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血清CA724、CEA、CA242、CA199联合检验对胃癌的诊断价值分析
Analysis of the Diagnostic Value of Serum CA724, CEA, CA242, CA199 for Gastric Cancer

DOI: 10.12677/ACM.2020.108248, PP. 1655-1662

Keywords: 胃癌，糖类抗原724，癌胚抗原，糖类抗原242，糖类抗原199
Gastric Cancer, Carbohydrate Antigen 724, Carcinoembryonic Antigen, Carbohydrate Antigen 242, Carbohydrate Antigen 199

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Abstract:

目的：探讨血清CA724、CEA、CA242、CA199联合检验对胃癌的诊断价值。方法：选取2014年2月至2018年1月医院收治的158例胃癌患者作为研究组，依据TNM分期标准分为I~II期组84例和III~IV期组74例；因胃部或上消化道系统症状行胃镜检查90例患者作为对照组，其中胃上皮瘤变48例，慢性萎缩性胃炎42例。抽取2组受试对象肘静脉血5 mL，采用化学发光免疫分析检测血清糖类抗原724 (Carbohydrate antigen724, CA724)、糖类抗原199 (Carbohydrate antigen199, CA199)表达水平，放射免疫法检测糖类抗原242 (Carbohydrate antigen242, CA242)水平，酶联免疫吸附试验法检测癌胚抗原(Carcinoembryonic antigen, CEA)水平，根据血清CA724、CEA、CA242、CA199表达水平绘制ROC曲线，对各指标ROC曲线进行分析。结果：研究组CA724、CEA、CA242、CA199表达水平明显高于对照组[(12.77 ± 2.61), (28.36 ± 7.30), (33.36 ± 9.31), (47.31 ± 11.61) vs (8.58 ± 2.87), (20.64 ± 6.99), (24.87 ± 8.90), (40.51 ± 9.20)] (U/mL)，差异具有统计学意义(t = 11.697, 8.133, 7.018, 4.763, P < 0.05)；III~IV期胃癌患者血清CA724、CEA、CA242、CA199水平明显高于I~II期[(14.77 ± 1.57), (33.77 ± 4.55), (41.27 ± 5.96), (53.97 ± 7.04) vs (10.95 ± 1.95), (23.47 ± 5.68), (26.23 ± 5.03), (42.49 ± 9.11)] (U/mL)，差异具有统计学意义(t = 13.426, 12.483, 17.185, 12.617, P < 0.05)。Logistic回归分析显示，CA724、CEA、CA242、CA199是胃癌的独立危险因素，差异具有统计学意义(P < 0.05)；ROC曲线分析显示，血清CA724鉴别胃癌和对照组的AUC为0.864、CEA为0.784、CA242为0.743、CA199为0.692，联合检验为0.940；其中联合检验明显高于CA724、CEA、CA242、CA199单独检测(Z = 4.012, 5.648, 6.680, 7.193, P < 0.05)。结论：胃癌患者血清CA724、CEA、CA242、CA199显著升高，联合检验可提高胃癌的诊断价值，能够为胃癌治疗方案提供可靠依据。
Objective: To investigate the diagnostic value of serum CA724, CEA, CA242, CA199 for gastric cancer. Method: A total of 158 patients with gastric cancer who were treated in the hospital from February 2014 to January 2018 were selected as the study group. According to the TNM staging criteria, they were divided into the stage I~II group (84 cases) and the stage III~IV group (74 cases). 90 patients with systemic symptoms underwent gastroscopy were selected as the control group, which included 48 cases of gastric epithelioma and 42 cases of chronic atrophic gastritis. The expression levels of carbohydrate antigen 724 (CA724) and carbohydrate antigen 199 (CA199) in two groups were detected by chemiluminescence immunoassay, the carbohydrate antigen 242 (CA242) levels were detected by using radioimmunoassay, and the carcinoembryonic antigen (CEA) levels were detected by using enzyme-linked immunosorbent assay. The ROC curves were drawn according to the serum CA724, CEA, CA242, CA199 expression levels, and the ROC curves of each index were analyzed. Results: The expression levels of CA724, CEA, CA242, CA199 in the study group were significantly higher than those in the control group [(12.77 ± 2.61), (28.36 ± 7.30), (33.36 ± 9.31), (47.31 ± 11.61) vs (8.58 ± 2.87), (20.64 ± 6.99), (24.87 ± 8.90), (40.51 ± 9.20)] (U/mL), and the differences

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