血清肿瘤标志物在五种消化系统肿瘤诊断中的价值

吴伟晴　廖淑萍　林小兰　黄琼芳　吴炎

血清肿瘤标志物在五种消化系统肿瘤诊断中的价值

吴伟晴1廖淑萍1林小兰1黄琼芳1吴炎2

目的评价12种血清肿瘤标志物在不同消化系统肿瘤中的临床诊断价值。方法研究对象包括直肠癌、结肠癌、胃癌、肝癌以及胰腺癌五种消化系统肿瘤患者共149例，健康人群299例。流式荧光发光法检测12种肿瘤标志物（AFP、CA125、CYFRA 21、CA242、CEA、f-βHCG、NSE、t-PSA、f-PSA、CA19-9、SCCA、CA15-3）在这5种消化系统肿瘤中的水平。结果CYFRA21与CA19-9在所有肿瘤患者中检出率相对较高；CA19-9以及CA242在胰腺癌中的灵敏度极高；CYFRA21+CA242+CEA+NSE+CA19-9联合检测可有效提高直肠癌的检出率，CA125+CYFRA21+CA242+CEA+NSE+CA19-9联合检测可提高胰腺癌的检出率，CA125+CYFRA21+CA19-9联合检测可提高胃癌的检出率，CA242+CEA+NSE+CA19-9+ CYFRA 21联和检测可提高结肠癌的检出率，AFP+CA125+CYFRA21+CA242+CEA+NSE+CA 19-9联合检测可提高肝癌的检出率。结论多种标志物适当组合之后联合检测可有效提高特定肿瘤的检出率，具有一定的临床参考价值。

血清肿瘤标志物；消化系统肿瘤；联合检测；诊断

【Abstract】Objective To evaluate the diagnostic value of jointdetection of 12 tumormarkers in digestive system tumors.Methods Onehundred and forty-nine patients including rectal cancer，colon cancer，gastric cancer，liver cancer and pancreatic cancer and 299 healthy subjectswere included in the study，and flow cytometry fluorescencemethodwasused to detect12 tumormarkers（AFP，CA125，CYFRA21，CA242，CEA，f-βHCG，NSE，t-PSA，f-PSA，CA 19-9，SCCA，CA15-3）in the serum samp les.Results The detection rates of CYFRA21 and CA19-9 were higher in 5 kindsof tumors；The detection rate of CA 19-9 and CA242 w ere higher in pancreatic cancer；jointdetection of CYFRA21+CA242+CEA+NSE+CA19-9 increased the detection rate of rectal cancer；jointdetection of CA 125+CYFRA 21+CA 242+CEA+NSE+CA19-9 increased the detection rate of pancreatic cancer；jointdetection of CA125+CYFRA21+CA19-9 increased the detection rate of gastric cancer，jointdetection of CA242+CEA+NSE+CA 19-9+CYFRA21 increased the detection rate of colon cancer；jointdetection of AFP+CA125+CYFRA21+CA242+CEA+NSE+CA 19-9 increased the detection rate of liver cancer.Conclusion Joint detection of differentmakers could increase the detection rate in certain tumorandm ightprovide valuable clinicalproof for the diagnosisof digestive system tumors．

【Keywords】Serum tumormarker；Digestive system tumor；Jointdetection；Diagnosis

消化系统肿瘤主要包括肝癌、胃癌、食管癌、结直肠癌和胰腺癌等，是死亡率相对较高的肿瘤大类之一，且消化系统肿瘤一旦出现临床症状，大多已届晚期。在我国每年因为肿瘤死亡的病例中有65%以上是消化系统肿瘤，患者5年生存率不足30%［1-2］。因此，消化道肿瘤的早发现、早诊断、早治疗是肿瘤防治研究中的重点课题。目前的研究已经积累了大量临床病理与影像资料作为消化系统肿瘤的指标，但总体来说其时效性不甚理想，在临床检查上具有一定局限性，因此早期诊断效果欠佳［3］。……