D-二聚体、高密度脂蛋白、癌胚抗原和糖类抗原724联合检测在胃癌诊断中的价值  

Value of plasma D-dimer, high-density lipoprotein, carcino embryonic antigen and carbohydrate antigen 724 on diagnosis of gastric cancer

作　　者：王欣[1] 曹军丽[2] 高立明[2] 程少会[2] 董立新[2] 王振宏[3] 王晓静[3] 

机构地区：[1]河北省秦皇岛市中医医院重症医学科,066000 [2]河北省秦皇岛市第一医院肿瘤科 [3]河北省唐山市丰润区人民医院肿瘤科

出　　处：《肿瘤研究与临床》2015年第8期535-538,共4页Cancer Research and Clinic

摘　　要：目的 探讨D-二聚体、高密度脂蛋白（HDL）、癌胚抗原（CEA）和糖类抗原724（CA724）联合检测在胃癌诊断中的价值.方法 选择胃癌患者103例和健康体检者111名,采用胶乳增强免疫比浊法测定D-二聚体水平,直接法测定血清HDL水平,化学发光法测定血清CEA和CA724水平,数据以中位数（四分位距）表示.通过ROC曲线分析每种检测指标及不同组合方式的敏感性、特异性.结果 胃癌患者血清D-二聚体、CEA和CA724水平[中位数（四分位距）]分别为0.87（2.69） μg/ml、2.66（4.38）ng/ml和5.10（7.79）U/ml,高于健康体检者的0.22（0.21）lμg/ml、1.28（1.60） ng/ml和1.81 （1.60）U/ml（均P=0.000）;胃癌患者HDL水平为0.86（0.35） mmol/L,低于健康体检者的1.29（0.44） mmol/L（P=0.000）.D-二聚体、HDL、CEA、CA724的ROC曲线下面积分别为0.799、0.859、0.739、0.743.D-二聚体诊断分界点为0.46 μg/ml,敏感度为68.0％,特异度为86.5％;HDL诊断分界点为0.995 mmol/L,敏感度为73.8％,特异度为84.7％;CEA诊断分界点为3.585 ng/ ml,敏感度为44.7％,特异度为92.0％;CA724诊断分界点为3.765 U/ml,敏感度为57.3％,特异度为89.2％.D-二聚体＋HDL＋CA724的ROC曲线下面积为0.942,敏感度为83.5％,特异度为89.2％.四者联合检测的ROC曲线下面积为0.948,敏感度为84.5％,特异度为89.2％.结论 D-二聚体、HDL、CEA和CA724联合检测可提高诊断的敏感性和特异性,对胃癌的诊断具有一定价值。Objective To evaluate the diagnostic value of the level of plasma D-dimer,high-density lipoprotein （HDL）,carcino embryonic antigen （CEA） and carbohydrate antigen 724 （CA724） in gastric cancer.Methods The plasma and clinicopathological data of 103 gastric cancer patients and 111 normal controls were collected.The levels of D-dimer,HDL,CEA and CA724 were detected.SPSS 13.0 statistical software was applied to analysis the sensitivity and specificity of each examination method and to find out the appropriate combination.Results The levels of D-dimer,CEA and CA724 in patients with gastric carcinoma were 0.87 （2.69） μg/ml,2.66 （4.38） ng/ml,5.10 （7.79） U/ml,respectively,they were distinctly higher than those in normal controls [0.22 （0.21） μg/ml,1.28 （1.60） ng/ml,1.81 （1.60） U/ml,all P =0.000].HDL level was significantly lower in patients than that in normal controls [0.86 （0.35） mmol/L vs 1.29 （0.44） mmol/L,P=0.000].The area ofROC curve of D-dimer,HDL,CEA,CA724 were 0.799,0.859,0.739,0.743,respectively.The cut-off of D-dimer was 0.46 μ.g/ml,the sensitivity was 68.0 %,the specificity was 86.5 %.The cut-off of HDL was 0.995 mmol/L,the sensitivity was 73.8 %,the specificity was 84.7 %.The cut-off of CEA was 3.585 ng/ml,the sensitivity was 44.7 %,the specificity was 92.0 %.The cut-off of CA724 was 3.765 U/ml,the sensitivity was 57.3 %,the specificity was 89.2 %.The sensitivity of D-dimer＋HDL＋CA724 was 83.5 %,the specificity was 89.2 %.The sensitivity and specificity of D-dimer＋HDL＋CEA＋CA724 were 84.5 % and 89.2 %,respectively.Conclusions The D-dimer＋HDL＋CEA＋CA724 may provide the evidence for diagnosis of gastric cancer.Combined detection has higher sensitivity and specificity.

关 键 词：胃肿瘤 D-二聚体 高密度脂蛋白 癌胚抗原 糖类抗原724 

分 类 号：R735.2[医药卫生—肿瘤]