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《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:

25卷

期数:

2019年03期

页码:

241-245

栏目:

临床医学

出版日期:

2019-05-20

文章信息/Info

Title:

Prognostic value of serum tumor biomarkers for lymph node metastasis of gastric cancer

文章编号:

1006-8147(2019)03-0241-05

作者:

白惠惠; 邓靖宇; 梁 寒

（天津医科大学肿瘤医院胃部肿瘤科，国家肿瘤临床医学研究中心，天津市“肿瘤防治”重点实验室，天津市恶性肿瘤临床医学研究中心，天津300060）

Author(s):

BAI Hui-hui;  DENG Jing-yu;  LIANG Han

（Department of Gastroenterology, Cancer Institute and Hospital, Tianjin Medical University, National Clinical Research Center for Cancer, Tianjin’s Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, China）

关键词:

肿瘤标志物; 胃癌; 淋巴结转移

Keywords:

tumor biomarkers;  gastric cancer;  lymph node metastasis

分类号:

R735.2

DOI:

-

文献标志码:

A

摘要:

目的：探讨4项血清肿瘤标志物水平对胃癌淋巴结转移的诊断价值。方法：回顾性分析病理活检确诊为胃癌的584例患者的血清肿瘤标志物水平，根据ROC曲线确定诊断胃癌淋巴结转移的Cut-off值，以提高肿瘤标志物对胃癌淋巴结转移诊断的敏感性。结果： （1）肿瘤直径、淋巴结送检数目及肿瘤浸润深度是影响胃癌患者淋巴结转移的危险因素；（2）胃癌淋巴结转移组患者血清肿瘤标志物水平显著高于无淋巴结转移组；（3）CA-724、CA-199、CA-242及CEA对胃癌淋巴结转移诊断的敏感性分别为64.4%、51.9%、41.9%、41.1%；特异性分别为92.9%、82.8%、86.6%、82.5%；（4）4项血清肿瘤标志物诊断胃癌淋巴结转移的Cut-off值分别为CA-724：6.69 U/mL、CA-199：17.36 U/mL、CA-242：17.20 IU/mL、CEA：3.12 μg/L；其中，单项检测时CA724或者联合检测3项以上血清肿瘤标志物诊断胃癌淋巴结转移的准确性较高；（5）4项肿瘤标志物联合检测对胃癌患者淋巴结转移判别的符合率达到76.6%。结论：血清肿瘤标志物可以用来预测患者是否存在淋巴结转移，CA-724对胃癌淋巴结转移的诊断价值较好，3项以上联合时可以提高诊断的敏感性。

Abstract:

Objective: To evaluate the prognostic value of serum tumor biomarkers for lymph node metastasis of gastric cancer. Methods: The diagnostic value of serum tumor biomarkers ( including CA-724, CA-199, CA-242 and CEA ) for lymph node metastasis in 584 patients with gastric cancer was analyzed retrospectively. Cut-off value of lymph node metastasis in gastric cancer was determined according to ROC curve, so as to improve the sensitivity of tumor biomarkers in the diagnosis of lymph node metastasis in gastric cancer. Results: The size of the tumor diameter, number of examined lymph nodes and the depth of tumor invasion were risk factors for lymph node metastasis in patients with gastric cancer. The level of serum tumor biomarkers in the gastric cancer patients in lymph node metastasis group was significantly higher than that in the non-lymph node metastasis group（P＜0.001）. It was found that the sensitivity of CA-724, CA-199, CA-242 and CEA to the diagnosis of lymph node metastasis in gastric cancer patients were 64.4%, 51.9%, 41.9% and 41.2%, respectively, while the specificity were 92.9%, 82.8%, 86.6% and 82.5%, respectively. The cut-off values of four serum tumor markers for the diagnosis of lymph node metastasis of gastric cancer were CA-724： 6.69 U/mL, CA-199：17.36 U/mL, CA-242:17.20 IU/mL, and CEA: 3.12 μg/L, respectively. Among them, CA-724, or more than three of the serum tumor biomarkers combined showed better diagnostic value for lymph nodes metastasis in gastric cancer patients. The coincidence rate of Fisher’s discriminant function was 76.6% when diagnosing lymph node metastasis of gastric cancer through levels of four serum tumor markers. Conclusion: The serum tumor biomarkers can be used to predict if there is a lymph node metastasis in gastric cancer patients, and CA724 shows better value for the diagnosis of gastric cancer lymph node metastasis. Combined detection of three or more serum tumor biomarkers may be more valuable to diagnose lymph node metastasis in gastric cancer patients.

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更新日期/Last Update: 2019-07-03