血清胃蛋白酶原和癌胚抗原联合检测对胃癌的诊断价值  

Diagostic value of combined detection of serum pepsinogen and carcinoembryonic antigen in gastric cancer

作　　者：杭永伦[1] 陈琳[1] 曾章锐[1] 刘靳波[1] 

机构地区：[1]泸州医学院附属医院检验科,四川泸州646000

出　　处：《泸州医学院学报》2015年第3期253-256,共4页Journal of Luzhou Medical College

摘　　要：目的:探讨血清胃蛋白酶原I(pepsinogen I,PGI)、PGI/II比值、癌胚抗原(carcinoembryonic antigen,CEA)和三个指标联合检测对胃癌的诊断价值。方法:将171例胃部疾病患者分为胃癌组68例和胃炎组103例,健康对照组50例。血清PGI、PGII和CEA分别采用透射免疫比浊法和化学发光法,并计算PGI/II比值。绘制受试者工作特征(ROC)曲线,计算PGI、PGI/II比值、CEA和3个指标联合检测诊断胃癌的灵敏度、特异性、阳性预测值和阴性预测值。结果:胃癌组血清PGI、PGII水平和PGI/II比值显著低于胃炎组和对照组(P<0.01,P<0.05),胃炎组血清PGI水平显著低于对照组(P<0.05),胃癌组血清CEA水平显著高于胃炎组和对照组(P<0.01)。以PGI≤50μg/L、PGI/II比值≤2.5和CEA≥10.0μg/L为阳性,血清PGI、PGI/II比值、CEA和3者联合诊断胃癌的灵敏度分别为58.8%、23.5%、23.5%和58.8%,特异性分别为88.5%、88.5%、100%和76.9%,阳性预测分别为76.9%、57.1%、100%和62.5%,阴性预测值分别为76.7%、63.9%、66.7%和74.1%。血清PGI、PGI/II和CEA诊断胃癌的ROC曲线下面积分别为0.774、0.732和0.491。结论:血清PGI、PGI/II比值对胃癌诊断的灵敏度和特异性不高,血清PGI、PGI/II比值和CEA联合检测有助于胃癌和胃炎的鉴别诊断。Objective： To investigate the diagnostic value of serum pepsinogen I（PGI）, PGI/II ratio,carcinoembryonic antigen（CEA） and combined detection of the three indexes in gastric cancer. Methods： 171 patients with gastric diseases were divided into gastric cancer group of 68 cases and gastritis group of 103 cases,with 50 healthy people as control group. Serum PGI, PGII and CEA were detected by turbidimetric immunoassay and chemiluminescence method, respectively, and PGI/II ratio was calculated. Receiver operator characteristic（ROC） curve was set up, and sensitivity, specificity, positive and negative predictive value for PGI, PGI/II ratio,CEA and combined detection of the three indexes were analyzed. Results：Serum PGI, PGII levels, PGI/PGII ratio and combined detection of the three in gastric cancer group were significantly lower than those in gastritis and healthy controls group（P 〈0.01, P〈0.05）, Serum PGI levels in gastritis group was significantly lower than those in healthy control group（P〈0.05）, serum CEA levels in gastric cancer group were significantly higher than those in gastritis and healthy control group（P 〈0.01）.When PGI ≤ 50 μg/L, PGI/II ratio ≤ 2.5 and CEA ≥10.0 μg/L, the sensitivity of serum PGI, PGI/II ratio and CEA for diagnosis of gastric cancer were 58.8%, 23.5%,23.5% and 58.8%, the specificity were 88.5%, 88.5%, 100% and 76.9%, the positive predictive were 76.9%,57.1%, 100% and 62.5%, the negative predictive were 76.7%, 63.9%, 66.7% and 74.1%, respectively. The area under ROC curve for serum PGI、PGI/II and CEA were 0.974, 0.732 and 0.491, respectively. Conclusion： Serum PGI, PGI/II ratio shows a low sensitivity and specificity for the diagnosis of gastric cancer. However, combined detection of PGI, PGI/II ratio and CEA may help the differential diagnosis of gastric cancer from gastritis.

关 键 词：胃蛋白酶原 癌胚抗原 胃癌 

分 类 号：R735.2[医药卫生—肿瘤]