血清胃蛋白酶原与CA724联合检测在胃癌鉴别诊断中的应用价值  

The application value of serum pepsinogen and CA724 detection for the differential diagnosis of gastric cancer

作　　者：徐育红[1] 李艳丽[1] 张雁[1] 

机构地区：[1]黑龙江省农垦总局总医院检验科,哈尔滨150088

出　　处：《国际免疫学杂志》2017年第4期401-403,共3页International Journal of Immunology

摘　　要：目的探讨血清胃蛋白酶原（PG）和糖类抗原CA724联合检测作为肿瘤标志物用于胃癌鉴别诊断的可行性。方法选取经纤维胃镜及病理组织学诊断为胃癌的患者195例，慢性萎缩性胃炎（CAG）患者175例，正常健康体检者210例。采用免疫分析法检测胃蛋白酶原Ⅰ（PGⅠ）、胃蛋白酶原Ⅱ（PGⅡ）并计胃蛋白酶原比值PGR（PGⅠ／PGⅡ），采用电化学发光免疫分析法检测糖化抗原CA724。结果胃癌组PGⅠ与PGR水平明显低于正常对照组，两组比较差异具有统计学意义（P=0．000）；PGⅡ的含量变化不大，两组比较差异无统计学意义（P=0．490）。CAG组PGⅠ与PGR水平明显低于正常对照组，两组比较差异具有统计学意义（P=0．003）；PGⅡ的含量变化不大，两组比较差异无统计学意义（P=0．407）。胃癌组与CAG组PCⅠ与PGR比较差异无统计学意义（P=0．400）。胃癌组的CA724水平明显高于CAG组与正常对照组，差异有统计学意义（P=0．003）；而CAG组与正常对照组比较差异无统计学意义（P=0．388）。对胃癌诊断的敏感性PG（71．79％）高于CA724（41．28％），特异性CA724（92．2％）高于PG（66．23％），二者联合检测敏感性为82．67％，特异性为73．59％，同时阴性时82．78％排除胃癌诊断。结论血清胃蛋白酶原和CA724联合检测二者同时阴性时可以82．78％排除胃癌诊断，可以作为胃癌鉴别诊断的标志物。Objectives To investigate clinical survey feasibility of pepsinogen （PG） and CA724 as markers in the differential diagnosis of gastric cancer. Methods Enrolled patients were divided into three groups：gastric cancer 195 cases,chronic atrophic gastritis （CAG） group 175 cases,normal control group 210 cases,according to the fibre gastroscopy and pathological cytology diagnosis. Pepsinogen Ⅰ （ PG Ⅰ ） and pep- sinogen Ⅱ （PG Ⅱ） level were detected by immunoassay, then calculate the PGR （ PG Ⅰ/PG Ⅱ ） . Using electrochemi-luminescence immunoassay to qualitatively CA724 level. Results The gastric cancer group PG Ⅰ and PGR levels were significantly decreased than normal control group, with significant differences between the two groups （P = 0. 000） ;the content change of PG II is little, no significant differences between the two groups （P = 0.490） ;The CAG group PG I and PGR levels were significantly lower than the normal control group, with significant differences between the two groups （ P = 0. 003） ; the content change of PG Ⅱ is little, no signif- icant differences between the two groups （ P = 0. 407 ）. PGR and PG I had no statistical significance in gastric cancer group and CAG group （P =0. 400） . CA724 levels in gastric cancer group was significantly higher than that of CAG group and the normal control group, the difference was statistically significant （P = 0. 003 ） ;but it had no significant differences in normal control group and CAG group （ P = 0. 388 ）. The PG sensitivity was 71.79% ,specificity was 66.23% for diagnosis of gastric cancer,and the CA724 sensitivity was 41.28% ,speci-ficity was 92.2%. When combined PG and CA724 detection, the sensitivity was 82.67% and specificity was 73.59%. If both of the two detection were negative 82.78% exclude gastric cancer diagnosis. Conclusions If combined detection of the serum PG and CA724 are both negative,82.78% gastric cancer can be discharged. It is feasible, as markers for gastric cancer differential

关 键 词：胃蛋白酶原 糖类抗原CA724 胃癌 慢性萎缩性胃炎 

分 类 号：R735.2[医药卫生—肿瘤]