窄带成像放大内镜联合血清CEA、CA72-4、CA199、CA242在胃癌早期诊断中的应用研究  

Application of magnified endoscopy with narrow band imaging combined with serum CEA,CA72-4,CA199 and CA242 in early diagnosis of gastric cancer

作　　者：黄土星 HUANG Tuxing(Department of Gastroenterology,Haining Second People's Hospital,Jiaxing 314419,China)

机构地区：[1]海宁市第二人民医院消化内科,浙江嘉兴314419

出　　处：《全科医学临床与教育》2024年第8期694-697,共4页Clinical Education of General Practice

摘　　要：目的探讨窄带成像放大内镜(ME-NBI)联合血清癌胚抗原(CEA)、癌抗原724(CA72-4)、癌抗原199(CA199)及癌抗原242(CA242)在胃癌早期诊断的应用价值。方法回顾性分析行胃癌筛查的2186例受检者临床资料。所有患者均接受ME-NBI检查,并检测血清CEA、CA72-4、CA199及CA242水平。以病理结果为准,分析良性病变者、早期胃癌者、进展期胃癌者及健康无病变者间血清CEA、CA72-4、CA199、CA242、ME-NBI检出率差异。绘制受试者工作特征(ROC)曲线,评估单一与联合诊断效能。结果病理结果显示,2186例受检者中,良性疾病者672例、早期胃癌者30例、进展期胃癌者5例、健康无病变者1479例。血清CEA、CA72-4、CA199、CA242水平与疾病严重程度呈正相关(rs分别=0.42、0.39、0.41、0.43,P均<0.05);ME-NBI对胃黏膜病变的总体检出率为88.40%,其中对早期胃癌检出率最高,为90.00%。ME-NBI对不同胃黏膜病变的检出率比较,差异无统计学意义(χ^(2)=1.30,P>0.05)。联合检测ROC曲线下面积(AUC)最高为0.95。结论ME-NBI技术联合血清CEA、CA72-4、CA199、CA242可作为临床诊断早期胃癌的辅助方法,能提高诊断准确性,对改善患者预后具有重要价值。Objective To investigate the application value of magnified endoscopy with narrow band imaging(ME-NBI)combined with serum carcinoembryonic antigen(CEA),cancer antigen 724(CA72-4),cancer antigen 199(CA199)and cancer antigen 242(CA242)in early diagnosis of gastric cancer.Methods The clinical data of 2,186 individuals who underwent gastric cancer screening were analyzed retrospectively.All subjects underwent ME-NBI examination and were detected for serum CEA,CA72-4,CA199 and CA242 levels.Based on pathological results,the levels of laboratory indicators in individuals with benign lesions,early gastric cancer,advanced gastric cancer and healthy ones,and the detection rates of ME-NBI were analyzed.The receiver operating characteristic(ROC)curves were plotted to evaluate the efficacy of single diagnosis and combined diagnosis.Results Of the 2,186 individuals,672 had benign diseases,30 had early gastric cancer,5 had advanced gastric cancer,and the remaining 1,479 were healthy.Serum CEA,CA72-4,CA199 and CA242 levels were positively correlated with disease severity(rs=0.42,0.39,0.41,0.43,P<0.05).The overall detection rate of ME NBI for gastric mucosal lesions was 88.40%,and the detection rate for early gastric cancer was the highest,which was 90.00%.There was no statistically significant difference in the detection rate of ME-NBI for different gastric mucosal lesions(χ^(2)=1.30,P>0.05).The AUC of combined detection was the largest,which was 0.95.Conclusion ME-NBI combined with serum CEA,CA72-4,CA199 and CA242 can serve as an auxiliary method for clinical diagnosis of early gastric cancer.The combination can improve diagnostic accuracy,which is of great importance for improving the prognosis.

关 键 词：窄带成像 放大内镜 癌胚抗原 癌抗原724 癌抗原199 癌抗原242 

分 类 号：R735.2[医药卫生—肿瘤]