消化系统肿瘤标记物联合检测的临床意义

目的探讨联合检测甲胎蛋白（AFP）、癌胚抗原（CEA）、糖类抗原19-9（CA19—9）辅助诊断消化系统恶性肿瘤的临床应用价值。方法对821例消化系统恶性肿瘤患者采用化学发光法检测血清AFP、CEA、CA19-9水平。结果恶性肿瘤组和良性肿瘤组AFP、CEA、CA19—9水平均明显高于健康对照组（t=2．345、2．224，均P〈0．05；t=2．785、2．749、2．897、2．865，均P〈0．01）；恶性肿瘤组AFP、CEA、CAl9-9水平均明显高于良性肿瘤组（t=2．445，P〈0．05；t=2．745、2．819，均P〈0．01）；肝癌患者AFP水平明显高于其它癌症（t=2．715、2．812、2．877、2．845、2．799，均P〈0．01）；肝癌患者CEA水平明显低于结、直肠癌和胰腺癌（t=2，775、2．801，均P〈0．01）；胰腺癌、胆道恶性肿瘤CA19—9水平明显高于其它癌症（t=2．733、2．851、2．788，均P〈0．01）；肝癌、胃癌、结直肠癌、胰腺癌、胆道恶性肿瘤3项联合检测阳性率分别为91．0％、90．0％、88．0％、90．0％、70．2％均高于单项检查阳性率85．0％、72．0％、67．5％、79．4％、55．3％（x^2=3．781、3．841、3．798、3．814、3．994，均P〈0．05）。结论三项肿瘤标记物均可作为消化系统恶性肿瘤的辅助诊断指标，联合检测可提高消化系统恶性肿瘤的检出率。

Clinical significance of combined Tests with malignant tumor in digestive system

Objective To investigate the clinical value of combined tests,including A-fetus protein(AFP)、cancer embryo agent(CEA),carbonhydrate agent 19-9(CA19-9)for the diagnosis of malignant tumors in digestive system.Methods Chemicalill-umination tests were used to detect serum levels of AFP,CEA and CA 19-9 in 821 patients with diseases of digestive system.Results The levels of AFP,CEA,CA19-9 in malignant group and the benign group were significantly higher than the control group(t=2.345,2.224,all P＜0.05;t=2.785,2.749,2.897,2.865,all P＜0.01＝;The levels of AFP、CEA、CA19-9 in malignant group were significantly higher than benign group (t=2.445,P＜0.05;t=2.745,2.819,all P＜0.01);The level of AFP in liver cancer group was significantly hisher than other groups(t=2.715,2.812,2.877,2.845,2.799,all P＜0.01);The level of CEA in hver cancer group was significantly lower in patients with liver colorectal cancer and pancreatic cancer(t=2.775,2.801,all P＜0.01);The level of CA19-9 in bile duct cancer group was significantly hisher than that of other cancers (t=2.733,2.851,2.788,all P＜0.01);The positive rates of liver、stomach、colorectal cancer、pancreatic cancer、bile duct cancer combined detection in three item were 91.0%,90.0,88.0%,90.0%,70.2%which were higher than the single check-positive rate of 85.0%,72.0%,67.5%,79.4%、55.3%(χ2=3.781,3.841,3.798,3.814,3.994,all P＞0.05).Conclusion The three tumor markers could be used as auxiliary diagnostic and ioint detection which could improve the detection rate in patients with malignant tumors of digestive system.