胃癌筛查3种评分方法的临床应用价值研究  

Study on the clinical application value of three scoring methods for gastric cancer screening

作　　者：王华[1] 王弦[2] 石振旺 WANG Hua;WANG Xian;SHI Zhenwang(Gastroenterology Department,the Second People’s Hospital of Hefei,Hefei 230000,China;Pathology Department,the Second Affiliated Hospital of Anhui Medical University,Hefei 230601,China)

机构地区：[1]合肥市第二人民医院消化内科,安徽合肥230000 [2]安徽医科大学第二附属医院病理科,安徽合肥230601

出　　处：《安徽医学》2023年第8期929-933,共5页Anhui Medical Journal

摘　　要：目的 评价新的胃癌筛查评分(即李氏评分)、日本评分法及ABC法在早期胃癌筛查中的应用价值。方法 收集2018年6月至2021年12月于合肥市第二人民医院住院及门诊患者147例。在记录相关信息后,采用日本评分法、李氏评分及ABC法对所有患者进行评分。根据患者的内镜病理检查绘制受试者工作特征(ROC)曲线,分别采用日本评分、李氏评分及ABC法确定诊断早期胃癌的最佳分界点。计算并比较3种评分方法的灵敏度和特异度。结果 纳入的147例患者中检出胃癌5例(3.4%),萎缩伴或不伴癌前病变65例(44.22%)。日本评分、李氏评分及ABC法诊断早期胃癌的ROC曲线下面积分别为0.686、0.736及0.594。日本评分最佳分界点为5.5分,即认为日本评分≥6分为早期胃癌筛查标准,灵敏度和特异度分别为94.3%和31.2%。李氏评分最佳分界点为9.5分,即认为李氏评分≥10分为早期胃癌筛查标准,灵敏度和特异度分别为71.4%和63.6%;ABC法最佳分界点为B和C之间,即认为ABC法≥C为早期胃癌筛查标准,灵敏度和特异度分别为60.0%和58.4%。结论 李氏评分特异度优于日本评分及ABC法,日本评分灵敏度优于李氏评分及ABC法。Objective To evaluate the new gastric cancer screening score(Li’s score).,Japanese scoring methods and ABC method for screening early gastric cancer in early gastric cancer and precancerous lesions.Methods A total of 147 inpatients and outpatients in the Second People's Hospital of Hefei City from June 2018 to December 2021 were collected.After recording the basic information,all volunteers were scored using the Li’s scoring method,Japanese scoring method and ABC method.The subjects’work characteristics(ROC curve)were drawn according to the patient’s endoscopic pathological examination to indicate early gastric cancer,to determine the best cut-off point for the diagnosis of early gastric cancer by the Li’s scoring method,Japanese scoring method and ABC method,respectively.The sensitivity and specificity of both scoring methods were calculated as well.Results Among the 147 patients included,5(3.4%)had gastric cancer and 65(44.22%)had atrophy with or without precancerous lesions.The area under the ROC curve of Li’s scoring method,Japanese scoring method and ABC method,in the diagnosis of early gastric cancer,was0.686、0.736and 0.594,respectively.The best cut-off point of Japanese scoring method was 5.5,that is,Japanese score≥6 was considered as the criteria for early gastric cancer screening,and the sensitivity and specificity were 94.3%and 31.2%,respectively.The best cut-off point of Li’s scoring method was 9.5,that is,Li’s score≥10 was considered as the screening standard for early gastric cancer,and the sensitivity and specificity were 71.4%and 63.6%,respectively.The best cut-off point of ABC method was between B and C,that is,ABC method≥C was considered as the screening standard for early gastric cancer,and the sensitivity and specificity were 60.0%and 58.4%,respectively.The area under the ROC curve in Li’s scoring is more significant than that in Japanese scoring and ABC method.Conclusions The Li’s scoring method has better specificity than the Japanese scoring method and ABC method,

关 键 词：李氏评分法 日本评分法 ABC法 胃癌 癌前病变 

分 类 号：R735.2[医药卫生—肿瘤]