血清CEA、AFP、CA199、CA125联合检测诊断胃癌的ROC曲线分析及临床指导意义  

ROC curve analysis of serum CEA,AFP,CA199 and CA125 in diagnosis of gastric cancer and its clinical guiding significance

作　　者：张莹[1] 李静[1] 徐有青[1] Zhang Ying;Li Jing;Xu You-qing(Department of Gastroenterology,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070 China)

机构地区：[1]首都医科大学附属北京天坛医院消化内科,北京100070

出　　处：《湖南师范大学学报（医学版）》2022年第4期84-87,共4页Journal of Hunan Normal University(Medical Sciences)

基　　金：北京市科技计划项目(2018-TG-23)。

摘　　要：目的:分析血清癌胚抗原(CEA)、甲胎蛋白(AFP)、糖类抗原199(CA199)、糖类抗原125(CA125)联合检测诊断胃癌的受试者工作曲线(ROC)及临床指导意义。方法:回顾性收集2019年1月~2021年12月我院收治的89例胃癌患者和77例胃良性病变患者临床资料分别作为恶性组和良性组,选取同期在我院进行体检的79例健康体检者体检资料作为健康对照组。比较三组患者血清CEA、AFP、CA199、CA125水平,根据胃癌患者临床分期将其分为Ⅰ/Ⅱ期组(34例)、Ⅲ/Ⅳ期组(55例),比较两组血清CEA、AFP、CA199、CA125水平。采用ROC曲线分析血清CEA、AFP、CA199、CA125单独及联合检测诊断胃癌的曲线下面积(AUC)、敏感度、特异度。结果:健康对照组、良性组、恶性组患者血清CEA、AFP、CA199、CA125水平呈升高趋势,差异有统计学意义(P<0.05)。Ⅲ/Ⅳ期组患者血清CEA、AFP、CA199、CA125水平高于Ⅰ/Ⅱ期组。通过Medcalc软件绘制ROC曲线对各指标单独及联合检验诊断胃癌的AUC进行比较,结果显示血清CEA、AFP、CA199、CA125水平联合检测诊断胃癌的AUC为0.950,高于CEA、AFP、CA199、CA125单一检测。结论:随着患者胃部病变恶性程度升高,血清CEA、AFP、CA199、CA125水平升高,同时四者联合检测诊断胃癌的AUC较高,因此临床可将CEA、AFP、CA199、CA125联合用于胃癌患者的早期诊断,提高胃癌早期检出率。Objective To analyze the receiver operating characteristic (ROC) analysis of serum CEA,AFP,CA199 and CA125 in the diagnosis of gastric cancer and its clinical significance.Methods The clinical data of 89 patients with gastric cancer and 77 patients with benign gastric lesions admitted to our hospital from January 2019 to December 2021 were retrospectively collected as the malignant group and the benign group,respectively.The physical examination data of 79 healthy people who underwent physical examination in our hospital during the same period were selected as the healthy control group.The levels of serum CEA,AFP,CA199 and CA125 of the three groups were analyzed.According to the clinical stage of gastric cancer,the patients were divided into the stage Ⅰ/Ⅱ group (34 cases) and the stage Ⅲ/Ⅳ group (55 cases),and the levels of serum CEA,AFP,CA199 and CA125 were compared between the two groups.ROC curve was used to analyze the area under curve (AUC),sensitivity and specificity of CEA,AFP,CA199 and CA125 in the diagnosis of gastric cancer alone and in combination.Results The levels of serum CEA,AFP,CA199 and CA125 in the healthy control group,the benign group and the malignant group showed an increasing trend,and the differences among groups were statistically significant.The levels of serum CEA,AFP,CA199 and CA125 in stage Ⅲ/Ⅳ group were higher than those in stage Ⅰ/Ⅱ group.The healthy control group and benign group were negative,while the malignant group was positive.ROC curves were drawn by Medcalc software to compare the AUC of each indicator in the diagnosis of gastric cancer by single and combined tests.The results showed that the AUC of serum CEA,AFP,CA199 and CA125 combined tests was 0.950,higher than CEA,AFP,CA199 and CA125.Conclusion With the increase of the malignant degree of gastric lesions,levels of serum CEA,AFP,CA199 and CA125 increased,and the AUC of the combined detection of the four patients was higher.Therefore,the combination of CEA,AFP,CA199 and CA125 could be used in the early di

关 键 词：胃癌 癌胚抗原 甲胎蛋白 糖类抗原199 糖类抗原125 受试者工作曲线 

分 类 号：R735.2[医药卫生—肿瘤]