新型胃癌筛查评分系统评分联合细胞角质蛋白19片段抗原21-1、糖类抗原242单独及联合检测对早期胃癌及癌前病变的诊断价值  

Diagnostic value of the new gastric cancer screening scoring system,cyto-keratin 19 fragment antigen 21-1 and carbohydrate antigen 242 single and combined detection in early gastric cancer and precancerous lesions

作　　者：李俊 李梦伶 李玥秋 李中华 LI Jun;LI Mengling;LI Yueqiu;LI Zhonghua(Department of Health Management Medicine,2Department of General Medicine,3Department of Gastroenterology,Shangrao People’s Hospital,Shangrao 334000,Jiangxi,China)

机构地区：[1]上饶市人民医院健康管理医学科,江西上饶334000 [2]上饶市人民医院全科医学科,江西上饶334000 [3]上饶市人民医院消化内科,江西上饶334000

出　　处：《癌症进展》2025年第4期452-455,共4页Oncology Progress

基　　金：上饶市社会发展领域科技指导计划项目(2023CZDX180)。

摘　　要：目的探讨新型胃癌筛查评分系统(简称新评分系统)评分联合细胞角质蛋白19片段抗原21-1(CYFRA21-1)、糖类抗原242(CA242)对早期胃癌及癌前病变的诊断价值。方法选取60例接受胃镜检查并取组织进行病理检查的胃部疾病患者,根据病理检查结果分为早期胃癌组(6例)、癌前病变组(17例)及良性病变组(37例)。比较3组患者的新评分系统评分及CYFRA21-1、CA242水平,并采用受试者工作特征(ROC)曲线及曲线下面积(AUC)分析新评分系统评分、CYFRA21-1、CA242对早期胃癌及癌前病变的诊断价值。结果早期胃癌组患者新评分系统评分及CYFRA21-1、CA242水平均高于癌前病变组及良性病变组,癌前病变组患者新评分系统评分及CYFRA21-1、CA242水平均高于良性病变组,差异均有统计学意义(P﹤0.05)。ROC曲线显示,新评分系统评分、CYFRA21-1、CA242诊断早期胃癌及癌前病变的AUC分别为0.926、0.969、0.912。新评分系统评分、CYFRA21-1、CA242联合检测诊断早期胃癌及癌前病变的AUC为0.976(95%CI:0.752~0.987),灵敏度为98.6%,特异度为89.6%。结论新评分系统评分、CYFRA21-1、CA242联合检测对早期胃癌及癌前病变的诊断价值较高。Objective To explore the diagnostic value of the new gastric cancer screening scoring system(referred to as the new scoring system),cyto-keratin 19 fragment antigen 21-1(CYFRA21-1)and carbohydrate antigen 242(CA242)single and combined detection in early gastric cancer and precancerous lesions.Method Sixty patients with gastric diseases who underwent gastroscopy and tissue biopsy for pathological examination were selected and divided into early gastric cancer group(6 cases),precancerous lesion group(17 cases),and benign lesion group(37 cases)according to the pathological examination results.The new scoring system score and the levels of CYFRA21-1 and CA242 in the three groups were compared,and the receiver operating characteristic(ROC)curve and area under the curve(AUC)were used to analyze the diagnostic value of the new scoring system score,CYFRA21-1,and CA242 for early gastric cancer and precancerous lesions.Result The new scoring system score and the levels of CYFRA21-1 and CA242 in the early gastric cancer group were higher than those in the precancerous lesion group and the benign lesion group,and the new scoring system score and the levels of CYFRA21-1 and CA242 in the precancerous lesion group were higher than those in the benign lesion group,and the differences were statistically significant(P<0.05).The ROC curve showed that the AUC of the new scoring system score,CYFRA21-1,and CA242 for the diagnosis of early gastric cancer and precancerous lesions were 0.926,0.969,and 0.912,respectively.The AUC of the combined detection of the new scoring system score,CYFRA21-1,and CA242 for the diagnosis of early gastric cancer and precancerous lesions was 0.976(95%CI:0.752-0.987),with a sensitivity of 98.6%and a specificity of 89.6%.Conclusion The new scoring system score,CYFRA21-1 and CA242 combined detection has a high diagnostic value in early gastric cancer and precancerous lesions.

关 键 词：早期胃癌 癌前病变 新型胃癌筛查评分系统 细胞角质蛋白19片段抗原21-1 糖类抗原242 

分 类 号：R735.2[医药卫生—肿瘤]