目的：探讨术前联合检测血清癌胚抗原（CEA）和糖类抗原CA19-9、CA125、CA724、CA211、CA242在胃癌腹膜转移诊断中的应用价值。方法：收集2015年12月—2016年12月间在上海交通大学医学院附属新华医院收治的89例胃癌患者术前血清肿瘤标志物检测值，其中17例患者有腹膜转移（转移组），72例无腹膜转移（无转移组），通过建立Logistic回归模型，绘制ROC曲线并计算曲线下面积（AUC）评价各血清肿瘤标志物单独与联合检测对胃癌腹膜转移的诊断效能。结果：转移组中肿瘤标志物CA125、CA724、CA211的阳性检出率明显高于无转移组相比较（均P<0.05），而其他3种肿瘤标志物阳性检出率在两组间均无统计学差异（均P>0.05）；单独检测时，CA125诊断胃癌腹膜转移的AUC最大，与其他5种肿瘤标志物的差异均有统计学意义（均P<0.05）；CA125、CA724、CA211联合检测与6种肿瘤标志物联合检测的AUC均明显大于各单项检测的AUC（均P<0.05），但两者间AUC差异无统计学意义（0.964 vs. 0.949，P=0.866）。结论：CA125可作为胃癌腹膜转移的预测指标，且与CA724、CA211的联合检测可为临床鉴别胃癌腹膜转移提供有效的参考，但与其他肿瘤标志物联合检测的价值不大。
Analysis of application value of combined detection of serum tumor markers in diagnosis of gastric cancer peritoneal metastasis
Objective: To investigate the application value of combined detection of serum carcinoembryonic antigen (CEA) and carbohydrate antigen CA19-9, CA125, CA724, CA211 and CA242 in diagnosis of gastric cancer peritoneal metastasis. Methods: The values of tumor markers in 89 gastric cancer patients treated in the Affiliated Xinhua Hospital, School of Medicine, Shanghai Jiaotong University from December 2015 to December 2016 were collected. Of the patients, 17 cases had peritoneal metastasis (metastasis group) and 72 cases did not have peritoneal metastasis (non-metastasis group). The diagnostic efficiencies of the single and combined detection of these tumor markers were evaluated through establishing Logistic regression model, drawing ROC curves and calculating the areas under the curve (AUC). Results: The positive detection rates of CA125, CA211 and CA724 in metastasis group were significantly higher than those in non-metastasis group (all P<0.05), while the positive detection rates of the other three tumor markers showed no significant difference between the two groups (all P>0.05). In single detection, the AUC of CA125 for diagnosis of gastric cancer peritoneal metastasis was biggest, which was significantly different from the other five tumor markers (all P<0.05); the AUC of combined detection of CA125, CA724 and CA211 or combined detection of the six tumor markers was significantly greater than that of any single detection (all P<0.05), but the AUC showed no significant difference between them (0.964 vs. 0.949, P=0.866). Conclusion: CA125 can be as a predictor for peritoneal metastasis of gastric cancer, and its detection in combination with CA724, CA125 and CA211 can provide effective information for clinical identification of gastric cancer peritoneal metastasis, but has no significant value in combination with other tumor markers.