Combined use of AFP, CEA, CA125 and CAl9-9 improves the sensitivity for the diagnosis of gastric cancer.
Combined use of AFP, CEA, CA125 and CAl9-9 improves the sensitivity for the diagnosis of gastric cancer.
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DOI：
10.1186/1471-230x-13-87
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发表时间：
2013-05-14
影响因子：
2.4
通讯作者：
Lv NH
中科院分区：
文献类型：
--
作者：
He CZ;Zhang KH;Li Q;Liu XH;Hong Y;Lv NH
血清肿瘤标志物检测已成为肿瘤筛查的常用方法。然而，该方法尚未广泛用于常规胃癌筛查。本研究旨在探讨联合应用肿瘤标志物是否能提高胃癌诊断的敏感性。对2011年5月至2012年5月在南昌大学第一附属医院就诊的149例胃癌患者、111例胃良性疾病患者和124例健康体检者血清AFP、CEA、CA 125和CA 19 -9水平进行检测。采用受试者工作特征（ROC）曲线、曲线下面积（AUC）和Logistic回归分析评价这些指标对胃癌的诊断价值。胃癌组血清CEA、CA 125、CA 19 -9水平均高于良性胃病组和健康对照组（P <0.005）。AFP、CEA、CA 125、CA 19 -9单项检测对胃癌诊断的敏感性为4.7-20.8%，联合检测敏感性为40.3%。采用最佳临界值可提高CEA、CA 125、CA 19 -9诊断胃癌的敏感性。尤其是CEA的敏感性提高到58.4%，四项指标联合应用的敏感性提高到69.1%。年龄和性别对这些指标的诊断价值无影响。根据ROC曲线和Logistic回归分析确定最佳临界值，可提高常用肿瘤标志物对胃癌的诊断水平。
The detection of serum tumor marker becomes a common method for screening tumors. However, this method has not been widely used for routine gastric cancer screening. In this study we aimed to determine whether the combined use of tumor markers may increase the sensitivity for the diagnosis of gastric cancer. Serum AFP, CEA, CA125 and CA19-9 levels were measured in 149 patients with gastric cancer, 111 patients with benign gastric diseases and 124 healthy people, who visited the First Affiliated Hospital of Nanchang University from May 2011 to May 2012. Statistical analysis including receiver operating characteristic (ROC) curve, the area under the curve (AUC), and logistic regression analysis was performed to evaluate the diagnostic value of these markers on gastric cancer. Serum levels of CEA, CA125, and CA19-9 in gastric cancer group were higher than that in the benign gastric disease group and the healthy control group (P <0.005). The sensitivity of AFP, CEA, CA125 and CA19-9 in the diagnosis of gastric cancer was 4.7-20.8% individually, and increased to 40.3% in combination. By using optimal cut-off value, the sensitivity of CEA, CA125, and CA19-9 for the diagnosis of gastric cancer was improved. Especially, the sensitivity of CEA increased to 58.4% and the sensitivity of combined use of four markers increased to 69.1%. The age and gender had no effects on the diagnostic value of these markers. The determination and application of optimal cut-off values based on ROC curve and logistic regression analysis could improve the diagnosis of gastric cancer based on common tumor markers.