胃蛋白酶原联合肿瘤标志物检测对健康人群胃癌发生的预测价值

Predictive value of the joint detection of pepsinogen and tumor markers on the occurrence of gastric cancer in healthy population

目的探讨胃蛋白酶原、CA72-4、CEA、CRP联合检测在胃癌诊断中的应用。方法选取2014年11月-2016年6月本院收治的胃癌患者59例、萎缩性胃炎患者55例纳入本研究,另选取本院同期健康体检者50例为对照组。检测相关指标并进行比较,其中AUC值采用Medcalc计算。结果胃癌组PGⅠ水平、PGⅡ水平、PGR显著低于萎缩性胃炎组、对照组,胃癌组CA72-4、CEA、CRP水平显著高于萎缩性胃炎组、对照组。血清胃蛋白酶原及CA72-4、CEA、CRP联合检测胃癌中灵敏度为93.57%、阳性预测值为95.85%、阴性预测值为89.97%以及准确度为93.43%,均显著高于单项检测,上述差异均有统计学意义(P<0.05)。各指标联合检测胃癌AUC值为0.942,与其他指标相比,差异有统计学意义(P<0.05)。结论胃蛋白酶原、CA72-4、CEA、CRP联合检测优于单项检测,在胃癌诊断中可显著提高检测的灵敏度,且准确度高,值得推广应用。

Objective To investigate the application of pepsinogen,CA72-4,CEA and CRP in the diagnosis of gastric cancer. Methods A total of 59 gastric cancer patients with complete medical records,55 chronic atrophic gastritis in our hosipital form Nov 2014 to Jun 2016 were selected as the research objects,in addition another 50 healthy examinees in the same period were selected as healthy control group. The relevant test indexes were compared,in which the AUC value was calculated by Medcalc. Results The levels of PGⅠ,PGⅡ and PGR in gastric cancer group were significantly lower than those in the chronic atrophic gastritis group and the healthy control group; the levels of CA72-4,CEA and CRP in gastric cancer were significantly higher than those of the chronic atrophic gastritis group and the healthy control group; the sensitivity of serum pepsinogen and CA72-4,CEA,CRP joint detection in gastric cancer was 93. 57%,the positive predictive value was 95. 85%,the negative predictive value was 89. 97% and the accuracy was 93. 43%,which all were significantly higher than those of single detection and the differences above were statistical significant（ P〈0. 05）. The AUC value of combined detection of gastric cancer was0. 942,and compared with other indexes,the difference was statistically significant（ P〈0. 05）. Conclusion The combined detection of pepsinogen,CA72-4,CEA and CRP was superior to individual detection,which can significantly improve the sensitivity of detection in gastric cancer diagnosis,and has high accuracy,so it is worthy of popularization and application.