The Value Of CEA,CA19-9,CA72-4 Combine Examine In Gastric And Large Intestine Carcinoma Diagnosis

Gastric and large intestine carcinoma are the most frequent malignant tumor of digestive system in the range of the whole world,with high fatality rate and threaten to the health of human beings.In the past few years,the incidence of large intestine carcinoma has the tendency of rising gradually,as well as the age of onset tendency of being younger.The stage of absence of symptoms and precancerous lesion is long,often missing the best opportunity of treatment.Therefore,the option of high risk group become the significant link of early discovery and early diagnosis.Besides fibro-endoscope,the detection of tumor markers in the serum has becoming the significant reference index for the diagnosis of gastric carcinoma and large intestine carcinoma in clinic.Metabolism cause glycoprotein and glycolipid on cell surface changing.It happens during the transformation from normal cell to malignant ones,presenting the elevation of glycoantigen on the surface of tumor cells.These antigens fall into body fluid,recognized by monoclonal antibodies of tumor.As tumor markers in serum,to make para-diagnosis.At present,although we didn't find tumor marker to gastric and large intestine carcinoma which has enough high sensitivity and specificity.Recently,more and more researchers begen to study the value of tumor markers to gastric and large intestine carcinoma.They use combining detection of multi-index to improve detection rate of carcinoma, which redeems the deficiency of single detection.In the paradiagnosis of gastric and large intestine carcinoma,CEA,CA19-9,CA72-4 are the most frequent tumor makers.This article analyzes 116 example of gastric and large intestine carcinoma patients in our hospital admitting and the outpatient service,to discusse the diagnosis value of single detection and the union detection for CEA,CA19-9,CA72-4 in circumferen ce blood,for gastric and large intestine carcinoma.Thus,it provides important advisory opinion for clinician in the early discovery and diagnosis of gastric and large intestine carcinoma.[Object of study]The observation group we choosed are 116 examples of gastrointestinal tract carcinoma patients from outpatients clinic and inpatients hospital in September,2006 to in March,2008,with male 72 examples,female 44 examples,age 29~87 years old,average age 56.4 years old;and gastric carcinoma 46 examples,large intestine carcinoma 70 examples.All patients are confirmed after clinical, fiberoptic endoscope and as well as pathology or cytology.The International Union Against Cancer (UICC) TNM standard is carried on according to 2003 clinical by stages,withⅠstage 11 examples,ⅡTime 25 examples,Ⅲstage 36 examples,Ⅳstage 44 examples;the gastro-intestinal tract atypical proliferation patholog ical change patient 20 examples,the male 12 examples,the female 8 examples,the age 41~72 years old,the average age 56.1 years old,confirmed by fiberoptic endoscope and pathology;Gastro- intestinal tract benign pathological change patient 40 examples, male 24 examples,female 16 examples,age 28~76 years old,average age 52.9 years old;And gastritis (including shallow table,erosion, atrophy) 11 examples,the gastric ulcer 6 examples,the gastric polyp 3 examples,the gastric yellow pigment lump 3 examples,the inflammatory bowel disease (including colitis gravis,Crohn's disease) 11 examples,colonic polyp/porctopolypus 6 examples, confirmed by fiberoptic endoscope and pathology.The normal control group is 40 example health examination adult in the same time,male 24 examples,female 16 examples,Age 23~74 years old,average age 53.4 years old.Sex,age are nonsignificance diff- erence (P > 0.05).[Methods]1.sample collection:all of the patient shoud be collected the veinal blood 3ml on an empty stomach,which shoud be centrifuged 3000r/min 15min at the condition of 4℃,then we separate all of the serums into 0.5～1ml,set them in the Ependorff tubes,and preserve them in the icebox at -20℃waiting to be examed.All the reagents and samples shoud be poised to the room temperature to exam. 2.Reagents and apparatuses:the reagent of CEA,CA 19-9, AXSYM system automatic immune analytic apparatus are offered by Abbtt company;the reagent of CA72-4,Elecsys 2010 electroche miluminescence automatic immune analytic apparatus are offered by Roche company;LDZ4-0.8 lowspeeded centrifuged machine is produced by curatorial centrifuged machine factory;ULT1386- 3-V14 vertical exceed low temperature refrigeratory is produced by Revco Scientific company.3.Operation procedure:We adopted the AXSYM system automatic immune analytic apparatus to mensurated the single expressive circs of CEA,CA19-9 apart.And we also adopted the Elecsys 2010 electric chemic radiant automatic immune analytic apparatus to mensurated the expressive circs of CA72-4.The course of operation was strict with the illumination.4. The diagnostic standard:The masculine criterion of each tumor markers is on the basis of the borderline reference according to the reagent,CEA > 8.99ng/ml,CA19-9 > 37.01u/ml,CA72-4 > 6.91u/ml.5.Combinational modus:Combine this three tumor markers as follow types to analyze:CEA + CA19-9,CEA + CA72-4,CA19-9 + CA72-4,CEA + CA19-9 + CA72-4.6. Statistics analyze:This group of data adopt SPSS 10.0 statistical software to analyze.[Result]1.Single mV and masculine rate of CEA,CA19-9,CA72-4 in the serum of Gastric and large intestine carcinoma patients,are both higher than gastrointestinal atypical hyperplasia group,benign lesion group and normal control group,with (P<0.01～0.05),while nonsignificant difference to last 3 group (P>0.05).CEA mV is significantly higher in large intestine carcinoma group than in gastric carcinoma group (P<0.01).Between the tow group,the comparison of CA19-9 and CA72-4 mV is nonsignificant diff- erence (P>0.05).2.The sensitinity of the single test of Serum CEA,CA19-9 and CA72-4 is not high,but as the increasing of the clinical stages,the sensitinity of the single tumor markers is ascend gradually.The difference between theⅣstage and theⅠ,Ⅱstage is significant (P<0.01～0.05).That is to say,the level of the single test of theⅣstage has some value to determine the pathogenetic condition of tumor.In addition,the specificity of the single test for all of this three symbols is above 95%.3.In this article,the masculine rate of the single test of the Serum CEA,CA19-9 and CA72-4 is 39.1%～47.1% to the diag- nostic of gastric and large intestine carcinoma.The high sens itinity in the group of gastric carcinoma is CA72-4,and in the group of large intestine carcinoma is the CEA.Moreover,the sensitinity of two or three join examine can reach 58.7%～76.1%.Expect that the CEA + CA19-9 in group of gastric carcinoma compared with single examine,CEA + CA72-4 with single examine of CA72-4 and CEA + CA72-4 with single examine of CEA have no statistics difference,and the sensitivity of other 2 or 3 combine examine compared with single examine is inceasing,with significant difference (P<0.01～0.05).In 4 modus,between 2 and 3 item combine detection,there is no statistics difference (P>0.05),with specificity decreasing,but no statistics difference (P>0.05).4.Examining CEA,CA19-9,and CA72-4 at the same time,the sensitivity can achieve to 72.4%,to compare with the single exam ascensusing obviously (P<0.01);to compare with both item exam,the sensitivity also ascensusing about 10%.to hint that three item exam obviously elevate the diagnosis rate to gastric and large intestine carcinoma,to be the first selection tumor marker combination for gastric and large intestine carcinoma.However,to consider economic reason,we can also choose firstly the hing sensitivity combine of CA19-9 + CA72-4 in the gastric carcino- ma,while CEA+ CA19-9 in large intestine carcinoma.In the occurrence and development process of gastric and large intestine carcinoma,the three item tumor markers of CEA,CAl9-9 and CA72-4 have different degree changes,but the sensitivity is obviously low to single exam.Adopting CEA,CAl9-9 and CA72-4 two or three item exam,although the specificity a little descends,the sensitivity and validity can ascensus obviously,overmatching the single exam of tumor marker,descressing missed diagnosis rate, ascensusing the diagnosis rate to gastric and large intestine carcinoma,taking on upper clinical application value to the assistant diagnosis of gastroenteric carcinoma.Even examing the tumor marker has traits such as economy,convenience and low pain. Now,people more and more think highly of the unite exam .