胃蛋白酶原、胰蛋白酶原-2、CEA、CA50、CA242在胃癌诊断中的应用价值分析  

THE CLINICAL EVALUATION OF PEPSINOGEN, TRYPSINOGEN -2, CEA, CA50 AND CA242 IN GASTRIC CANCER DIAGNOSIS

作　　者：张艺[1] 张珏[1] 严子禾[2] 龚镭[2] 马智鸿[1] 朱岚[1] 黄飚[1] 

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

出　　处：《现代预防医学》2010年第6期1116-1118,共3页Modern Preventive Medicine

基　　金：江苏省社会发展基金项目"双标记胃蛋白酶原免疫分析的建立及胃癌早期筛查的应用"(BS2006015);江苏省卫生厅项目"胃癌风险因素的高通量筛查及其在胃癌早期诊断中的应用"(H200856)

摘　　要：[目的]分析血清胃蛋白酶原(PG)I、PGII、胰蛋白酶原-2(TAT2)、CEA、CA50、CA242指标在胃癌诊断中的应用价值。[方法]采用时间分辨荧光免疫分析法,检测116名胃癌患者和60名正常人血清PGI、PGII、CEA、CA50、CA242、TAT2含量,并计算PGI/PGII比值。[结果]血清PGI、PGI/PGII、CEA、CA50、CA242、TAT2与对照组比较结果在统计学上差异均有统计学意义,敏感度分别是34.48%、38.79%、12.93%、13.79%、26.72%和27.59%。而多项并联检测可有效提高敏感度,且特异度保持较高水平(均大于80%)。其中PGI、PGI/PGII和TAT23项联合敏感度为70.96%,再增加肿瘤标志物CEA、CA50与CA242全检,敏感度提高至84.02%,同时获得高的阳性似然比和低的阴性似然比。[结论]利用高通量TRFIA联合检测血清PGI、PGI/PGII、TAT2、CEA、CA50、CA242水平,能显著提高胃癌检出水平。[Objective] To study the clinic value of pepsinogen （PG） I, PG II, tumor markers trypsinogen-2, CEA, CA50, CA242 in diagnosis of gastric cancer. [Methods] The levels of serum PGI, PGII, TAT2, CEA, CA50 and CA242 as well as PGI / PGII ratio were determined by time-resolved fluoroimmunoassay （TRFIA） in 116 patients with gastric cancer and 60 healthy volunteers. [Results] The sensitivity of PGI, PGI / PGII ratio, CEA, CA50, CA242 and TAT2 in diagnosis of gastric cancer was 34.48%, 38.79%, 12.93%, 13.79%, 26.72% and 27.59%, respectively, while the levels of them in tumor group were significantly different from those in control group. The parallel detection could improve the sensitivity of detection methods, and kept a high specificity （﹥80%） . The sensitivity of parallel detection of PGI, PGI / PGII ratio and TAT2 was 70.96%. If adding more tumor marker tests including CEA, CA50 or CA242, the sensitivity increased to 84.02%, and the positive likelihood ratio showed to be high, while the negative likelihood ratio presented to be low. [Conclusion] Combined determination of serum levels of PGI, PGI / PGII ratio, TAT2, CA242, CA50 and CEA in TRFIA with high throughout quality could obviously improve the detective rate of mass screening for gastric cancer.

关 键 词：胃蛋白酶原 胰蛋白酶原-2 肿瘤标志物 胃癌 时间分辨荧光免疫分析 

分 类 号：R735.2[医药卫生—肿瘤]