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用RIA法分別测定慢性浅表性胃炎、慢性萎缩性胃炎、胃癌病人及正常空腹胃液癌胚抗原(CEA)值,然后检测正常人pH和胃蛋白酶对CEA测定的影响,同时进行体内体外pH调整前后CEA测定值的比较,以及测定上述四个实验组胃内调整pH后胃液CEA值。结果表明:1、空腹胃液CEA随pH值增高而增高;2、高酸及胃液内胃旦白酶使CEA测定值下降;3、体外调整pH对CEA测定无明显影响,而体内调整pH则影响明显。因此,我们认为:不考虑空腹胃液酸度,不论是用RIA法还是用EIA法所测定的空腹胃液CEA值没有实际意义,如不管原空腹胃液pH值高低,均统一按常规作胃内调整pH,保证比较上的统一性,则可更客观地评价胃液CEA测定对胃癌的辅助诊断和对胃癌高危人群筛选的临床价值。
The levels of carcinoembryonic antigen (CEA) in chronic superficial gastritis, chronic atrophic gastritis, and gastric cancer patients and normal fasting gastric fluid were determined by RIA. Then the effects of pH and pepsin on CEA were measured, and the in vitro and in vivo pH adjustments were performed. Comparison of CEA measurements before and after, and determination of gastric CEA after gastric pH adjustment in the above four experimental groups. The results showed that: 1. CEA in fasting gastric juice increased with the increase of pH value; 2. The content of CEA decreased with high acid and gastric intragastric enzyme; 3. In vitro adjustment of pH had no significant effect on CEA determination, but pH adjustment in vivo affected obvious. Therefore, we believe that: Regardless of fasting gastric acidity, no matter whether the CEA value of fasting gastric juice measured by RIA method or EIA method has no practical significance, regardless of the pH level of the original fasting gastric juice, uniform adjustment of pH is routinely performed in the stomach. To ensure the uniformity of comparison, it is possible to more objectively evaluate the clinical value of gastric juice CEA in the diagnosis of gastric cancer and the screening of high-risk groups for gastric cancer.