血清胰岛素样生长因子结合蛋白2联合糖链抗原72-4检测对胃癌的诊断价值  

The Research on the Relationship between Insulin-like Growth Factor Binding Protein-2 and Gastric Cancer

作　　者：赵彩霞[1] 马丽莉[1] 王娟 ZHAO Caixia;MA Lili;WANG Juan(Department of Pathology,Changzhi Medical College,Changzhi 046000,Shanxi,China;Department of Digestive System,Peace Hospital of Changzhi Medical College,Changzhi 046000,Shanxi,China)

机构地区：[1]长治医学院病理学教研室长治医学院科技创新团队,山西长治046000 [2]长治医学院附属和平医院消化内科,山西长治046000

出　　处：《贵州医科大学学报》2018年第5期613-616,620,共5页Journal of Guizhou Medical University

基　　金：长治医学院科技启动基金项目(QDZ201505)

摘　　要：目的:探讨血清胰岛素样生长因子结合蛋白2(IGFBP-2)联合糖链抗原72-4(CA72-4)检测对胃癌的诊断价值。方法:62例胃癌患者作为胃癌组,30例良性胃病患者作为良性胃部疾病组,40例正常体检者作为对照组,采用酶联免疫吸附法测定受试者血清IGFBP-2、CA72-4水平,放射免疫法测定受试者血清胰岛素样生长因子-1(IGF-1)、IGF-2水平,Pearson法分析胃癌患者血清IGFBP-2、CA72-4与IGF-1、IGF-2的相关性;应用受试者工作特征(ROC)曲线下面积(AUC)分析IGFBP-2、CA72-4对胃癌诊断的灵敏度和特异度。结果:胃癌组患者血清IGFBP-2、CA72-4、IGF-1及IGF-2水平显著高于良性胃部疾病组和对照组(P<0.05),且血清IGFBP-2水平分别与CA72-4、IGF-1及IGF-2水平呈正相关(r=0.849、0.603、0.711,P<0.05),血清CA72-4水平分别与IGF-1及IGF-2水平呈正相关(r=0.611、0.694,P<0.05);CA72-4早期诊断胃癌的敏感度最高(91.3%),IGFBP-2的特异度最高(92.6%);IGFBP-2截断值(579.74)高于CA72-4(17.83),CA72-4联合IGFBP-2检测胃癌的AUC=0.89,优于单一IGFBP-2(AUC=0.73)或CA72-4(AUC=0.65),单一IGFBP-2又优于CA72-4,差异有统计学意义(P<0.05)。结论:血清IGFBP-2联合CA72-4检测对胃癌的早期诊断优于单一IGFBP-2或CA72-4。Objective： To investigate the diagnostic value of insulin-like growth factor binding protein-2（ IGFBP-2） in the detection of gastric cancer. Methods： All the blood serum samples from 62 patients with gastric cancer,30 patients with stomach benign pancreatic diseases and 40 healthy controls were determined by enzyme-linked immuno-sorbent assay（ ELISA） and immuno-radiometric analysis（ IRMA）. The diagnostic values of IGFBP-2 and CA72-4 were analyzed and compared by the receiver operator characteristics（ ROC） curve and the area under curve（ AUC）. Results： The levels of serum IGFBP-2,CA72-4,IGF-1 and IGF-2 in patients with gastric cancer were significantly higher than those in other two groups（ P〈0. 01）. In the gastric cancer group,the serum level of IGFBP-2 was positively correlated with CA72-4,IGF-1 and IGF2（ P〈0. 01）. The AUC of IGFBP-2 was larger than that of CA72-4 alone（ P〈0. 01）; The AUC of combined samples of IGFBP-2 and CA72-4 was larger than that of single IGFBP-2 or CA72-4,and the difference was statistically significant（ P〈0. 01）.Conclusions： IGFBP-2,IGF-1 and IGF2 may be associated with the growth of gastric cancer. Combined detection of IGFBP-2 and CA72-4 appears to be a suitable indicator of gastric cancer. It can be applied in the diagnosis of gastric cancer.

关 键 词：胃癌 血清 胰岛素样生长因子结合蛋白-2 癌抗原72-4 相关性分析 ROC曲线 截断值 筛查 

分 类 号：R363.21[医药卫生—病理学]