血清CEA、CA125及CA72-4在胃癌腹膜转移中的临床意义

发布时间：2018-03-24 04:21

本文选题：肿瘤标志物　切入点：CEA　出处：《中国癌症杂志》2017年03期

【摘要】：背景与目的:胃癌腹膜转移多处于疾病终末期,但每种肿瘤标志物在胃癌腹膜转移中的临床意义仍不是很明确。该研究探讨血清肿瘤标志物CEA、CA125及CA72-4在胃癌腹膜转移中的诊断价值及其临床意义。方法:收集延边大学附属医院肿瘤科2008年1月—2013年12月间经影像学、手术和病理学等检查确诊、并接受静脉及腹腔灌注化疗的108例胃癌腹膜转移患者为研究对象,分别于确诊时、每次化疗前检测血清CEA、CA125及CA72-4,分析单独、2或3种肿瘤标志物同时检测在胃癌腹膜转移的诊断敏感性,并分析其与临床病理因素、化疗疗效及生存期之间的相关性。结果:在胃癌腹膜转移患者CEA、CA125和CA72-4的阳性率各为20.4%、46.3%和45.4%,联合CEA/CA125、CEA/CA72-4、CA125/CA72-4及CEA/CA125/CA72-4的阳性率分别为54.7%、52.8%、69.5%和79.6%,3种标志物联合检测明显优于单独检测(P0.05)。CEA、CA125和CA72-4水平均与ECOG分级存在相关性(P0.05)。CA125阳性与腹水有关(P0.001)。CA72-4阳性与卵巢转移相关(P0.05)。确诊时血清CEA、CA125和CA72-4阳性患者中位生存期短于CEA、CA125和CA72-4阴性的患者(P0.05)。在3周期化疗后3种肿瘤标志物较治疗前均下降,差异有统计学意义(P0.05)。化疗后CA125下降与腹水量的减少有明显相关性(P0.05)。确诊时肿瘤标志物阳性患者经化疗3个周期后转为阴性的患者生存期明显延长(P0.001)。结论:联合检测血清CEA、CA125和CA72-4可明显提高胃癌腹膜转移的诊断率。
[Abstract]:Background & objective: the peritoneal metastasis of gastric cancer is mostly at the end stage of the disease. However, the clinical significance of each tumor marker in peritoneal metastasis of gastric cancer is still not clear. This study was to investigate the diagnostic value and clinical significance of serum tumor marker CEACA125 and CA72-4 in peritoneal metastasis of gastric cancer. Methods: Yanbian was collected. Department of Oncology, University Hospital, January 2008-December 2013, 108 patients with peritoneal metastasis of gastric cancer, who were diagnosed by surgery and pathology and received intravenous and intraperitoneal infusion chemotherapy, were studied at the time of diagnosis. Serum CEA CA125 and CA72-4 were detected before each chemotherapy. The sensitivity of single tumor markers 2 or 3 to detect peritoneal metastasis of gastric cancer was analyzed simultaneously, and the diagnostic sensitivity was also analyzed with clinicopathological factors. Results: the positive rates of CEACA125 and CA72-4 in patients with peritoneal metastasis of gastric cancer were 20.46.3% and 45.4%, respectively. The positive rates of CEA / CA125CEA / CA72-4 / CA125CA72-4 and CEA/CA125/CA72-4 were 54.7% and 69.5% respectively. The levels of CA125 and CA72-4 in serum CEACA125 and CA72-4 were correlated with ECOG grade. The positive rate of CA125 and ascites was associated with ovarian metastasis. The median survival time of patients with positive serum CEACA125 and CA72-4 was shorter than that of patients with negative serum CEACA125 and CA72-4. The median survival time of patients with positive serum CEACA125 and CA72-4 was shorter than that of patients with negative CA72-4 and CEACA125 after 3 cycles of chemotherapy. The tumor markers were lower than those before treatment. The difference was statistically significant (P 0.05). There was a significant correlation between the decrease of CA125 and the decrease of ascites after chemotherapy. The survival time of the patients with positive tumor markers turned negative after 3 cycles of chemotherapy was significantly prolonged. Conclusion: combined examination can prolong the survival time of patients with positive tumor markers after 3 cycles of chemotherapy. Serum CEA CA 125 and CA72-4 can significantly improve the diagnosis rate of peritoneal metastasis of gastric cancer.
【作者单位】：延边大学附属医院肿瘤科;
【基金】：国家自然科学基金(81460366-H1617) 吉林省教育厅“十二五”规划项目(2015)
【分类号】：R735.2

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