血清胃蛋白酶原、CEA、CA199、CA724与胃泌素17联合检测在胃癌早期诊断中的应用价值分析

Clinical value of serum pepsinogen,CEA,CA199,CA724 and gastrin 17 combined detection in early diagnosis of gastric cancer

[目的]探讨血清胃蛋白酶原(PGⅠ、PGⅡ)、癌胚抗原(CEA)、糖蛋白抗原19-9(CA199)、糖蛋白抗原-724(CA724)与胃泌素17(GAS-17)联合检测在胃癌早期诊断中的应用价值。[方法]收集我院2015年1月~2016年12月收治胃癌患者65例(胃癌组),另外选取同期胃良性疾病者47例(胃良性疾病组)、正常健康体检者45例(正常对照组)。分析三组患者PGⅠ、PGⅡ、CEA、CA199、CA724与GAS-17水平,比较各项指标单独检测及联合检测对胃癌早期诊断的灵敏度及特异度。[结果]3组患者PGⅠ、PGⅡ、CEA、CA199、CA724及GAS-17指标水平存在明显差异,数据差异具有统计学意义(P<0.05);随疾病程度升高,PGⅠ、CA724指标水平逐渐下降(P<0.05),而PGⅡ、CEA、CA199、GAS-17指标水平逐渐升高(P<0.05);PGⅠ、PGⅡ、CEA、CA199、CA724及GAS-17水平在各期胃癌中存在明显差异,随着胃癌病理分期的增高,PGⅠ、PGⅡ、CEA、CA199、CA724及GAS-17水平呈现逐渐上升趋势(P<0.05);单独检测诊断胃癌灵敏度及特异度最高的指标分别为CA199(67.69%)和CA724(90.76%),PGⅠ+PGⅡ+CEA+CA199+CA724+GAS-17联合检测胃癌特异度及灵敏度分为98.46%、76.92%,明显高于单独指标检测(P<0.05)。[结论]PGⅠ、PGⅡ、CEA、CA199、CA724及GAS-17指标联合检测能够提高胃癌早期诊断的特异度及灵敏度,其可为临床早期诊断、制定治疗方案提供相关参考。

[Objective]To investigate the clinical value of serum pepsinogen（PG I and PG II）,carcinoembryonic antigen（CEA）,carbohydrate antigen 19-9（CA199）,carbohydrate antigen-724（CA724）and gastrin17（GAS-17）in early diagnosis of gastric cancer.[Methods]A total of 65 patients with gastric cancer（gastric cancer group）treated in our hospital from January 2015 to December 2016 were enrolled.In addition,47 patients with benign gastric diseases（benign gastric diseases group）and 45 healthy subjects were selected（normal control group）.The PG I,PG II,CEA,CA199,CA724 and GAS-17 levels in the three groups were analyzed.The sensitivity and specificity of each index individually and combined detection in the early diagnosis of gastric cancer were compared.[Results]The levels of PG I and PG II,CEA,CA199,CA724 and GAS-17 were significant difference among three groups（P〈0.05）.With the severity of the disease increased,the levels of PG I and CA724 significantly decreased（P〈0.05）.With the extent of the disease increased,the levels of PG II,CEA,CA199,GAS-17 significantly increased（P〈0.05）.The levels of PG I and PG II,CEA,CA199,CA724 and GAS-17 were obviously different in different stages of gastric cancer,and with increased pathological staging of gastric cancer,the levels of PG I and PG II,CEA,CA199,CA724 andGAS-17 levels showed a gradual upward trend（P〈0.05）.The highest sensitivity of single detection of gastric cancer was CA199（67.69%）and the highest specificity single detection of gastric cancer was CA724（90.76%）.The specificity and sensitivity of PG I＋PG II＋CEA＋CA199＋CA724＋GAS-17 combined detection in early diagnosis of gastric cancer were 98.46% and 76.92%,which was significantly higher than that of single index detection（P〈0.05）.[Conclusion]The combined detection of PG I,PG II,CEA,CA199,CA724 and GAS-17 markers can improve the specificity and sensitivity of early diagnosis of gastric cancer.It can provide reference for early clinical diagnosis and the establishment of treatment programs.