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目的研究胃癌患者血清中甲胎蛋白(AFP)、癌胚抗原(CEA)、糖类抗原199(CA199)、糖类抗原153(CA153)、糖类抗原125(CA125)、糖类抗原724(CA724)的表达与病理学联合检查及其临床意义。方法选取1 543例健康体检者为对照组(Ⅰ组),1 675例胃病患者为胃肠道疾病组,其中胃良性疾病组患者885例(Ⅱ组),胃癌患者790例(Ⅲ组)。采用化学发光分析仪检测AFP、CEA、CA199、CA153、CA125、CA724浓度,并进行统计学分析。结果与Ⅰ组、Ⅱ组比较,Ⅲ组患者CEA、CA199、CA153、CA125、CA724水平明显升高;胃癌患者血清中CEA水平变化与CA199、CA724呈正相关;其血清中多项肿瘤标志物联合检测的灵敏度显著高于各单项指标检测的灵敏度;病理学检查结合血清中多项肿瘤标志物检测,对胃癌早期诊断的准确率显著高于单纯进行病理学检查,差异均有统计学意义(P<0.05)。结论血清中多项肿瘤标志物与病理学联合检查对提高胃癌患者鉴别诊断的准确性,减少漏诊率,具有十分重要的临床意义。
Objective To study the clinical significance of serum AFP, CEA, CA199, CA153, CA125, CA724 ) Expression and pathological examination and its clinical significance. Methods One hundred and seventy-three healthy volunteers were selected as the control group (group Ⅰ). One hundred and sixty-five patients with gastric diseases were gastrointestinal diseases, including 885 patients with gastric benign disease (group Ⅱ) and 790 patients with gastric cancer (group Ⅲ). The concentrations of AFP, CEA, CA199, CA153, CA125 and CA724 were detected by chemiluminescence analyzer and analyzed statistically. Results The levels of CEA, CA199, CA153, CA125 and CA724 in group Ⅲ were significantly higher than those in group Ⅰ and group Ⅱ. The changes of CEA levels in serum of patients with gastric cancer were positively correlated with those of CA199 and CA724. Combined detection of multiple tumor markers in serum Sensitivity was significantly higher than the sensitivity of the individual indicators of detection; pathological examination combined with serum tumor markers detection, the accuracy of early diagnosis of gastric cancer was significantly higher than the simple pathological examination, the difference was statistically significant (P < 0.05). Conclusion The combination of multiple tumor markers and pathology in serum is of great clinical significance in improving the accuracy of differential diagnosis of gastric cancer patients and reducing the rate of misdiagnosis.