血清胃蛋白酶原及肿瘤标志物联合检测在老年胃癌诊断中的意义

Meaning on pepsinogen andtumor markers joint detection in the diagnosis for elderly patients with gastric cancer

目的探讨血清胃蛋白酶原及肿瘤标志物联合检测在老年胃癌诊断中的意义。方法选择2012年12月~2014年12月于吉林省肿瘤医院诊治的老年（≥65岁）胃部疾病患者150例,其中胃癌患者50例为胃癌组、胃溃疡患者50例为胃溃疡组、浅表性胃炎患者50例为浅表性胃炎组。对血清胃蛋白酶原Ⅰ（PGⅠ）、胃蛋白酶原Ⅱ（PGⅡ）采用酶联免疫吸附法定量检测,对血清糖类抗原724（CA724）、糖类抗原199（CA199）及癌胚抗原（CEA）采用化学发光法检测。比较血清胃蛋白酶原比值（PGR）（PGⅠ/PGⅡ）、CA199及CA724、CEA单独检测和联合检测的灵敏度、特异度。结果三组患者血清PGⅠ、PGⅡ、CEA、CA199、CA724水平及PGR比较,差异有统计学意义（P〈0.05）。胃癌组PGⅠ水平、PGR低于浅表性胃炎组（P〈0.05）,但两组PGⅡ水平差异无统计学意义（P〉0.05）,CEA、CA199及CA742水平均高于浅表性胃炎组（P〈0.05）;胃溃疡组PGⅠ、PGⅡ,PGR均明显高于浅表性胃炎组（P〈0.05）;胃癌组PGⅠ、PGⅡ水平、PGR低于胃溃疡组（P〈0.05）,CEA、CA199及CA742水平均高于胃溃疡组（P〈0.05）。联合检测的灵敏度（68%,34/50）高于单独检测,差异有统计学意义（P〈0.05）。结论血清胃蛋白酶原及肿瘤标志物联合检测有助于提高老年胃癌检出率,且联合检测优于单独检测。

Objective To discuss the meaning on pepsinogen and tumor markers joint detection in the diagnosis for elderly patients with gastric cancer. Methods From November 2012 to October 2014, in Tumor Hospital of Jilin Province,150 elderly patients（≥65 yares） with gastric disease were selected, 50 patients were gastric cancer（gastric cancer group）,50 patients were gastric ulcer（gastric ulcer group）, 50 patients were superficial gastritis（superficial gastritis group）. PGⅠ,PGⅡ in serum were detected by ELISA. CEA, CA199 and CA242 were detected by chemiluminescence. The sensibility and specificity of single detection and joint detection of PGR（PGⅠ/PGⅡ）, CEA, CA199 and CA242 were calculated and compared. Results PGⅠ, PGⅡ, CEA, CA199 and CA724 in serum, PGR of three groups were compared, the differences were statistically significant（P〈0.05）. Compared with superficial gastritis group, in gastric cancer group,PGⅠ, PGR reduced（P〈0.05）, the difference of PG Ⅱ between two groups was not statistically significant（P〈0.05）,CEA, CA199, CA742 increased（P〈0.05）; in gastric ulcer group, PGⅠ, PGⅡincreased（P〈0.05）,PGR reduced（P〈0.05）. Compared with gastric ulcer group, in gastric cancer group, PGⅠ, PGⅡ,PGR reduced（P〈0.05）, CEA, CA199,CA742 increased（P〈0.05）. The sensibility of united detection（68%, 34/50） was higher than that of single detection,the differences were statistically significant（P〈0.05）. Conclusion The pepsinogen and tumor markers joint detection is helpful on diagnosis for elderly patients with gastric cancer, and united detection is better than single detection.