上消化道恶性肿瘤患者血清CEA、CA199和SCC联合检测的研究【荐】.docVIP

上消化道恶性肿瘤患者血清CEA、CA199和SCC联合检测的研究 　　　作者：马江涛 刘春 吴文苑 　(广东省深圳市人民医院 518000) 　　关键词：上消化道,恶性肿瘤,血清 　　【摘要】　目的：探讨血清肿瘤标记物癌胚抗原(CEA)、唾液酸化岩藻戊糖(CA199)和鳞状上皮细胞癌抗原(SCC)联合检测对上消化道恶性肿瘤的临床诊断价值。方法：采用酶联免疫法(ELISA)测定90例上消化道恶性肿瘤患者(肿瘤组)和90例正常健康者(对照组)的三种肿瘤标志物(CEA、CA199、SCC)水平。 　　结果：肿瘤组三种血清标志物的水平显著高于对照组(p0.05);CEA和CA199在腺癌中具有较高的阳性率，SCC在鳞癌中具有较高的阳性率，相比较均有显著性差异(P0.05);在不同TNM临床分期患者中，CEA和CA199的阳性率为Ⅳ期Ⅲ期Ⅰ～Ⅱ期，相比较均有显著性差异(p0.05);SCC的阳性率Ⅰ～Ⅱ期显著低于Ⅲ期、Ⅳ期，相比较均有显著性差异(p0.05)，但Ⅲ期和Ⅳ期比较差异无统计学意义(p0.05)。结论：血清肿瘤标志物CEA、CA199和SCC在上消化道恶性肿瘤的诊断、病理类型的鉴别、临床分期的诊断上都有重要的临床价值。 　　Diagnostic value of combined determination of serum CEA, CA199, SCC in patients with upper gastric tract malignancies Ma Jiangtao, Liu Chun, Wu Wenyuan. Shenzhen peoples hospital, Guangdong 518000 　　[Abstract] Objective: To investigate the clinical value of combined measurement of CEA, CA199 and SCC in diagnosing upper gastric tract malignancies. Methods: enzyme-linked immunosorbent assay (ELISA) was used to detect CEA, CA199 and SCC in sera from 90 patients with cancer and 90 healthy control group. Result: The levels of CEA, CA199 and SCC in patient group were significantly higher than that in control group(p0.05); the positive rate of CEA and CA199 in patients with gland cancer was relatively higher, the positive rate of SCC in patients with squamous cell carcinoma was higher. The levels of these tumor markers in patients with upper gastric tract malignancies increased as the TNM stages advanced (p0.05), but SCC had no obvious difference between stage Ⅲ and Ⅳ(p0.05). Conclusions: CEA, CA199 and SCC, as serum tumor markers, were useful for diagnosis, pathological differentiation and clinical stage determination. 　　[Keywords] upper gastric tract malignancies; CEA; CA199; SCC 　　上消化道肿瘤包括食管癌、贲门癌及胃癌，是我国最常见的恶性肿瘤之一，上消化道肿瘤的发病率和致死率高，近年来呈上升趋势。目前对于上消化道肿瘤的确切病因和癌变机理仍不十分清楚，造成上消化道肿瘤预后差的一个重要原因是其早期发生隐匿，待患者自觉临床症状出现时往往肿瘤已发生了局部组织浸润和淋巴结的转移，大多数患者就诊时已属于中晚期而失去最佳治疗时机[1]。因此，对上消化道肿瘤的早诊断和早治疗是临床上亟待解决的问题。目前上消化道肿瘤的诊断多依靠影像学和组织细胞学等方法，而尚未发现特异性的肿瘤标志物用于上消化道肿瘤的诊断