角蛋白18、CEA、CA19-9、CA72-4在胃癌诊断中的成本-效果分析

Cost effectiveness analysis of CK18、CEA、CA19-9、CA72-4 in the diagnosis of gastric cancer

目的利用成本-效果分析探讨细胞角蛋白18片段(CK18)、癌胚抗原(CEA)、糖类抗原19-9(CA19-9)和糖类抗原72-4(CA72-4)联合检测对胃癌的诊断价值。方法检测已确诊胃癌患者115例,胃良性病变者70例,健康体检者95例的血清CK18、CEA、CA19-9、CA72-4含量,进行成本-效果分析。结果肿瘤标志物的联合检测可以提高胃癌诊断的灵敏度和特异性。4种肿瘤标记物联合检测灵敏度最高(68.70%),特异性也较好(79.39%)。每增加1%的灵敏度所需追加的成本以CK18、CA72-4组合最低。结论CK18、CEA、CA19-9、CA72-4组合灵敏度最高,对胃癌辅助诊断的价值也最大。CK18、CA72-4组合的成本-效果比最小,适用于胃癌的高危人群筛查。

Objective To explore the diagnostic value of the combined detection of cell keratin 18 fragment （CK18） ,carcino‐embryonic antigen （CEA） ,carbohydrate antigen 19‐9 （CA19‐9） ,carbohydrate antigen 72‐4 （CA72‐4） and carbohydrate antigen 72‐4 （CA72‐4） in gastric cancer ,which was analyzed by cost effectiveness analysis .Methods CK18 ,CEA ,CA19‐9 ,CA72‐4 content in115 cases of patients with gastric cancer ,70 cases of benign gastric lesions ,95 cases of healthy serum were detected , doing the cost‐effectiveness analysis .Results Combined detection of tumor markers in the diagnosis of gastric cancer could im‐prove the sensitivity and specificity .Four tumor markers combined detection sensitivity was the highest （68.70% ） ,specificity was better （79.39% ） .In addition ,The CK18 and CA72‐4 combination test had the best cost‐effect .Conclusions CK18 ,CEA , CA19‐9 ,CA72‐4 combined detection had the highest sensitivity .The Value diagnosis of gastric cancer was also the largest . CK18 ,CA72‐4 combined detection had the best for gastric cancer screening in high‐risk groups .