Expressions of serum tumor markers in different early malignant tumors of digestive tract
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摘要:目的 比较不同早期消化道恶性肿瘤的血清肿瘤标志物癌胚抗原（CEA）、糖类抗原19-9（CA19-9）和糖类抗原72-4（CA72-4）的表达差异。方法 采用电化学发光免疫法测定56例早期食管癌患者、91例早期胃癌患者和100例早期结直肠癌患者血清CEA、CA19-9和CA72-4的水平，比较其阳性率和表达水平。结果 血清CEA在食管癌、胃癌、结直肠癌中的阳性率依次为16.1%、17.6%、37.0%，差异有统计学意义（P < 0.01）；血清CA19-9在食管癌、胃癌、结直肠癌中的阳性率依次为3.6%、13.2%和14.0%，差异无统计学意义（P>0.05）；血清CA72-4在食管癌、胃癌、结直肠癌中的阳性率依次为3.6%、23.1%、20.0%，差异有统计学意义（P < 0.05）。结直肠癌患者CEA水平最高，食管癌患者次之，胃癌患者最低，差异有统计学意义（P < 0.01）；结直肠癌患者CA19-9水平最高，胃癌患者次之，食管癌患者最低，差异有统计学意义（P < 0.01）；结直肠癌患者CA72-4水平最高，胃癌患者次之，食管癌患者最低，差异有统计学意义（P < 0.05）。结论 CEA、CA19-9、CA72-4这3种肿瘤标志物在食管癌、胃癌和结直肠癌中的阳性率和表达水平均存在差异，对于肿瘤诊断具有一定的价值。Abstract:Objective To compare the expressions of serum tumor markers such as carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9) and carbohydrate antigen 72-4 (CA72-4) in different early malignant tumors of digestive tract.Methods Electrochemiluminescence immunoassay was used to detect the serum levels of CEA, CA19-9 and CA72-4 in 56 patients with early esophageal cancer, 91 patients with early gastric cancer and 100 patients with early colorectal cancer, and the positive rates and expression levels were compared.The positive rates of serum CEA in esophageal cancer, gastric cancer and colorectal cancer were 16.1%, 17.6% and 37.0% respectively, and there were significant differences (P < 0.01).The positive rates of serum CA19-9 in esophageal cancer, gastric cancer and colorectal cancer were 3.6%, 13.2% and 14.0% respectively, but there were no significant differences (P>0.05).The positive rates of serum CA72-4 in esophageal cancer, gastric cancer and colorectal cancer were 3.6%, 23.1% and 20.0% respectively, and there were significant differences (P < 0.05).The level of CEA was the highest in colorectal cancer patients, followed by esophageal cancer patients with the intermediate level and gastric cancer patients with the lowest level, and there were significant differences (P < 0.01).The level of CA19-9 was the highest in colorectal cancer patients, followed by gastric cancer patients with the intermediate level and esophageal cancer patients with the lowest level, and there were significant differences (P < 0.01).The level of CA72-4 was the highest in colorectal cancer patients, followed by gastric cancer patients with the intermediate level and esophageal cancer patients with the lowest level, and there were significant differences(P < 0.05).Conclusion There are significant differences in the positive rates and expression levels of CEA, CA19-9 and CA72-4 in esophageal cancer, gastric cancer and colorectal cancer, which has a certain value for tumor diagnosis.
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表 1 CEA、CA19-9、CA72-4在食管癌、胃癌、结直肠癌中的阳性率比较
肿瘤类型 CEA CA19-9 CA72-4 阳性/例 阳性率/% 阳性/例 阳性率/% 阳性/例 阳性率/% 食管癌(n=56) 9 16.1 2 3.6 2 3.6 胃癌(n=91) 16 17.6** 12 13.2 21 23.1* 结直肠癌(n=100) 37 37.0**## 14 14.0 20 20.0 *# CEA: 癌胚抗原; CA19-9: 糖类抗原19-9; CA72-4: 糖类抗原72-4。
与食管癌比较, *P < 0.05, **P < 0.01; 与胃癌比较, #P < 0.05, ##P < 0.01。
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表 2 不同肿瘤患者CEA、CA19-9、CA72-4水平比较[中位数(最小值，最大值)]
指标 食管癌(n=56) 胃癌(n=91) 结直肠癌(n=100) CEA/(ng/mL) 2.9(0.8, 998.4) 2.0(0.2, 68.1)**## 3.1(0.3, 292.9)**## CA19-9/(ng/mL) 8.7(0.9, 674.7) 10.3(0.8, 324.7)**## 12.5(0.7, 193.8)**## CA72-4/(ng/mL) 1.2(0.5, 20.0) 1.8(0.6, 161.6)*# 1.9(0.9, 14.0)*# CEA: 癌胚抗原; CA19-9: 糖类抗原19-9; CA72-4: 糖类抗原72-4。
与食管癌比较, *P < 0.05, **P < 0.01; 与胃癌比较, #P < 0.05, ##P < 0.01。
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