联合检测 AFP、CEA、CA125 和 CA19-9 可提高胃癌诊断的灵敏度。
Combined use of AFP, CEA, CA125 and CAl9-9 improves the sensitivity for the diagnosis of gastric cancer.
机构信息
Department of Gastroenterology, The First Affiliated Hospital of Nanchang University; Jiangxi Institute of Gastroenterology & Hepatology, Nanchang, Jiangxi, 330006, China.
出版信息
BMC Gastroenterol. 2013 May 14;13:87. doi: 10.1186/1471-230X-13-87.
BACKGROUND
The detection of serum tumor marker becomes a common method for screening tumors. However, this method has not been widely used for routine gastric cancer screening. In this study we aimed to determine whether the combined use of tumor markers may increase the sensitivity for the diagnosis of gastric cancer.
METHODS
Serum AFP, CEA, CA125 and CA19-9 levels were measured in 149 patients with gastric cancer, 111 patients with benign gastric diseases and 124 healthy people, who visited the First Affiliated Hospital of Nanchang University from May 2011 to May 2012. Statistical analysis including receiver operating characteristic (ROC) curve, the area under the curve (AUC), and logistic regression analysis was performed to evaluate the diagnostic value of these markers on gastric cancer.
RESULTS
Serum levels of CEA, CA125, and CA19-9 in gastric cancer group were higher than that in the benign gastric disease group and the healthy control group (P <0.005). The sensitivity of AFP, CEA, CA125 and CA19-9 in the diagnosis of gastric cancer was 4.7-20.8% individually, and increased to 40.3% in combination. By using optimal cut-off value, the sensitivity of CEA, CA125, and CA19-9 for the diagnosis of gastric cancer was improved. Especially, the sensitivity of CEA increased to 58.4% and the sensitivity of combined use of four markers increased to 69.1%. The age and gender had no effects on the diagnostic value of these markers.
CONCLUSIONS
The determination and application of optimal cut-off values based on ROC curve and logistic regression analysis could improve the diagnosis of gastric cancer based on common tumor markers.
背景
血清肿瘤标志物的检测已成为肿瘤筛查的常用方法。然而，这种方法尚未广泛用于常规胃癌筛查。本研究旨在确定联合使用肿瘤标志物是否可以提高胃癌诊断的敏感性。
方法
对 2011 年 5 月至 2012 年 5 月南昌大学第一附属医院就诊的 149 例胃癌患者、111 例良性胃部疾病患者和 124 例健康对照者的血清 AFP、CEA、CA125 和 CA19-9 水平进行了检测。统计分析包括受试者工作特征（ROC）曲线、曲线下面积（AUC）和逻辑回归分析，以评估这些标志物对胃癌的诊断价值。
结果
胃癌组血清 CEA、CA125 和 CA19-9 水平均高于良性胃部疾病组和健康对照组（P<0.005）。AFP、CEA、CA125 和 CA19-9 单独诊断胃癌的敏感性分别为 4.7%～20.8%，联合应用敏感性提高至 40.3%。使用最佳截断值可提高 CEA、CA125 和 CA19-9 诊断胃癌的敏感性。特别是 CEA 的敏感性提高至 58.4%，四种标志物联合应用的敏感性提高至 69.1%。年龄和性别对这些标志物的诊断价值无影响。
结论
基于 ROC 曲线和逻辑回归分析确定和应用最佳截断值可提高基于常见肿瘤标志物的胃癌诊断。
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