机构地区:[1]中山大学孙逸仙纪念医院检验科,广东广州510120 [2]珠海市中西医结合医院检验科,广东珠海519020
出 处:《中华临床实验室管理电子杂志》2022年第4期233-237,共5页Chinese Journal of Clinical Laboratory Management(Electronic Edition)
摘 要:目的探讨甲胎蛋白(AFP)、癌胚抗原(CEA)、糖类抗原199(CA199)、糖类抗原724(CA724)、糖类抗原125(CA125)、糖类抗原50(CA50)、糖类抗原242(CA242)及胃蛋白酶原Ⅰ(PGⅠ)、胃蛋白酶原Ⅱ(PGⅡ)、胃蛋白酶原比值(PGR,PGⅠ/PGⅡ)十项血清标志物在胃癌诊疗中的应用价值。方法选取2018年8月至2019年2月在中山大学孙逸仙纪念医院就诊并经胃镜及病理组织确诊为胃癌的患者67例,设为胃癌组,根据是否行腹腔下根治术,分为胃癌术前亚组30例,胃癌术后亚组37例。同时期30例良性胃病患者设为胃炎组,20例健康体检者设为健康对照组。分别检测其AFP、CEA、CA199、CA724、CA125、CA50、CA242、PGⅠ、PGⅡ和PGR,分析这些指标在胃癌诊疗中的应用价值。结果胃癌术前亚组CEA、CA199、CA724、CA125、CA242水平均高于健康对照组、胃炎组及胃癌术后亚组(P<0.05),PGⅠ、PGⅡ、PGR水平低于健康对照组、胃炎组,PGⅠ、PGⅡ高于胃癌术后亚组(P<0.05);胃癌术后亚组PGⅠ、PGⅡ水平低于健康对照组。单项和联合指标诊断胃癌ROC曲线分析结果显示,PGⅠ+PGⅡ+PGR联合诊断曲线下面积为0.759;十项血清标志物联合诊断曲线下面积为0.871。结论CEA、CA199、CA724、CA125、CA242、PGⅠ、PGⅡ、PGR在胃癌的诊断、良恶性肿瘤的鉴别诊断中均有一定的临床价值,PGⅠ、PGⅡ、PGR检测有助于评估监测胃黏膜功能,PGⅠ+PGⅡ+PGR、十项血清标志物联合检测对胃癌诊断均具有较好的诊断性能。Objective To investigate the diagnostic performance of ten serum markers of AFP,CEA,CA199,CA724,CA125,CA50,CA242 and PGⅠ,PGⅡand PGR(PGⅠ/PGⅡ)in gastric cancer.Methods 67 cases of gastric cancer patients in our hospital from August 2018 to February 2019 were selected as gastric cancer patients.All of the included cases were diagnosed with gastric cancer by gastroscopy and pathological tissue.According to whether sub-abdominal radical resection was performed,it was divided into 30 cases in the preoperative subgroup of gastric cancer and 37 cases in the postoperative subgroup of gastric cancer.In the same period,30 cases with benign gastric disease were selected as gastritis group,and 20 cases of healthy physical examination were selected as healthy control group.AFP,CEA,CA199,CA724,CA125,CA50,CA242,PGⅠ,PGⅡand PGR were detected,and the application value of these indicators in the diagnosis and treatment of gastric cancer.Results The concentration levels of CEA,CA199,CA724,CA125 and CA242 in the preoperative subgroup of gastric cancer were higher than those in healthy control group,gastritis group and postoperative gastric cancer subgroup(P<0.05),and the levels of PGⅠ,PGⅡand PGR were lower than those in the healthy control group and the gastritis group,the levels of PGⅠ,PGⅡwere higher than the postoperative subgroup of gastric cancer(P<0.05).The levels of PGI and PGII in the postoperative subgroup of gastric cancer were lower than those in the healthy control group.The results of ROC curve analysis showed that the area under the combined diagnostic curves of PGⅠ,PGⅡand PGR was 0.759.The area under the combined diagnostic curve of ten serum markers was 0.871.Conclusions CEA,CA199,CA724,CA125,CA242,PGⅠ,PGⅡ,PGR have certain clinical value in the diagnosis of gastric cancer and the differential diagnosis of benign and malignant tumors.PGⅠ,PGⅡ,PGR tests are useful for assessing and monitoring gastric mucosal function,The combination of PGⅠ,PGⅡ,PGR and ten serum markers have good diagnost
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