摘要目的 探讨肿瘤标志物CEA、CA19-9、CA72-4及CA242在胃癌诊断及预后判断中的应用价值.方法 回顾性分析2002-2007年间在北京肿瘤医院就诊的160例胃癌患者血清肿瘤标志物、临床病理参数以及预后资料.结果 160例胃癌患者中CEA、CA19-9、CA72-4及CA242的初诊阳性率分别为37.7％、26.7％、37.6％及21.3％,4种标志物联合检测阳性率为62.9％.CEA阳性与淋巴结转移有关(P=0.029);CA72-4阳性与脉管浸润及Ⅲ、Ⅳ期胃癌有关(P=0.039,P=0.011).CA19-9阳性和阴性患者中位生存期分别为17.0和32.0个月,CA72-4阳性和阴性患者中位生存期分别为14.8和37.5个月,差异有统计学意义(P＜0.01).多因素生存分析提示,CA72-4可以作为独立预后因子(P=0.012),CA72-4阳性患者的死亡危险系数是阴性患者的2.147倍.结论 肿瘤标志物CEA、CA19-9、CA72-4及CA242在胃癌患者的诊断和预后判断中有重要价值,联合检测可提高阳性率;其中CA72-4可以作为独立预后因子,CA19-9及CA72-4与胃癌患者预后相关.

abstractsObjective To investigate the clinical value of tumor markers CEA, CA19-9,CA72-4 and CA242 in the diagnosis and prognosis of patients with gastric caneer.Methods One hundred and sixty gastric cancer patients who had received treatment from 2002 to 2007 at the Beijing Cancer Hospital were retrospectively analyzed.Blood samples were taken from patients upon admission to the hospital,and CEA,CA19-9,CA72-4,CA242 levels were detected.Statistical analysis was performed to identify the clinical value of these tumor markers in diagnosis and prognosis.Results On initial diagnosis,the positive rates of CEA,CA19-9,CA72-4 and CA242 were 37.7％,26.7％,37.6％ and 21.3％,respectively,and the positive rate of combined detection was 62.9％.CEA was more frequently positive in patients with lymph node metastasis (P=0.029); CA72-4 was more frequently positive in patients with vascular involvement and advanced stage (P=0.039,P=0.011).Multivaraite analysis showed that CA72-4 was an independent prognostic factor (P=0.012).Patients with positive CA72-4 carried a 2.147-fold increased risk of death than those with negative CA72-4.Kaplan-Meier analysis showed that patients with positive CA19-9 or positive CA72-4 had worse survival than those with negative CA19-9 or CA72-4 (P=0.006,P=0.002).Conclusions Tumor markers including CEA,CA19-9,CA72-4 and CA242 have clinical significance and prognostic value in patients with gastric cancer.Combined detection of four tumor markers can increase the positive rate.CA72-4 is an independent prognostic factor.CA19-9 and CA72-4 are associated with the prognosis of patients with gastric cancer.