血清CEA、CYFRA21-1、CTC及PNI在胃癌腹膜转移患者中的诊断价值  

Diagnostic value of serum CEA,CYFRA21-1,CTC and PNI in patients with peritoneal metastasis of gastric cancer

作　　者：李剑峰[1] 丁才智 周化敏 LI Jianfeng;DING Caizhi;ZHOU Huamin(Department of Clinical Laboratory,People's Hospital of Songzi City,Songzi,Hubei 434200,China)

机构地区：[1]湖北省松滋市人民医院检验科,湖北松滋434200

出　　处：《检验医学与临床》2020年第24期3611-3614,共4页Laboratory Medicine and Clinic

摘　　要：目的分析血清癌胚抗原(CEA)、细胞角蛋白19片段(CYFRA21-1)、循环肿瘤细胞(CTC)、预后营养指数(PNI)在胃癌腹膜转移患者中的诊断价值。方法选取2017年11月至2019年2月该院收治的胃癌患者93例作为研究对象,其中22例腹膜转移患者为转移组,71例无转移患者为未转移组,另选取88例同期健康体检者作为对照组。比较3组PNI、CTC、CEA、CYFRA21-1水平,采用受试者工作特征曲线(ROC曲线)分析上述指标单独及联合诊断胃癌腹膜转移的效能。结果转移组CTC、CEA、CYFRA21-1水平高于未转移组与对照组,PNI低于未转移组与对照组,差异均有统计学意义(P<0.05);未转移组CTC、CEA、CYFRA21-1水平高于对照组,PNI低于对照组,差异均有统计学意义(P<0.05)。ROC曲线分析结果显示,CTC诊断胃癌腹膜转移的灵敏度为63.6%、特异度为98.6%、AUC为0.857,高于CEA、CYFRA21-1、PNI单独诊断;CEA、CYFRA21-1、CTC、PNI联合诊断胃癌腹膜转移的AUC为0.906,高于各项指标单独诊断。结论CEA、CYFRA21-1、CTC、PNI联合诊断胃癌腹膜转移的价值较高。Objective To analyze the diagnostic value of serum carcinoembryonic antigen(CEA),cytokeratin 19 fragment(CYFRA21-1),circulating tumor cells(CTC)and prognostic nutritional index(PNI)in patients with peritoneal metastasis of gastric cancer.Methods A total of 93 patients with gastric cancer admitted to the hospital from November 2017 to February 2019 were selected as the research objects.Among them,22 patients with peritoneal metastasis were in the metastatic group,and 71 patients without peritoneal metastasis were in the non-metastatic group.Another 88 healthy people undergoing physical examination during the same period were selected as the control group.The PNI,CTC,CEA and CYFRA21-1 levels were compared among the 3 groups.The receiver operating characteristic curve(ROC curve)was used to analyze the diagnostic value of the above indicators alone and in combination for the diagnosis of peritoneal metastasis of gastric cancer.Results The levels of CTC,CEA and CYFRA21-1 in the metastatic group were higher than those in the non-metastatic group and the control group,and the PNI was lower than that in the non-metastatic group and the control group,the differences were statistically significant(P<0.05).The levels of CTC,CEA and CYFRA21-1 in the non-metastatic group were higher than those in the control group,and the PNI was lower than that in the control group,the differences were statistically significant(P<0.05).The results of ROC curve analysis showed that the sensitivity,specificity and AUC of CTC in the diagnosis of peritoneal metastasis of gastric cancer were 63.6%,98.6%and 0.857 respectively,which were higher than those of CEA,CYFRA21-1 and PNI alone.The AUC of CEA,CYFRA21-1,CTC and PNI combined diagnosis of peritoneal metastasis of gastric cancer was 0.906,which was higher than that of each index individual diagnosis.Conclusion The combined detection of CEA,CYFRA21-1,CTC and PNI has high diagnostic value for peritoneal metastasis of gastric cancer.

关 键 词：胃癌 腹膜转移 癌胚抗原 细胞角蛋白19片段 循环肿瘤细胞 预后营养指数 

分 类 号：R735.2[医药卫生—肿瘤]