联合检测血清TAT-2、PG、GP73在早期胃癌及胃癌前病变中的诊断价值

Diagnostic value of serum TAT2 combined with PG,GP73 for precancerous lesions and early gastric cancers

目的:研究血清胰蛋白酶原2(TAT-2)、胃蛋白酶原(PG)和高尔基体蛋白(GP73)单独和联合检测对早期胃癌和胃癌前病变的诊断价值。方法:165例胃部不适患者根据内镜和病理诊断结果,分为胃癌前病变组49例,早期胃癌组36例,进展期胃癌组80例,另选90例活检为正常胃黏膜或慢性浅表性胃炎作为对照组,采用时间分辨荧光免疫法(TRFIA)检测血清TAT-2、PG和GP73水平,运用ROC曲线和logistic回归评价对早期胃癌和胃癌前病变的诊断效果。结果:与对照组相比,胃癌前病变组、早期胃癌组和进展期胃癌组血清TAT-2、GP73水平较高,胃癌前病变组、早期胃癌组PGⅠ、PGR(PGⅠ/PGⅡ)较高,进展期胃癌组较低(P<0.05),PGⅡ组间差异无统计学意义。TAT-2、PGⅠ、PGR和GP73单独和联合诊断胃癌前病变的ROC曲线下面积分别为0.743、0.676、0.810、0.824和0.925,最大Youden指数分别为0.43、0.36、0.62、0.65和0.67;四项指标单独和联合诊断早期胃癌的ROC曲线下面积分别为0.641、0.730、0.857、0.908和0.950,最大Youden指数分别为0.32、0.41、0.69、0.74和0.78;四项指标单独和联合诊断进展期胃癌的ROC曲线下面积分别为0.727、0.694、0.900、0.911和0.976,最大Youden指数分别为0.42、0.40、0.68、0.70和0.86,联合检测曲线下面积大于单独检测。结论:TAT-2、PGⅠ、PGR和GP73单独检测对早期胃癌、胃癌前病变和胃癌具有一定的诊断价值,而联合检测具有较高的临床诊断价值。

Objective:To explore the diagnostic value of serum TAT2,PG and GP73 individual and combined detection of early gastric cancers and precancerous lesions. Methods: Based on the results of the pathological diagnosis, 165 cases were enrolled and divided into the precancerous lesions group(49 cases), the early gastric cancers group(36 cases), and the gastric cancers group(80 cases). Before gastroscopy, fasting serum TAT2,PG, and GP73 were analyzed by time-resolved fluoroimmunoassay(TRFIA).The levels of TAT2,PG, and GP73in serum were compared among the four groups.The diagnostic efficacy of TAT2, PG, and GP73 were evaluated by ROC curve combined with logistic regression.Results: Serum TAT2 and GP73levels significantly increased (P<0.05) in the precancerous lesions group, the early gastric cancers group and the gastric cancers group compared with the control groups. Serum PGⅠlevelsand PGR(PGⅠ/PGⅡ) significantly increased in the precancerous lesions group and the early gastric cancers group,but significantly decreased(P<0.05) in the gastric cancers group.There was no significant difference in PGⅡ level among the four groups. The area under the ROC curve of TAT2,PGⅠ, PGR and GP73individual and combined detection of precancerous lesions were 0.743, 0.676, 0.810, 0.824, 0.925. The maximum of Youden index were 0.43, 0.36, 0.62, 0.65, 0.67. The area under the ROC curve of TAT2,PGⅠ, PGR and GP73 individual and combined detection of early gastric cancers were 0.641, 0.730, 0.857, 0.908, 0.950. The maximum of Youden index were 0.32, 0.41, 0.69, 0.74, 0.78. The area under the ROC curve of TAT2, PGⅠ, PGR and GP73 individual and combined detection of gastric cancers were 0.727, 0.694, 0.900, 0.911, 0.976. The maximum of Youden index were0.42, 0.40, 0.68, 0.70, 0.86. The area of the combined detection was higher than that of individual detection.Conclusion: The individual detection of TAT2, PGⅠ, PGR and GP73 has a certain diagnostic value for early gastric cancers and precancerous lesions,and combined detection has a higher value of clinical diagnosis.