不同联合策略的血清标志物组合在胃癌诊断中的应用价值  

Application value of serum marker combination in different combination strategies for the diagnosis of gastric cancer

作　　者：袁秀梅[1] 鲁彦 杨晓燕 颜丽[1] 杨兴文 李德红[1] YUAN Xiu-mei;LU Yan;YANG Xiao-yan;YAN Li;YANG Xing-wen;LI De-hong(Clinical Laboratoryy Gansu Provincial Hospital,Lanzhou,Gansu 730000,China;不详)

机构地区：[1]甘肃省人民医院检验中心,甘肃兰州730000 [2]甘肃省中医院检验科,甘肃兰州730300

出　　处：《中国卫生检验杂志》2022年第3期266-270,276,共6页Chinese Journal of Health Laboratory Technology

基　　金：甘肃省自然基金项目(20JR5RA146);甘肃省人民医院国家级科研项目培育计划(19SYPYB-25);甘肃省人民医院院内青年项目(20GSSY4-4)。

摘　　要：目的通过对常用的血清标志物癌胚抗原(CEA)、糖类抗原19-9(CA19-9)、糖类抗原72-4(CA72-4)、胃蛋白酶原Ι/胃蛋白酶原Ⅱ比值(PGⅠ/PGⅡ)以及胃泌素-17(G-17)进行不同的串联、并联的组合策略,筛选出对胃癌早期诊断灵敏度、特异度最优且最经济的组合。方法选取88例表观健康者,88例萎缩性胃炎,61例胃癌患者,检测所有研究对象血清CEA、CA19-9、CA72-4、PGⅠ/PGⅡ和G-17的水平,比较不同的串联、并联组合在区分表观健康者、萎缩性胃炎和胃癌患者的诊断效能。结果不同联合策略比较,串联组合时阳性率较低,且串联的指标越多阳性率越低,5项指标串联时阳性率为0.0%。并联组合时,阳性率显著高于串联组合,且并联项目越多阳性率越高,5项指标并联检测的阳性率达到71.7%。结论不同的联合策略诊断胃癌的效能不同,串联组合随着项目的增加阳性率下降明显,不适宜早期诊断。3项指标血清G-17、PGΙ/PGⅡ与CEA组合、血清G-17、PGΙ/PGⅡ与CA19-9组合以及血清G-17、CEA、CA19-9的组合诊断效能最优。Objective Through different series and parallel combination strategies of commonly used serum markers(carcinoembryonic antigen,carbohydrate antigen 19-9,carbohydrate antigen 72-4,pepsinogenΙ/pepsinogenⅡ ratio and gastrin-17),the optimal combination of sensitivity,specificity and economy for the early diagnosis of gastric cancer was screened out.Methods The serum CEA,CA19-9,CA72-4,PGΙ/PGⅡ,and G-17 levels of 88 apparently healthy subjects,88 atrophic gastritis patients,and 61 gastric cancer patients were selected,and the diagnostic efficacy of different series and parallel combinations in distinguishing apparently healthy subjects,atrophic gastritis patients,and gastric cancer patients was compared.Results Compared with different combination strategies,the positive rate of tandem combination was lower,and the more indicators in tandem,the lower the positive rate,and the positive rate of 5 indicators in tandem was 0.0%.In parallel combination,the positive rate was significantly higher than that in series combination,and the more parallel items,the higher the positive rate was.The positive rate of the 5 indexes in parallel detection reached 71.7%.Conclusion Different combination strategies have different efficacy in the diagnosis of gastric cancer,and the positive rate of tandem combination decreases obviously with the increase of items,which is not suitable for early diagnosis.The optimal diagnostic efficiency can be obtained by the combination of serum G-17,PGΙ/PGⅡ and CEA,serum G-17,PGΙ/PGⅡ and CA19-9,and G-17,CEA and CA19-9.

关 键 词：胃癌 血清标志物 组合策略 串联 并联 早期诊断 

分 类 号：R735.2[医药卫生—肿瘤]