胃液高效液相荧光光谱对胃癌诊断的价值

Study on the high performance liquid chromatography with fluorescence detection of gastric juice in the diagnosis of gastric carcinoma

目的 探讨胃液高效液相荧光光谱在胃癌诊断中的应用价值。方法 胃液高速离心后 ,进行高效液相分析 ,色谱柱选用反相C 18柱 ,流动相为 2 0 %甲醇 水溶液 ,流速为 1ml/min ,采用荧光检测器进行检测。结果 共测定了 2 5 1例各种胃内良、恶性病变患者 (其中进展期胃癌 39例 ,重度异型增生 1例 )的胃液高效液相荧光光谱 ,发现荧光光谱有 2个峰 ,胃癌与胃内良性病变胃液高效液相荧光光谱的峰位和峰数基本相同 ,其差别在于胃癌两峰峰面积均较胃内良性病变增大 (P <0 .0 5 )。用CARTV2 .0软件进行分析 ,用于诊断进展期胃癌的先验概率的敏感度为 92 .5 % ,特异度为 92 .4% ;后验概率的敏感度为 85 .0 % ,特异度为 89.1%。结论 胃液高效液相荧光光谱在胃癌诊断中具有临床应用价值。

Objective To investigate the value of the high performance liquid chromatography (HPLC) with fluorescence detection of gastric juice in the diagnosis of gastric carcinoma. Methods After being super centrifuged, the supernatant of the gastric juice was chromatographed by reversed phase HPLC using C 18 column as the stationary phase and 20% methanol/H 2O as the mobile phase. The flow rate was set to 1 ml/min. The eluate was then detected with a fluorometer. Results 251 patients with different gastric diseases including 40 cases with gastric carcinoma were enrolled in our study. There were two characteristic peaks in the chromatograms, which appeared in both the benign and malignant lesions. The difference between benignancy and malignancy was the areas of the two peaks. The areas in the malignancy were much larger than those of the benignancy ( P <0.05). The result was analysed with CART V2.0 software. The sensitivity and specificity of this method in prior probability were 92.5% and 92.4%, respectively. The sensitivity and specificity in posterior probability were 85.0% and 89.1%.Conclusion The high performance liquid chromatography with fluorescence detection of gastric juice was effective in the diagnosis of gastric carcinoma.