胃蛋白酶原、胸苷激酶-1联合检测在胃癌筛查中的应用

Application of pepsinogen, thymidine kinase 1 joint detection in the screening for gastric cancer

目的探讨胃蛋白酶原(PG)与胸苷激酶-1(TK1)联合检测在胃癌筛查中的应用价值。方法收集南通市中医院2016年2月~2017年6月消化内科病例178例,其中,胃癌组106例(早期胃癌46例,进展期胃癌60例)、萎缩性胃炎组72例,正常对照组为同期健康体检人员80例。采用酶联免疫吸附试验(ELISA)定量测定空腹血PG,酶免疫点印迹化学发光法测定TK1。结果胃癌组患者胃蛋白酶原Ⅰ(PGⅠ)和胃蛋白酶原Ⅰ/胃蛋白酶原Ⅱ(PGR)水平显著低于萎缩性胃炎组(P<0.05)和正常对照组(P<0.05),胃癌组TK1水平明显高于萎缩性胃炎组(P<0.05)和正常对照组(P<0.05);进展期胃癌组PGⅠ及PGR水平明显低于早期胃癌组(P<0.05),TK1水平与胃癌的分期无关(P>0.05)。PG检测的灵敏度和特异度为52.1%、81.9%,TK-1检测的灵敏度和特异度为47.2%、86.1%,两者联合检测的灵敏度和特异度为81.1%、79.2%,联合检测的灵敏度明显高于单独检测(P<0.05)。结论联合测定PG、TK1在健康人群胃癌的筛查中具有较好的临床应用价值。

Objective To investigate the value of pepsinogen（PG） and thymidine kinase 1（TK1） combined detection for gastric cancer screening. Methods Two hundred and fifty-eight cases were included in the research from February2016 to June 2017, who were stomach cancer（n=178） [including early gastric cancer（n=46）, progress gastric cancer（n=60）], atrophic gastritis（n=72）, and healthy individuals（n=80） as control respectively. Blood PG and TK1 were assayed with enzyme linked immonosorbent assay（ELISA） and Western blot-enayme immunoassay chemilumiescence commercial kit. Results PGⅠand PGⅠ/Ⅱ（PGR） of gastric cancer were lower than those of atrophic gastritis and normal control（P〈0.05）, and which of advanced gastric cancer were lower than those of early gastric cancer（P〈0.05）. TK1 of gastric cancer was higher than that of atrophic gastritis and normal control patients（P〈0.05）, which had nothing to do with the staging of gastric cancer（P〈0.05）. Sensitivity and specificity for PG and TK1 were 52.1%, 81.9%and 47.2%, 86.1% respectively. Sensitivity and specificity for PG and TK1 combined assay were 81.1% and 79.2%,which were significantly higher than those of individual assay（P〈0.05）. Conclusion This study shows that PG and TK1 combined detection has excellent value for gastric cancer screening.