血清CEA、CA19-9、CA72-4、G-17、PGⅠ、PGⅡ在胃癌中的表达及意义  

Expression and significance of serum CEA,CA19-9,CA72-4,G-17,PGⅠ,PGⅡin gastric cancer

作　　者：史跃燕[1] 林兰[1] 顾益凤[1] 刘红利[1] SHI Yueyan;LIN Lan;GU Yifeng;LIU Hongli(Department of Clinical Laboratory,Nantong Cancer Hospital,Nantong,Jiangsu 226000,China)

机构地区：[1]江苏省南通市肿瘤医院检验科,江苏南通226000

出　　处：《检验医学与临床》2022年第17期2305-2308,2313,共5页Laboratory Medicine and Clinic

基　　金：江苏省南通市科技局计划项目(MSZ18246)。

摘　　要：目的探讨血清肿瘤标志物癌胚抗原(CEA)、糖类抗原(CA)19-9、CA72-4、胃泌素-17(G-17)、胃蛋白酶原(PG)Ⅰ、PGⅡ及PGⅠ/PGⅡ(PGR)在胃癌中的表达及意义。方法选取2019年8月至2020年5月于该院住院的68例胃癌患者为胃癌组,84例胃部良性病变患者为良性病变组,150例体检健康者为对照组。分析各组肿瘤标志物血清水平对胃癌的早期诊断价值及与胃癌患者的病变部位、是否转移、性别和年龄之间的关系。分析手术前后血清G-17和PGⅡ水平变化。采用受试者工作特征(ROC)曲线评价各指标对胃癌的辅助诊断价值。结果G-17、PGⅡ、PGR在对照组和良性病变组间比较,差异有统计学意义(P<0.05)。CEA、CA19-9、CA72-4、G-17、PGⅠ、PGⅡ、PGR在对照组和胃癌组间比较,差异有统计学意义(P<0.05)。CA19-9在贲门+胃底部和胃窦+胃角部间比较,差异有统计学意义(P<0.05)。肿瘤是否转移、患者性别和年龄对各肿瘤标志物血清水平无影响(P>0.05)。Spearman相关分析结果表明,CEA和CA19-9(P=0.009,r=0.316)、CEA和CA724(P=0.001,r=0.427)、PGⅠ和PGⅡ(P=0.001,r=0.616)、PGⅠ和G-17(P=0.013,r=0.299)、PGⅡ和G-17(P=0.013,r=0.299)均呈正相关。ROC曲线结果表明,CEA、CA19-9、CA72-4、G-17、PGⅠ、PGⅡ诊断胃癌的曲线下面积分别是0.600、0.630、0.627、0.603、0.636、0.725。PGⅠ和PGⅡ联合诊断的准确度最高,为78.9%。PGⅡ在胃癌患者手术前后血清水平比较,差异无统计学意义(P=0.593),G-17在胃癌患者手术前后血清水平比较,差异有统计学意义(P=0.001)。结论PGⅡ在胃癌早期大规模筛查中诊断价值最大,其次是PGⅠ,合理地选择联合诊断项目,可提高诊断效率。G-17可作为胃癌术后动态监测指标。Objective To investigate the expression and significance of serum tumor markers carcinoembryonic antigen(CEA),carbohydrate antigen(CA)19-9,CA72-4,gastrin-17(G-17),pepsinogen(PG)Ⅰ,PGⅡand PGⅠ/PGⅡ(PGR)in gastric cancer.Methods A total of 68 patients with gastric cancer who were hospitalized in the hospital from August 2019 to May 2020 were selected as the gastric cancer group,84 patients with benign gastric lesions were selected as the benign lesion group,and 150 patients with healthy physical examinations were selected as the control group.The value of serum levels of tumor markers in each group for early diagnosis of gastric cancer and the relationship with the lesion location,metastasis,gender and age of gastric cancer patients were analyzed.The changes of serum G-17 and PGⅡlevels before and after surgery were analyzed.The receiver operating characteristic(ROC)curve was used to evaluate the auxiliary diagnostic value of each index for gastric cancer.Results There were significant differences in G-17,PGⅡ,and PGR between the control group and the benign lesion group(P<0.05).There were significant differences in CEA,CA19-9,CA72-4,G-17,PGⅠ,PGⅡ,and PGR between the control group and the gastric cancer group(P<0.05).The difference of CA19-9 level between the cardia+fundus and the antrum+gastric angle was statistically significant(P<0.05).The tumor metastasis,gender and age of patients had no effect on the serum levels of each tumor marker(P>0.05).Spearman correlation analysis showed that CEA and CA19-9(P=0.009,r=0.316),CEA and CA724(P=0.001,r=0.427),PGⅠand PGⅡ(P=0.001,r=0.616),PGⅠand G-17(P=0.013,r=0.299),PGⅡand G-17(P=0.013,r=0.299)were positively correlated.The ROC curve results showed that the area under the curve of CEA,CA19-9,CA72-4,G-17,PGⅠ,PGⅡfor the diagnosis of gastric cancer were 0.600,0.630,0.627,0.603,0.636,0.725,respectively.The combined diagnosis of PGⅠand PGⅡhad the highest accuracy rate of 78.9%.There was no significant difference in serum levels of PGⅡbefore and after s

关 键 词：胃癌 肿瘤标志物 联合诊断 胃泌素-17 胃蛋白酶原 

分 类 号：R735.2[医药卫生—肿瘤]