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李健,乔世铭,史枫,等.联合检测血清CEA、CA199、TGFα和TGFβ₁在胃癌诊断中的价值[J].同济大学学报（医学版）,2015,36(3):21-26. [点击复制]
,et al.Combined detection of serum CEA, CA199, TGFα and TGFβ₁for diagnosis of gastric cancer[J].同济大学学报（医学版）,2015,36(3):21-26. [点击复制]

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联合检测血清CEA、CA199、TGFα和TGFβ₁在胃癌诊断中的价值
李健,乔世铭,史枫,叶朕雄,李奇,王世伟
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(同济大学附属杨浦医院普外科,上海 200090)

摘要:

目的检测血清CEA、CA199、TGFα和TGFβ₁在胃癌患者血清中的水平,探讨其在胃癌诊断中的临床价值。方法采用化学发光免疫法和酶联免疫吸附法测定60例胃癌患者血清CEA、CA199、TGFα和TGFβ₁水平,选择同期的20例健康体检者作为对照。分别于术前、术后对患者血清CEA、CA199、TGFα和TGFβ₁进行检测,对比胃癌患者手术前、后CEA、CA199、TGFα和TGFβ₁血清水平及术后变化规律。研究CEA、CA199、TGFα和TGFβ₁血清水平与临床因素(性别、年龄)和胃癌肿瘤特性(肿瘤大小、淋巴转移、远处转移、临床分期)的关系,观察其在不同TNM分期的变化。结果与正常对照组相比,胃癌患者血清CEA、CA199、TGFα和TGFβ₁含量均显著升高(P＜0.05)。胃癌组患者术后血清CEA、CA199、TGFα和TGFβ₁水平均显著低于术前,差异有统计学意义(P＜0.05)。术后7、14、28、56d,各血清指标逐渐下降,趋近正常水平。CEA、CA199、TGFα和TGFβ₁四项血清指标联合检测的阳性检出率(85.00%)显著高于单项检测的阳性检出率(38.33%,46.67%,53.33%,51.67%),差异有统计学意义(P＜0.05)。各血清指标CEA、CA199、TGFα和TGFβ₁的表达水平在胃癌患者的年龄、性别、肿瘤大小各因素方面无统计学差异,而TGFβ₁在有无淋巴结转移,有无淋巴结远处转移方面有显著性差异。各血清指标水平升高与胃癌的临床病理分期有密切的关系。结论血清CEA、CA199、TGFα和TGFβ₁水平与胃癌的发展程度相关,联合检测CEA、CA199、TGFα和TGFβ₁,有助于胃癌的早期诊断,提高胃癌的检出率。

关键词: 胃肿瘤血清糖类抗原199 癌胚抗原转化生长因子α 转化生长因子β₁

DOI：10.16118/j.1008-0392.2015.03.005

投稿时间：2014-12-28

基金项目:上海市卫生局项目(2010168)

Combined detection of serum CEA, CA199, TGFα and TGFβ₁for diagnosis of gastric cancer

(Dept. of General Surgery, Yangpu Hospital, Tongji University, Shanghai 200090, China)

Abstract:

Objective To investigate serum levels of CEA, CA199, TGFα and TGFβ₁ in patients with gastric cancer and the diagnostic value of combination of these 4 markers. Methods Serum CEA, CA199, TGFα and TGFβ₁ levels were measured by electric chemilluminescent assay or enzyme-linked immunosorbent assay in 60 patients with gastric cancer and 20 healthy subjects(control group). The serum markers were measured before and after operation in patients with gastric cancer. The relationship of serum tumor marker levels with gender, age, tumor size, lymph node metastasis, distant metastasis and clinical stages were analyzed. Results Compared with the control group, serum CEA, CA199, TGFα and TGFβ₁levels of gastric cancer patients were significantly increased(P＜0.05). The average levels of these markers of patients were significantly decreased at d7, d14, d28 and d56 after surgery(P＜0.05) and gradually returned to normal levels. The positive rate of combined detection of CEA, CA199, TGFα and TGFβ₁(85.0%) was significantly higher than that of single detection(38.3%,46.7%,53.3% and 51.7%), the difference was statistically significant(P＜0.05). Serum CEA, CA199, TGFα and TGFβ₁ levels were not correlated with age, gender and tumor size of patients, while correlated with clinicopathologic staging of gastric cancer; and serum TGFβ₁ level was correlated with lymph node metastasis and distant metastasis. Conclusion The levels of serum markers are related to gastric cancer development. Combined detection of CEA, CA199, TGFα and TGFβ₁might be helpful to early diagnosis of gastric cancer.

Key words: gastric cancer serum CEA CA199 TGFα TGFβ₁