血清PG和TAM联合检测对胃癌早期诊断的价值

Clinical value of pepsinogen and serum tumor association material co-detection in the early diagnosis of gastric cancer

目的探讨血清胃蛋白酶原(PG)Ⅰ、Ⅱ和血清肿瘤相关物质(TAM)联合检测筛查胃癌的应用价值,为胃癌早期诊断提供新的理论和实验依据。方法选择80例受试者,其中胃癌患者40例,健康者40例,采用免疫比浊法测定血清PGⅠ、PGⅡ含量,并计算PGⅠ/PGⅡ比值;采用分光光度法测定血清TAM含量,分析联合检测血清PG和TAM对胃癌诊断的敏感性和特异性。结果与正常对照组相比,胃癌患者血清PGⅠ含量、PGⅠ/PGⅡ比值均显著降低(P<0.01),血清TAM含量明显升高(P<0.01),而血清PGⅡ含量无明显变化(P>0.05);单检胃癌患者血清胃蛋白酶原(PGⅠ及PGⅠ/PGⅡ)、TAM敏感性分别为75.00%、77.50%;特异性分别为72.50%、87.50%,两者联合检测在胃癌诊断中敏感性为92.50%,特异性为70.00%,联合检测的敏感性与单项检测的敏感性相比差异具有显著性(P<0.05)。结论联合检测血清胃蛋白酶原(PG)与血清肿瘤相关物质(TAM)筛查胃癌优于PG或TAM单筛,可明显提高胃癌早期诊断灵敏度。

[Objective] To explore the clinical value of c.ombined assay of serum pepsinogen Ⅰ （PG Ⅰ ）, pcpsino- gen Ⅱ （PG Ⅱ） and serum tumor association material （TAM） concentration for gastrie cancer sereening so as to pro- vide new theoretical and experimental basis for Ⅰhe early diagnosis of gastric cancer. [Methods] 80 subjects which include 40 gastric cancers and 40 healthy eontrols were chosen to measure serum PG Ⅰ and PG Ⅱ levels by immum）- turbidimetry and to calculate the ralio of the PG Ⅰ and PG Ⅱ. Serum TAM levels were measured by speetrophotome- try method. Then the sensitivity and specificity were analyzed when serum PC and serum TAM co-detection was used in the early diagnosis of gastric cancer. [Results] Compared with normal control group, serum PG Ⅰ amt the ratio of the PG Ⅰ and PG Ⅱ level in gastric cancer group significantly decreased （P 〈0.01）, TAM level in gastrie can- cer group significantly increased （P 〈0.01）, while the serum PG Ⅱ level in gash＇ie caneer group had no nolable varia- tion （P 〉0.05）. The sensitivity of single PG （PC Ⅰ and PG Ⅰ PG Ⅱ ）, TAM for diagnosis of gastric cancer were 75.00% and 77.50% respectively. Their specifieitities were 72.50% and 87.50% respectively. The sensilivity and specificity of combined measurement of these two projects were 92.50% and 70.00% respectively, the sensitivity was shown to occur statistical difference （P 〈0.05）. [Conclusions] Combined detection of sermu PC and TAM level is superior to single detection of PG or TAM for gastric cancer screening. This may improve sensitivily obviously when used in the early diagnosis of gastrie cancer.