• 上海醫(yī)科大學(xué)附屬中山醫(yī)院普外科(上海200032);

對(duì)162例經(jīng)手術(shù)和病理證實(shí)的胃癌患者血中的腫瘤標(biāo)記物CEA、CA19-9、CA72-4及幽門螺旋桿菌(HP)抗體進(jìn)行了測(cè)定，并以90例非腫瘤患者作為對(duì)照。結(jié)果： 胃癌組患者CEA、CA19-9及CA72-4的敏感性分別為24.0%、35.5%和21.9%，特異性分別為93%、77%和100%；陽性預(yù)測(cè)值(擬然比)分別為85.7%(3.24)、78.6%(1.52)和100%(0)，陰性預(yù)測(cè)值(擬然比)分別為39.9%(0.28)、33.0%(0.84)和38.9%(0.78)。CA19-9及CA72-4的含量隨腫瘤直徑的增大而明顯增高(Ｐ＜0.05)；當(dāng)腫瘤浸潤(rùn)深度增加時(shí)，CA19-9含量也顯著增高(Ｐ＜0.05)。在淋巴結(jié)轉(zhuǎn)移率＞50%或有遠(yuǎn)處轉(zhuǎn)移的患者，其CEA、CA72-4及CA19-9含量顯著增加；在腫瘤分化差的患者，這3種腫瘤標(biāo)記物的含量均明顯高于對(duì)照組(Ｐ＜0.05)。胃癌患者HP抗體陽性率為54%，對(duì)照組為22%(χ2＝23.319，Ｐ＜0.001；比數(shù)比為3.75，95%可信限為2.11～5.41，Ｐ＜0.01)。結(jié)論： CEA、CA19-9及CA72-4在胃癌的診斷性試驗(yàn)中特異性高而敏感性低；CEA、CA19-9及CA72-4的含量與腫瘤直徑、浸潤(rùn)深度、淋巴結(jié)和遠(yuǎn)處的轉(zhuǎn)移及腫瘤的分化程度密切相關(guān)；HP的感染與胃癌的發(fā)生有一定關(guān)系。

引用本文： 牛偉新,盛衛(wèi)忠,秦新裕. 胃癌患者CEA、CA19-9、CA72-4及幽門螺旋桿菌抗體測(cè)定及其臨床意義. 中國(guó)普外基礎(chǔ)與臨床雜志, 1999, 6(3): 162-165. doi: 復(fù)制

1. Talley NJ, Zinsmeister AR, Weaver A, et al. Gastric adenocarcinoma and Helicobacter pylori infection. National Cancer Institute, 1991; 83(23)∶1734.
2. Forman D, Newell DG, Fullerton F, et al. Association between infection with Helicobacter pylori and risk of gastric cacner: evidence from a prospective investigation. BMJ, 1991; 302(1)∶1302.
3. Gold P, Freedman SO. Specific carcinoembryonic antigens of the human digestive system. J Exp Med, 1965; 122(3)∶467.
4. Jalanko H, Kuusela P, Roberts P, et al. Comparison of a new tumour marker, CA199 TM, with AFP and CEA in patients with upper gasrointestinal diseases. J Clin Pathol, 1984; 37(2)∶218.
5. Quentmeier A, Schlag P, Geisen HP, et al. Evaluation of CA125 as a tumor marker for gastric and colorectal cancer in comparison to CEA and CA199. Eur J Surg Oncol, 1987; 13(3)∶197.
6. Joypaul B, Browning M, Newman E, et al. Comparison of serum CA724 and CA199 levels in gastric cancer patients and correlation with recurrence. Am J Surg, 1995; 169(6)∶595.
7. Shimizu N, Wakatsuki T, Murakami A, et al. Carcinoembryonic antigen in gastric cancer patients. Oncol, 1987; 44(4)∶240.
8. Ikeda Y, Oomori H, Koyanagi N, et al. Prognostic value of combination assays for CEA and CA199 in gastric cancer. Oncol, 1995 ; 52(6)∶483.
9. Maeta M, Yoshioka H, Shimizu T, et al. Carbohydrate antigen CA199 in tissues and sera from patients with gastric cancer. Oncol, 1990; 47(3)∶229.
10. Kornek G, Depisch D, Temsch EM, et al. Comparative analysis of cancerassociated antigen CA195, CA199 and CEA in diagnosis, followup and monitoring of response to chemotherapy in patients with gastrointestinal cancer. J Cancer Res Clin Oncol, 1991; 117(5)∶493.
11. Gupta M, Arciaga R, Bocci L, et al. Measurement of a monoclonalantibodydefined antigen (CA199) in the sera of patients with maliganant and nonmaliganat diseases. Cancer, 1985; 56(2)∶277.
12. Nomura A, Stemmermann G, Chyou P, et al. Helicobacter pylori infection and gastric carcinoma among Japanese Americans in Hawaii. New Engl J Med, 1991; 325(16)∶1132.
13. Parsonnet J Friedman GD, Vandersteen DP, et al. Helicobacter pylori infection and the risk of gastric carcinoma. New Engl J Med, 1991; 325(16)∶1127.
14. Blaser M, PerezPerez GI, Kleanthous H, et al. Infection with Helicobacter pylori strains possessing CagA is associated with an increased risk of developing adenocarcinoma of the stomach. Cancer Res, 1995; 55(10)∶2111.
15. The Eurogast Study Group. An international association between Helicobacter pylori infection and gastric cancer. Lancet, 1993; 341(8857)∶1359.
16. Kikuchi S, Wada O, Nakajima T, et al. Serum antiHelicobacter pylori antibody and gastric carcinoma among young adults. Cancer, 1995; 75(12)∶2789.
  1. 1. Talley NJ, Zinsmeister AR, Weaver A, et al. Gastric adenocarcinoma and Helicobacter pylori infection. National Cancer Institute, 1991; 83(23)∶1734.
  2. 2. Forman D, Newell DG, Fullerton F, et al. Association between infection with Helicobacter pylori and risk of gastric cacner: evidence from a prospective investigation. BMJ, 1991; 302(1)∶1302.
  3. 3. Gold P, Freedman SO. Specific carcinoembryonic antigens of the human digestive system. J Exp Med, 1965; 122(3)∶467.
  4. 4. Jalanko H, Kuusela P, Roberts P, et al. Comparison of a new tumour marker, CA199 TM, with AFP and CEA in patients with upper gasrointestinal diseases. J Clin Pathol, 1984; 37(2)∶218.
  5. 5. Quentmeier A, Schlag P, Geisen HP, et al. Evaluation of CA125 as a tumor marker for gastric and colorectal cancer in comparison to CEA and CA199. Eur J Surg Oncol, 1987; 13(3)∶197.
  6. 6. Joypaul B, Browning M, Newman E, et al. Comparison of serum CA724 and CA199 levels in gastric cancer patients and correlation with recurrence. Am J Surg, 1995; 169(6)∶595.
  7. 7. Shimizu N, Wakatsuki T, Murakami A, et al. Carcinoembryonic antigen in gastric cancer patients. Oncol, 1987; 44(4)∶240.
  8. 8. Ikeda Y, Oomori H, Koyanagi N, et al. Prognostic value of combination assays for CEA and CA199 in gastric cancer. Oncol, 1995 ; 52(6)∶483.
  9. 9. Maeta M, Yoshioka H, Shimizu T, et al. Carbohydrate antigen CA199 in tissues and sera from patients with gastric cancer. Oncol, 1990; 47(3)∶229.
  10. 10. Kornek G, Depisch D, Temsch EM, et al. Comparative analysis of cancerassociated antigen CA195, CA199 and CEA in diagnosis, followup and monitoring of response to chemotherapy in patients with gastrointestinal cancer. J Cancer Res Clin Oncol, 1991; 117(5)∶493.
  11. 11. Gupta M, Arciaga R, Bocci L, et al. Measurement of a monoclonalantibodydefined antigen (CA199) in the sera of patients with maliganant and nonmaliganat diseases. Cancer, 1985; 56(2)∶277.
  12. 12. Nomura A, Stemmermann G, Chyou P, et al. Helicobacter pylori infection and gastric carcinoma among Japanese Americans in Hawaii. New Engl J Med, 1991; 325(16)∶1132.
  13. 13. Parsonnet J Friedman GD, Vandersteen DP, et al. Helicobacter pylori infection and the risk of gastric carcinoma. New Engl J Med, 1991; 325(16)∶1127.
  14. 14. Blaser M, PerezPerez GI, Kleanthous H, et al. Infection with Helicobacter pylori strains possessing CagA is associated with an increased risk of developing adenocarcinoma of the stomach. Cancer Res, 1995; 55(10)∶2111.
  15. 15. The Eurogast Study Group. An international association between Helicobacter pylori infection and gastric cancer. Lancet, 1993; 341(8857)∶1359.
  16. 16. Kikuchi S, Wada O, Nakajima T, et al. Serum antiHelicobacter pylori antibody and gastric carcinoma among young adults. Cancer, 1995; 75(12)∶2789.