免疫组化标志物Her-2和肿瘤标志物在胃癌诊断中的价值分析

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英文篇名：The value of immunohistochemical marker Her-2 and tumor markers in the diagnosis of gastric cancer 作者：侯洁心 ; 郭萍 英文作者：HOU Jiexin;GUO Ping;Pathology Department of Shaanxi Friendship Hospital; 关键词：胃癌 ; 免疫组化 ; 肿瘤标志物 ; Her-2 ; 癌胚抗原 ; 诊断 英文关键词：Gastric cancer;;Immunohistochemistry;;Tumor markers;;Her-2;;CEA;;Diagnosis 中文刊名：SXYZ 英文刊名：Shaanxi Medical Journal 机构：陕西省友谊医院病理科;陕西省友谊医院消化内科; 出版日期：2019-01-05 出版单位：陕西医学杂志 年：2019 期：v.48;No.523 基金：陕西省自然科学基础研究计划项目(C0303) 语种：中文; 页：SXYZ201901038 页数：4 CN：01 ISSN：61-1104/R 分类号：123-126

摘要

目的:探讨免疫组化指标Her-2和肿瘤标志物糖类抗原CA_(199)、CA_(242)、甲胎蛋白(AFP)和癌胚抗原(CEA)单项检测及其联合检测在胃癌诊断中的应用价值。方法:对纳入研究的78例胃癌患者胃镜活检组织中Her-2及CA_(199)、CA_(242)、AFP和CEA表达水平进行检测分析。结果:免疫组化分析结果显示,胃癌患者胃黏膜组织中肿瘤标志物CEA表达阳性率最高,其次为CA_(199)、CA_(242)。而免疫组化Her-2及肿瘤标志物AFP表达阳性率均相对较低,且与肿瘤标志物CEA、CA_(199)、CA_(242)表达阳性率比,差异均具有统计学意义(P<0.05)。但肿瘤标志物CEA、CA_(199)、CA_(242)表达阳性率间比较差异无统计学意义(P>0.05)。且肿瘤分化程度越低和未分化者肿瘤组织中Her-2、CA_(199)、CA_(242)、AFP和CEA表达阳性率均明显高于中高度分化者(P<0.05),但腺癌和印戒细胞癌两种癌变患者肿瘤组织中上述检测指标诊断阳性率间差异无统计学意义(P>0.05)。与单独Her-2检测相比,Her-2+CA_(199)、Her-2+CA_(199)、Her-2+CEA联合检测灵敏度明显均明显提高,差异具有统计学意义(P<0.05)。结论:免疫组化指标Her-2和肿瘤标志物CA_(199)、CA_(242)对胃癌的诊断、分化程度具有显著意义,且肿瘤标志物与免疫组化指标Her-2联合检测可显著提高胃癌患者诊断灵敏度。
        Objective:To investigate the immunohistochemical index Her-2 and tumor markers carbohydrate antigenCA_(199),CA_(242),alpha fetoprotein(AFP)and carcinoembryonic antigen(CEA)single detection and 6 indicators combined detection in the diagnosis of gastric cancer Value.Methods:The expression levels of Her-2 and CA_(199),CA_(242),AFP and CEA in the gastroscopic biopsy of 78 patients with gastric cancer were analyzed.Results:Immunohistochemical analysis showed that the positive rate of tumor marker CEA was the highest in gastric mucosa of gastric cancer patients,followed by CA_(199) and CA_(242);the positive rates of immunohistochemical Her-2 and tumor marker AFP were relatively low,and the positive rates of tumor markers CEA,CA_(199) and CA_(242) were statistically significant(P<0.05).The positive rates of Her-2,CA_(199),CA_(242),AFP and CEA in the tumor tissues of the undifferentiated and pooly differentiated tumors were significantly higher than those in the moderately highly differentiated individuals(P<0.05).However,there was no significant difference in the positive rate of the above-mentioned detection indexes between the adenocarcinoma and signet ring cell carcinoma patients(P>0.05).Compared with Her-2 alone,the detection sensitivity of Her-2+CA_(199),Her-2+CA_(199) and Her-2+CEA was significantly improved,and the difference was statistically significant(P <0.05).Conclusion:The immunohistochemical index Her-2 and tumor markers CA_(199) and CA_(242) have significant significance in the diagnosis and differentiation of gastric cancer,and the combined detection of tumor markers and immunohistochemical index Her-2 can significantly improve the diagnostic sensitivity of gastric cancer patients.

引文

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