肿瘤标志物及血清胃蛋白酶原指标联合检测对早期胃癌的诊断价值探讨  

The value of combined detection of tumor markers and serum pepsinogens in the diagnosis of early gastric cancer

作　　者：王志达 肖峰 芦珂 WANG Zhi-da;XIAO Feng;LU Ke(School Hospital,Qilu University of Technology(Shandong Academy of Sciences),Jinan 250353,China)

机构地区：[1]齐鲁工业大学(山东省科学院)校医院,250353 [2]山东省第二人民医院检验科,250022 [3]济南市中医医院检验科,250012

出　　处：《中国实用医药》2025年第2期69-72,共4页China Practical Medicine

摘　　要：目的探讨肿瘤标志物[癌胚抗原(CEA)、糖类抗原724(CA724)、糖类抗原199(CA199)]及血清胃蛋白酶原指标[胃蛋白酶原Ⅰ(PGⅠ)、胃蛋白酶原Ⅱ(PGⅡ)、胃蛋白酶原Ⅰ/胃蛋白酶原Ⅱ比值(PGR)]联合检测对早期胃癌的诊断价值。方法选取60例胃癌患者作为胃癌组、60例良性胃部疾病患者作为胃病组,另选取60例健康体检者作为健康组。三组均行肿瘤标志物及血清胃蛋白酶原指标检测。对比三组肿瘤标志物及血清胃蛋白酶原指标水平与阳性检出率,肿瘤标志物及血清胃蛋白酶原指标单项检测与联合检测的阳性检出率以及对胃癌的诊断效能。结果胃癌组的CEA(15.57±3.94)ng/ml、CA724(25.45±4.53)U/ml、CA199(58.25±8.05)U/ml均高于胃病组的(2.03±0.45)ng/ml、(3.87±0.65)U/ml、(14.23±3.74)U/ml和健康组的(1.45±0.40)ng/ml、(2.11±0.42)U/ml、(11.06±3.01)U/ml,PGⅠ(39.52±9.47)ng/ml、PGⅡ(10.47±2.15)ng/ml、PGR(2.15±0.40)低于胃病组的(77.46±10.30)ng/ml、(15.39±2.06)ng/ml、(4.11±0.67)和健康组的(118.12±31.03)ng/ml、(16.15±2.89)ng/ml、(7.23±1.40)(P<0.05)。胃癌组的CEA、CA724、CA199、PGⅠ、PGⅡ、PGR阳性检出率分别为35.00%、66.67%、48.33%、55.00%、51.67%、63.33%,均高于胃病组的15.00%、16.67%、8.33%、10.00%、8.33%、11.67%和健康组的3.33%、1.67%、0、0、1.67%、1.67%(P<0.05)。胃癌组的肿瘤标志物及血清胃蛋白酶原指标单项检测与联合检测的阳性检出率均高于胃病组和健康组(P<0.05)。肿瘤标志物及血清胃蛋白酶原指标联合检测对早期胃癌的诊断准确度、敏感度分别为95.56%、91.67%,均高于肿瘤标志物单项检测的89.44%、78.33%和血清胃蛋白酶原指标单项检测的88.88%、75.00%(P<0.05)。结论肿瘤标志物及血清胃蛋白酶原指标在早期胃癌患者中呈异常表达,两项指标联合检测能够提高早期胃癌的检出率,具有一定的临床诊断价值。Objective To explore the value of combined detection of tumor markers[carcinoembryonic antigen(CEA),carbohydrate antigen 724(CA724),carbohydrate antigen 199(CA199)]and serum pepsinogens[pepsinogen Ⅰ(PG-Ⅰ),pepsinogen Ⅱ(PG-Ⅱ),PG-Ⅰ/PG-Ⅱ ratio(PGR)]in the diagnosis of early gastric cancer.Methods 60 patients with gastric cancer were selected as the gastric cancer group,60 patients with benign gastric diseases were selected as the gastric disease group,and another 60 healthy medical checkups were selected as the healthy group.Tumor markers and serum pepsinogen indexes were tested in all three groups.The levels and positive rates of tumor markers and serum pepsinogens were compared among the three groups;the positive rates of single and combined detection of tumor markers and serum pepsinogens were compared,as well as their diagnostic efficacy for gastric cancer.Results The gastric cancer group had CEA of(15.57±3.94)ng/ml,CA724 of(25.45±4.53)U/ml and CA199 of(58.25±8.05)U/ml,which were higher than those in the gastric disease group[(2.03±0.45)ng/ml,(3.87±0.65)U/ml and(14.23±3.74)U/ml]and the healthy group[(1.45±0.40)ng/ml,(2.11±0.42)U/ml and(11.06±3.01)U/ml];the gastric cancer group had PG-Ⅰ of(39.52±9.47)ng/ml,PG-Ⅱ of(10.47±2.15)ng/ml and PGR of(2.15±0.40),which were lower than those in the gastric disease group[(77.46±10.30)ng/ml,(15.39±2.06)ng/ml and(4.11±0.67)]and the healthy group[(118.12±31.03)ng/ml,(16.15±2.89)ng/ml and(7.23±1.40)](P<0.05).The positive rates of CEA,CA724,CA199,PG-Ⅰ,PG-Ⅱ and PGR in gastric cancer group were 35.00%,66.67%,48.33%,55.00%,51.67%and 63.33%,which were higher than those in the gastric disease group(15.00%,16.67%,8.33%,10.00%,8.33% and 11.67%)and the healthy group(3.33%,1.67%,0,0,1.67% and 1.67%)(P<0.05).The positive rates of single and combined detection of tumor markers and serum pepsinogens in gastric cancer group were higher than those in the gastric disease group and the healthy group(P<0.05).The diagnostic accuracy and sensitivity of combined d

关 键 词：肿瘤标志物 血清胃蛋白酶原指标 早期胃癌 诊断 

分 类 号：R735.2[医药卫生—肿瘤]