. 5％ and 77. 5 ％ for esophageal carcinoma ,respectively. The best combination of 4 TMs (CEA+ CA199+Ferritin+CA125) had not statistically significant comparied with C-12 and yielded a sensitivity of 75. 0％, a specificity of 90. 0％ and a vaLidity of 82. 5％. Conclusions: The multiple tumor markers protein biochip has a relatively high value in the diagnosis of esophageal carcinoma. The combination of 4 TMs (CEA + Ferritin+CA199+CA125) can replace 12 TMs of C-12 and may be the economical and effective in the diagnosis of esophageal carcinoma.%目的:探讨多肿瘤标志物蛋白芯片(C-12)对食管癌诊断的价值. 方法:应用C-12同时检测37例食管癌患者、52例消化系统良性疾病患者和65例健康体检者血清中CA199、CEA、AFP、CA125、Ferritin、β-HCG、HGH、CA153、CA242、PSA、f-PSA和NSE共12项肿瘤标志物的表达水平,筛选出与食管癌相关性最强的肿瘤标志物及标志物组合,并盲法验证最佳标志物组合的诊断价值. 结果:食管癌组与良性疾病组和正常对照组相比, CA199 、CEA、Ferritin、AFP、CA125和C-12的检测阳性率差异有统计学意义,食管癌组中CEA、Ferritin、β-HCG、CA125和HGH的表达水平显著高于良性疾病组和对照组.对食管癌诊断价值最高的肿瘤标志物是CEA,检测的敏感性、特异性和准确性分别为40.5%、98.5%和77.5%.不同标志物联合检测组合中,最佳4项组合CEA+Ferritin+CA199+CA125的敏感性、准确性最高,但与C-12相比,差异均无统计学意义.盲法验证最佳4项组合联合检测食管癌的敏感性为75.0%,特异性为90.0%,准确性为82.5%. 结论:C-12对食管癌具有较高的诊断价值,最佳4项组合(CEA+Ferritin+CA199+CA125)联合检测足以替代C-12的12项肿瘤标志物联合检测,可能是一种既经济又有效的诊断食管癌的标志物组合.