血浆中四种肿瘤标志物和13C-尿素呼气试验对胃癌诊断的对比研究

Clinical application of four plasma tumor markers and 13C-urea breath test in diagnosis of patients with gastric carcinoma

    摘要
  • 摘要:
    目的 探讨胃癌患者血浆中胃泌素、瘦素、糖类抗原125（CA125）、糖类抗原72-4（CA72-4）水平和13C-尿素呼气试验（13C-UBT）对胃癌诊断的对比研究。
    方法 采用放射免疫分析法、酶免疫吸附测定法测定126例胃癌患者（其中Ⅰ~Ⅱ期32例、Ⅲ期57例和Ⅳ期37例）和60名正常对照者血浆中胃泌素、瘦素、CA125和CA72-4水平；用13C-UBT测定幽门螺旋杆菌（HP）感染的阳性率并进行比较性分析。
    结果 126例胃癌患者血浆中的胃泌素、CA125和CA72-4水平较60名正常对照者均明显升高（t分别为3.125、3.519、3.788，P均 < 0.01），并随疾病的严重程度而增加；血浆瘦素水平较60名正常对照者明显降低（t=3.524，P < 0.01），并随疾病的严重程度不断减少。与正常对照组相比，4种肿瘤标志物中CA72-4水平变化最明显。126例胃癌患者HP感染的阳性率为84.9%，其中，Ⅰ~Ⅱ期、Ⅲ期和Ⅳ期胃癌患者HP感染的阳性率分别为46.9%、89.5%和89.2%；60名正常对照者HP感染的阳性率为15.0%。
    结论 通过对126例胃癌患者血浆中胃泌素、瘦素、CA125和CA72-4水平的分析表明，血浆中的CA72-4水平诊断胃癌为最佳，其次为瘦素、CA125及胃泌素。因胃癌与HP的关系密切，故尽早使用13C-UBT测定HP感染和治疗HP感染者甚为重要。

     

    Abstract:
    Objective To investigate clinical value of plasma gastrin, leptin, carbohydrate antigen 125(CA125), carbohydrate antigen 72-4(CA72-4)and 13C-urea breath test(13C-UBT)in diagnosis of patients with gastric carcinoma.
    Methods Radioimmunoassay and enzyme immunosorbent assay were used to determine the plasma gastrin, leptin, CA125 and CA72-4 levels, and helicobacter pylori(HP)infection rate was determined by 13C-UBT.Compared all the determined results from 126 patients with gastric carcinoma (including 32 casesⅠ-Ⅱstage gastric carcinoma, 57 casesⅢstage gastric carcinoma and 37 casesⅣstage gastric carcinoma)and 60 normal controls.
    Results The plasma gastrin, CA125 and CA72-4 levels in 126 patients with gastric carcinoma were significantly higher(t=3.125, t=3.519, t=3.788, P < 0.01)but plasma level was significantly lower(t=3.524, P < 0.01)than those in 60 normal controls.Compared with normel controls, the result of CA72-4 was signeficantly changed.The plasma gastrin, CA125 and CA72-4 levels in 126 patients with gastric carcinoma were increased with the severity of gastric carcinoma, but plasma leptin was decreased. The HP infection rate in 126 patients with gastric carcinoma(84.9%)were significantly higher than those in 60 normal controls(15%).The HP infection rate in 32Ⅰ-Ⅱ, 57Ⅲand 37Ⅳstage gastric carcinoma were 46.9%, 89.5%and 89.2%respectively and were increased with severity of gastric carcinoma.
    Conclusion The determination of plasma CA72-4 was the best item for diagnosis of gastric carcinoma in four tumor markers, leptin, CA125 and gastrin followed.The determination of HP infection rate in gastric carcinoma by 13C-UBT played a considerable role for diagnosis and therapy.

     

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