CEA、CA19-9与CA72-4用于诊断老年胃癌的临床价值研究

目的:探讨CEA、CA19-9以及CA72-4诊断老年胃癌的临床价值。方法:对192例经活检确诊为老年胃癌患者的血清CEA、CA19-9以及CA72-4水平进行分析,比较不同TNM分期老年胃癌患者的血清CEA、CA19-9以及CA72-4阳性率,并评价血清CEA、CA19-9以及CA72-4水平诊断老年胃癌的敏感性和特异性。结果:TNM 3期及4期的胃癌患者CEA以及CA19-9阳性率明显高于1期及2期胃癌患者,而TNM1-4期的胃癌患者CA72-4的阳性率都明显高于CEA以及CA19-9。以6.5 ng/m L、30U/m L以及4 ng/m L分别作为CEA、CA19-9以及CA72-4的上限临界值,其诊断老年患者的胃癌的敏感性分别为15.6%、19.3%以及29.2%,特异性分别为98.9%、97.2%以及98.0%,曲线下面积分别为0.59、0.62以及0.66。结论:CEA、CA19-9以及CA72-4对于诊断老年胃癌都有较好的特异性,但敏感性一般,尤其对于早期胃癌,CEA及CA19-9敏感性较差,CA72-4敏感性要优于二者。

Application of CEA, CA199 and CA72-4 in the Diagnosis and Evaluation of Disease Severity of Gastric Cancer in Elderly Patients

Objective:To investigate the clinical significance of CEA, CA19-9 and CA72-4 in the diagnosis and evaluation of disease severity of gastric cancer in elderly patients.Methods:The levels of CA72-4, CA19-9 and CEA in the serum of 192 patients with gastric cancer were analyzed, the positive rates of CEA, CA19-9 and CA72-4 were compared, and the sensitivity and specificity of CEA, CA19-9 and CA72-4 on the diagnosis of gastric cancer were evaluated.Results:The positive rates of CEA and CA19-9 were sigmificantly higher in elderly patients with gastric cancer at Stage 3 and stage 4 than those at stage 1 and stage 2. Meanwhile, the positive rates of CA72-4 were higher than CEA and CA19-9 at all four stages. The sensitivities of CEA, CA19-9 and CA72-4 were 15.6%, 19.3% and 29.2%, with a specificity of 98.9%, 97.2%and 98.0%, respectively, using cutoff values of 6.5 ng/mL, 30U/mL and 4 ng/mL, respectively. Areas under the curve for the three biomarker are 0.59, 0.62 and 0.66.Conclusion:CEA, CA19-9 and CA72-4 had high specificities for the diagnosis of gastric cancer in elderly patientsgastric cancer, but with mild sensitivities, especially at early stages. The sensitivity of CA72-4 was better than CEA and CA19-9.