CEA、CA125、CA199、CA724、G⁃17诊断早期胃癌的效果  

Efficacy of CEA,CA125,CA199,CA724,and G-17 in diagnosing early gastric cancer

作　　者：张晓彤 张兰胜 赵亚琦 韩卫 Zhang Xiaotong;Zhang Lansheng;Zhao Yaqi;Han Wei(Department of Laboratory Medicine,General Hospital of Xuzhou Mining Group,the Second Affiliated Hospital of Xuzhou Medical University,Xuzhou 221006,China;Department of Radiotherapy,General Hospital of Xuzhou Mining Group,the Second Affiliated Hospital of Xuzhou Medical University,Xuzhou 221006,China)

机构地区：[1]徐州医科大学第二附属医院徐州矿务集团总医院检验科,徐州221006 [2]徐州医科大学第二附属医院徐州矿务集团总医院放疗科,徐州221006

出　　处：《肿瘤研究与临床》2025年第3期206-210,共5页Cancer Research and Clinic

摘　　要：目的探讨癌胚抗原(CEA)、糖类抗原125(CA125)、糖类抗原199(CA199)、糖类抗原724(CA724)、胃泌素17(G⁃17)检测在胃癌患者早期诊断中的临床价值。方法回顾性病例对照研究。选取徐州矿务集团总医院2019年1月至2021年12月住院的120例胃部疾病患者,根据胃镜检查病理结果分为胃溃疡组(23例)、萎缩性胃炎组(58例)、早期胃癌组(39例),健康对照组为同期体检健康者(30名)。所有入组者行血清CEA、CA125、CA199、CA724、G⁃17等水平测定。比较各组各指标水平。以胃镜检查病理结果为金标准,采用受试者工作特征(ROC)曲线分析各指标在鉴别早期胃癌与健康人、胃溃疡、萎缩性胃炎中的效果。结果早期胃癌组患者血清CA125[M(Q1,Q3)][19.94(8.29,22.99)U/ml比6.03(4.07,10.48)U/ml、7.49(4.96,12.19)U/ml、7.54(6.20,11.91)U/ml]、CA199[32.09(15.68,41.97)U/ml比19.19(10.01,30.05)U/ml、21.00(16.01,32.71)U/ml、18.95(13.90,32.76)U/ml]、CA724[19.55(3.91,26.25)U/ml比4.61(3.06,5.24)U/ml、4.09(3.37,5.00)U/ml、4.88(3.92,5.46)U/ml]和G⁃17[21.01(14.67,24.00)pmol/L比11.80(10.07,16.58)pmol/L、12.74(11.09,14.69)pmol/L、12.08(8.40,15.10)pmol/L]水平均高于胃溃疡组、萎缩性胃炎组和健康对照组,差异均有统计学意义(均P<0.05);早期胃癌组、胃溃疡组和萎缩性胃炎组CEA水平均高于健康对照组[4.38(3.22,7.56)ng/ml、4.51(3.37,5.51)ng/ml、4.49(4.13,5.09)ng/ml比3.95(2.16,4.44)ng/ml],差异均有统计学意义(均P<0.05)。ROC曲线分析显示,各指标中,G⁃17鉴别早期胃癌和健康人的曲线下面积(AUC)最大,为0.825(95%CI:0.728~0.922),最佳临界值为18.21 pmol/L,相应的特异度亦最高,为96.7%;CA125和CA724的AUC也较高,分别为0.768(95%CI:0.653~0.884)、0.744(95%CI:0.622~0.866),最佳临界值分别15.41、39.60 U/ml,相应的灵敏度均为71.8%,为几项指标中最高者。各指标中,CA125鉴别早期胃癌和胃溃疡的AUC最大,为0.829(95%CI:0.729~0.930),最佳临界值为11.60 U/ml,相应的灵敏Objective To explore the clinical values of carcinoembryonic antigen(CEA),carbohydrate antigen 125(CA125),carbohydrate antigen 199(CA199),carbohydrate antigen 724(CA724)and gastrin 17(G-17)detections in the early diagnosis of gastric cancer patients.Methods A retrospective case-control study was conducted.A total of 120 patients with gastric diseases who were admitted to General Hospital of Xuzhou Mining Group from January 2019 to December 2021 were selected.According to the pathological results of gastroscopy examination,the patients were divided into gastric ulcer group(23 cases),atrophic gastritis group(58 cases)and early gastric cancer group(39 cases).The healthy control group consisted of 30 healthy individuals who underwent physical examination during the same period.All participants were detected for serum levels of CEA,CA125,CA199,CA724,and G-17.The levels of various indicators in each group were compared.Using the pathological results of gastroscopy as the gold standard,the receiver operating characteristic(ROC)curve was used to analyze the efficacy of various indicators in distinguishing early gastric cancer from healthy individuals,gastric ulcer and atrophic gastritis.Results The serum levels of CA125[M(Q1,Q3)][19.94(8.29,22.99)U/ml vs.6.03(4.07,10.48)U/ml,7.49(4.96,12.19)U/ml,7.54(6.20,11.91)U/ml],CA199[32.09(15.68,41.97)U/ml vs.19.19(10.01,30.05)U/ml,21.00(16.01,32.71)U/ml,18.95(13.90,32.76)U/ml],CA724[19.55(3.91,26.25)U/ml vs.4.61(3.06,5.24)U/ml,4.09(3.37,5.00)U/ml,4.88(3.92,5.46)U/ml]and G-17[21.01(14.67,24.00)pmol/L vs.11.80(10.07,16.58)pmol/L,12.74(11.09,14.69)pmol/L,12.08(8.40,15.10)pmol/L]in the early gastric cancer group were higher than those in the gastric ulcer group,atrophic gastritis group and healthy control group,and the differences were statistically significant(all P<0.05).The CEA level in the early gastric cancer group,gastric ulcer group and atrophic gastritis group was all higher than that in the healthy control group[4.38(3.22,7.56)ng/ml,4.51(3.37,5.51)ng/ml,4.49(4.13,5.09)ng/ml v

关 键 词：胃肿瘤 癌胚抗原 胃泌素类 CA⁃125抗原 CA⁃19⁃9抗原 CA724抗原 诊断 鉴别 

分 类 号：R735.2[医药卫生—肿瘤]