摘要
目的探讨食管癌患者血清中甲胎蛋白(AFP)、癌胚抗原(CEA)、糖类抗原125(CA125)、糖类抗原19-9(CA19-9)、铁蛋白(FERRITIN)测定在诊治及病情评估中的临床意义。方法选用1 028例健康体检者为对照组,1 047例食管癌患者为观察组,采用化学发光分析仪测定AFP、CEA、CA125、CA19-9、FERRITIN浓度与阳性率;比较各指标在肿瘤转移中的情况,并进行统计学分析。结果与对照组比较,观察组患者AFP、CEA、CA125、CA19-9、FERRITIN水平与阳性率显著升高;肿瘤转移患者的阳性率显著高于肿瘤未转移患者,差异均有统计学意义(P<0.05)。结论血清中多项肿瘤标志物测定可提高食管癌患者诊治的准确性、在肿瘤转移的评估中具重要的临床意义。
Objective To investigate the clinical detection significance of serum alpha fetoprotein(AFP),carcinoembryonic antigen(CEA),carbohydrate antigen 125(CA125),carbohydrate antigen 19-9(CA19-9) and ferritin(FERRITIN) in patients with esophageal cancer. Methods A total of 1 028 healthy subjects were selected as the control group and 1 047 patients with esophageal cancer were selected as the observation group. The concentrations and positive rates of AFP,CEA,CA125,CA19-9 and FERRITIN were measured by chemiluminescence analyzer. Various clinical index in tumor metastasis were compared and analyzed statistically. Results Compared to the control group,the levels and positive rates of AFP,CEA,CA125,CA19-9 and FERRITIN in the control group significantly increased. The positive rates of tumor metastasis patients were significantly higher than that of the patients without tumor metastasis,with the differences statistically significant(P <0. 05). Conclusion The determination of multiple tumor markers in the serum can improve the accuracy of the diagnosis,and it has important clinical significance in the evaluation of tumor metastasis.
引文
[1]Bagaria B,Sood S,Sharma R,et al.Comparative study of CEA and CA19-9 in esophageal,gastric and colon cancers individually and in combination(ROC curve analysis)[J].Cancer Biol Med,2013,10(3):148-157.
[2]Scarpa M,Noaro G,Saadeh L,et al.Esophageal cancer management:preoperative CA19-9 and CEA serum levels may identify occult advanced adenocarcinoma[J].World J Surg,2015,39(2):424-432.
[3]Haas M,Heinemann V,Kullmann F,et al.Prognostic value of CA19-9,CEA,CRP,LDH and bilirubin levels in locally advanced and metastatic pancreatic cancer:Results from a multicenter,pooled analysis of patients receiving palliative chemotherapy[J].J Cancer Res Clin Oncol,2013,139(4):681-689.
[4]黄国福,冷晓玲.三种血清学肿瘤标志物与食管癌分期的价值[J].标记免疫分析与临床,2014,21(4):380-382.
[5]唐菁,陈海霞,李笃军.CRP联合CEA、CA724检测对胃癌早期诊断及病情判断的临床应用价值[J].重庆医学,2013,42(1):63-65.
[6]卢晨,于在诚.食管癌相关血清肿瘤标志物的临床应用[J].安徽医科大学学报,2013,48(2):192-193.
[7]Wallin U,Rothenberger D,Lowry A,et al.CEA-a predictor for pathologic complete response after neoadjuvant therapy for rectal cancer[J].Dis Colon Rectum,2013,56(7):859-868.
[8]郭小林,张宁.肿瘤标志物的联合检测在肺癌诊断中的临床价值[J].中国当代医药,2013,20(21):35-36,38.
[9]Cui C,Niu GP.Multi-tumor markers combined detection in diagnosis of primary hepatocellular carcinoma[J].Modern Oncology,2015,23(9):1262-1265.
[10]Giannini EG,Sammito G,Farinati F,et al.Determinants of alphafetoprotein levels in patients with hepatocellular carcinoma:Implications for its clinical use[J].Cancer,2014,120(14):2150-2157.
[11]Lai Q,Avolio AW,Graziadei I,et al.Alpha-fetoprotein and modified response evaluation criteria in solid tumors progression after locoregional therapy as predictors of hepatocellular cancer recurrence and death after transplantation[J].Liver Transpl,2013,19(10):11O8-1118.
[12]Chen YY,Hsu WH,Hu HM,et al.A case of alpha-fetoproteinproducing esophageal adenocarcinoma[J].Kaohsiung J Med Sci,2013,29(2):106-110.
[13]Feng JF,Chen QX.Prognostic Significance of Preoperative CA72-4 in Patients with Esophageal Squamous Cell Carcinoma[J].Arch Iran Med,2013,16(6):338-342.
[14]Wang XB,Jiang XR,Yu XY,et al.Macrophagc inhibitory factor1acts as a potential biomarker in patients with esophageal squamouscell carcinoma and is a target for antibody-based therapy[J].Cancer Sci,2014,105(2):176-185.
[15]周永美.血清CA125、CA724、AFP联合检测在卵巢肿瘤鉴别诊断及临床分期中的应用[J].山东医药,2014,54(24):56-57.