胃蛋白酶原与胰蛋白酶原-2联合检测筛查胃癌的意义  

Evaluation of Pepsinogen Combined with Trypsinogen-2 Co-detection in Gastric Cancer Screening

作　　者：张艺[1] 张珏[1] 马智鸿[1] 严子禾[2] 沈洪远[2] 黄飚[1] 

机构地区：[1]江苏省原子医学研究所,江苏无锡214063 [2]江苏省无锡市第二人民医院检验科,江苏无锡214002

出　　处：《中国临床医学》2009年第4期548-550,共3页Chinese Journal of Clinical Medicine

基　　金：江苏省社会发展基金项目(BS2006015);江苏省卫生厅项目(H200856)

摘　　要：目的:探讨血清胃蛋白酶原(PG)Ⅰ、PGⅡ和胰蛋白酶原-2(TAT-2)联合检测筛查胃癌的应用价值。方法:选择145例受试者,其中胃癌者83例,健康者62例。采用时间分辨荧光免疫分析法检测受试者血清PGⅠ、PGⅡ和TAT-2含量,应用受试者工作特征曲线(ROC)评估不同临界值TAT-2和PG筛查胃癌的效率。结果:83例胃癌患者的血清PGⅠ与PGⅠ/PGⅡ比值显著低于正常组,而TAT-2含量明显高于健康者,前者具有高特异度,后者有灵敏度优势。结合血清TAT-2的ROC曲线综合分析,TAT-2取临界值60ng·mL-1和PG并联较单筛相比,能同时实现筛查胃癌的高灵敏度和高特异度。结论:利用血清PG与TAT-2联合筛查胃癌效果优于TAT-2或PG单筛,该方法可成为一种人群胃癌筛查的新方法。Objective：To explore the value of combined assay of serum pepsinogen（PG） and trypsinogen-2 （TAT-2） concentration for gastric cancer screening. Methods：PG Ⅰ, PG Ⅱand TAT-2 concentrations in fasting serum were measured by timeresolved fluorescence immunoassay（TRFIA） in 145 subjects, including 83 gastric cancer patients and 62 healthy controls. The cut off points for TAT-2 and PG were determined by using receiver operator characteristics curves（ROC）. Results： Different from the healthy control, PGⅠ concentration and PGⅠ / PGⅡ ratio of gastric cancer patients were markedly lower, while TAT-2 level was much higher. The specificity was good using the PG detection only, and the sensitivity was preponderant obtained by TAT-2 detection alone. Using a serum TAT-2 ≥60 ng · mL^-1 based on ROC combining with PG for gastric cancer, both high sensitivity and specificity can be achieved. Conclusion：Combining serum PG and TAT-2 concentration for gastric cancer screening is superior to PG or TAT-2 only. It could be used as a new method in gastric cancer mass screening.

关 键 词：胃癌 胃蛋白酶原 胰蛋白酶原-2 时间分辨荧光免疫分析法 

分 类 号：R735.2[医药卫生—肿瘤]