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1、血清CA72-4、CA19-9检测联合全身骨显像在胃癌骨转移中的诊断价值路宝士(通信作者)赵立明(临沂市人民医院核医学科山东临沂276003)【屮图分类号】R735.2【文献标识码】A【文章编号】1672-5085(2013)27-0109-02【摘要】R的评价血淸肿瘤标志物糖类抗原72-4(CA72-4)、糖类抗原19-9(CA19-9)检测联合全身骨显像在H癌骨转移诊断屮的价值。方法对97例胃癌患者(其屮，骨转移者34例、无骨转移者63例)及54例良性胃部疾病患者(对照组)行SPECT全身骨显像和CT或
2、MRI检查，同时，用电化学发光法测定其血淸CA72-4、CA19-9含量，并将两者的结果进行比较。结果骨转移组CA72-4、CA19-9水平明显高于无骨转移组和对照组，其诊断阳性率分别为75.29%、62.43%,骨转移组全身骨显像32例为阳性(占94.12%)，仅2例为阴性(占5.88%),但CT或MRI发现转移；无骨转移组及对照组骨显像个别为阳性，均由手术或外伤引起。结论CA72-4、CA19-9检测联合全身骨显像有助于提高胃癌骨转移的检出率。【关键词】全身骨显像血淸肿瘤标志物胃癌骨转移Thevalue
3、ofcombinedexaminationofserumCA72-4,CA19-9levelandwholebodybonescaninthediagnosisofbonemetastasisingastriccancerLUBao-shi,ZHAOLi-ming(DepartmentofNuclearMedicine,ThePeople’HospitalofLinyi,Linyi276003,China)【Abstract】ObjectiveToexplorethevalueofcombine
4、dexaminationofserumtumormarkerscarbohydrateantigen72-4(CA72-4),carbohydrateantigenl9-9(CA19-9)andwholebodybonescaninthediagnosisofbonemetastasisingastriccancer.MethodsWholebodybonescan,CTorMRI,serumCA72-4andCA19-9levelswithachemicalluminiferousdeterminatio
5、nwereperformedin97patientswithgastriccancer(34caseswithbonemetastasisand63caseswithoutbonemetastasis)and54patientswithbenigngastricdiseases.ResultsTheserumlevelofCA72-4andCA19-9weresignificantlyhigherinpatientswithbonemetastasisthanthoseinpatientswithoutbo
6、nemetastasisandthecontrols.Thepositivepredictingvalueswere75.29%,62.43%.Mostpatientswithbonemetastasishadpositiveresultsinbonescan（94.12%）,only2caseshadnegativeresults（5.88%）,whichispositivebyCTorMRI.Afewpatientswithoutbonemetastasisandthecontrolshadpositi
7、veresultsinbonescan,thatmaybecausedbypreviousoperationorinjury.ConclusionThecombinedexaminationofCA72-4,CA19-9andwholebodybonescanwerevaluableinthediagnosisofbonemetastasisofgastriccancer.【Keywords］wholebodybonescanserumtumormarkergastriccancerbonemetastas
8、is胃癌是我国常见的亲骨性恶性肿瘤之一，其发病率逐年上升，骨转移是其最常见的并发症之一，发生骨转移将极人地影响患者的生存质量,II预后不佳,其病死率居各种消化道恶性肿瘤之首［1】。判断胃癌有无骨转移，对制定治疗方案、判断预后有重要意义。全身骨显像是诊断骨转移的重要方法，通过放射性核素的异常分布发现转移灶。糖类抗原CA72-4和CA19-9是胃癌诊断中常用的血清肿瘤标志物［2】。本研究探讨全身骨显像联合血清CA72
