血清胃蛋白酶原Ⅰ、胃泌素17联合癌胚抗原检测对进展期胃癌患者化疗疗效的评估价值  

Evaluation value of serum pepsinogenⅠ,gastrin 17 combined with carcinoembryonic antigen on efficacy of chemotherapy in patients with advanced gastric cancer

作　　者：王真真 贾彦巍 景天闯[2] 曾进 徐冰 WANG Zhen-zhen;JIA Yan-wei;JING Tian-chuang;ZENG Jin;XU Bing(Department of Clinical Laboratory,Nanyang Central Hospital,Nanyang 473000,Henan,CHINA;Department of Clinical Pharmacy,Nanyang Central Hospital,Nanyang 473000,Henan,CHINA;Department of Clinical Laboratory,the Second People's Hospital of Nanzhao County,Nanyang 473000,Henan,CHINA)

机构地区：[1]南阳市中心医院检验科,河南南阳473000 [2]南阳市中心医院临床药学室,河南南阳473000 [3]南召县第二人民医院检验科,河南南阳473000

出　　处：《海南医学》2025年第6期804-807,共4页Hainan Medical Journal

基　　金：2023年度河南省南阳市科技发展计划项目(编号:23KJGG115)。

摘　　要：目的探究血清胃蛋白酶原Ⅰ(PGⅠ)、胃泌素17(G-17)联合癌胚抗原(CEA)对进展期胃癌患者行新辅助化疗疗效的评估价值。方法回顾性分析2021年1月至2024年1月于南阳市中心医院行新辅助化疗治疗的103例进展期胃癌患者的临床资料,根据化疗效果分为化疗有效组71例和化疗无效组32例,比较两组患者临床资料和PGⅠ、G-17、CEA水平,采用Logistic多因素回归模型分析化疗疗效的影响因素,采用Spearman法分析PGⅠ、G-17、CEA与化疗疗效的相关性,采用受试者工作特征(ROC)曲线分析PGⅠ、G-17、CEA对进展期胃癌患者行新辅助化疗疗效的评估价值。结果化疗有效组患者的PGⅠ水平为(89.52±18.21)μg/L,明显高于化疗无效组的(75.21±18.14)μg/L,G-17和CEA水平分别为(6.23±1.45)pmol/L、(5.42±1.81)μg/L,明显低于化疗无效组的(8.33±1.55)pmol/L、(7.26±1.84)μg/L,差异均有统计学意义(P<0.05);Logistic多因素回归模型分析结果显示,PGⅠ、G-17、CEA是进展期胃癌新辅助化疗疗效的独立影响因素(P<0.05);Spearman法分析结果显示,PGⅠ与化疗进展期胃癌新辅助化疗疗效呈负相关(r=-0.258,P=0.036),G-17、CEA与化疗疗效呈正相关(r=0.135/0.336,P=0.691/0.013);ROC曲线分析结果显示,PGⅠ、G-17、CEA及三者联合评估进展期胃癌新辅助化疗疗效的特异度分别为0.634、0.676、0.746、0.746,敏感度分别为0.719、0.875、0.719、0.844,曲线下面积(AUC)分别为0.692、0.846、0.749、0.882,PGⅠ、G-17、CEA联合评估进展期胃癌新辅助化疗疗效的敏感度、曲线下面积、特异度均大于PGⅠ、G-17、CEA单一指标评估(P<0.05)。结论血清PGⅠ、G-17联合CEA对进展期胃癌新辅助化疗患者的疗效具有较高的评估价值,PGⅠ与化疗疗效呈负相关,G-17、CEA与化疗疗效呈正相关。Objective To explore the evaluation value of combination of serum pepsinogenⅠ(PGⅠ),gastrin 17(G-17)combined with carcinoembryonic antigen(CEA)on the efficacy of neoadjuvant chemotherapy(NACT)in patients with advanced gastric cancer(GC).Methods A retrospective analysis was conducted on 103 patients with advanced GC who underwent NACT at Nanyang Central Hospital from January 2021 to January 2024.Patients were divided into an effective group(n=71)and an ineffective group(n=32)based on chemotherapy outcomes.Clinical data and levels of PGⅠ,G-17,and CEA were compared between the two groups.Logistic regression was used to identify factors influencing chemotherapy efficacy,Spearman correlation was applied to analyze the relationship between PGⅠ,G-17,CEA and efficacy,and receiver operating characteristic(ROC)curves was adopted to evaluate the diagnostic performance of PGⅠ,G-17,and CEA.Results The level of PGⅠin the effective group was(89.52±18.21)μg/L,significantly higher than(75.21±18.14)μg/L in the ineffective group;the levels of G-17 and CEA were(6.23±1.45)pmol/L and(5.42±1.81)μg/L,significantly lower than(8.33±1.55)pmol/L and(7.26±1.84)μg/L in the ineffective group;the differences were statistically significant(P<0.05).Multivariate logistic regression analysis showed that PGⅠ,G-17 and CEA were independent influencing factors of NACT efficacy in patients with advanced GC(P<0.05).Spearman analysis revealed that PGⅠwas negatively correlated with the efficacy of NACT(r=-0.258,P=0.036),while G-17 and CEA were positively correlated with the efficacy(r=0.135/0.336,P=0.691/0.013).ROC analysis revealed that the combination of PGⅠ,G-17,and CEA had higher sensitivity(0.844 vs 0.719/0.875/0.719),specificity(0.746 vs 0.634/0.676/0.746),and area under the curve(AUC)(0.882 vs 0.692/0.846/0.749)compared to individual biomarkers(P<0.05).Conclusion Serum PGⅠ,G-17 combined with CEA has high evaluation value on the efficacy of NACT in patients with advanced GC.PGⅠis negatively correlated with the efficacy

关 键 词：进展期胃癌 新辅助化疗 胃蛋白酶原Ⅰ 胃泌素17 癌胚抗原 疗效评估 

分 类 号：R735.2[医药卫生—肿瘤]