胃癌诊断中辅以血清G17、TK1联合检测的价值

The value of combined detection of serum G17 and TK1 in diagnosis of gastric cancer

目的探讨血清胃泌素17(gastrin 17,G17)、胸苷激酶1(thymidine kinase 1,TK1)联合检测在胃癌诊断中的应用价值。方法选择2018年3月至2019年3月收治的50例胃癌患者(胃癌组)、50例慢性胃溃疡患者(胃溃疡组)、50例慢性胃炎患者(胃炎组)和50例正常人(对照组)作为研究对象,采用酶联免疫吸附法检测空腹血清G17水平,采用化学发光结合斑点杂交法检测血清TK1水平。比较4组血清G17和TK1水平差异。采用受试者工作特征(receiver operating characteristic,ROC)曲线评估血清G17和TK1水平单独与联合检测对胃癌的诊断效能。结果胃癌组患者血清G17和TK1水平显著高于其他3组(P<0.05)。Pearson相关性分析结果,血清G17水平与TK1水平呈显著正相关(P<0.05)。血清G17和TK1水平诊断胃癌的ROC曲线的AUC分别为0.886(95%CI:0.839~0.934)、0.890(95%CI:0.850~0.930)、0.872(95CI:0.807~0.936)。血清G17和TK1诊断胃癌的最佳阈值分别为15.63 pmol/L和2.10 pmol/L,灵敏度分别为82.0%和68.0%、特异度分别为78.7%和94.7%,符合率分别为79.5%和88.0%,阳性预测值分别为56.2%和81.0%,阴性预测值分别为56.2%和89.9%。血清G17和TK1水平联合诊断胃癌的灵敏度、特异度、符合率、阳性预测值和阴性预测值分别为86.0%、96.0%、93.5%、87.7%和95.4%。结论血清G17和TK1水平是胃癌诊断的良好指标,两者联合能够提高胃癌诊断效能,值得临床推广应用。

Objective To explore the value of combined detection of serum gastrin 17(G17)and thymidine kinase 1(TK1)in the diagnosis of gastric cancer.Methods Fifty patients with gastric cancer(gastric cancer group),50 patients with chronic gastric ulcer(gastric ulcer group),50 patients with chronic gastritis(gastritis group)and 50 healthy subjects(control group)who were admitted to our hospital from March 2018 to March 2019 were enrolled as research subjects.The levels of fasting serum G17 were detected by enzyme-linked immunosorbent assay(ELISA),and serum TK1 levels were detected by chemiluminescence combined with dot blot hybridization.The differences in serum G17 and TK1 levels were observed and compared among the 4 groups.The receiver operating characteristic(ROC)curve was used to evaluate the diagnostic efficacy of simple detection or combination detection of serum G17 and TK1 levels in diagnosis of gastric cancer.Results The serum levels of G17 and TK1 in gastric cancer group were significantly higher than those in the other three groups(P<0.05).Pearson correlation analysis showed a significant positive correlation between serum G17 level and TK1 level(P<0.05).The AUC of the ROC curve for the diagnosis of gastric cancer with serum G17 and TK1 levels were 0.886(95%CI:0.839~0.934),0.890(95%CI:0.850~0.930),and 0.872(95%CI:0.807~0.936),respectively.The optimal thresholds for the diagnosis of gastric cancer by serum G17 and TK1 were 15.63pmol/L and 2.10pmol/L,respectively,the sensitivity was 82.0%and 68.0%,and the specificity was 78.7%and 94.7%,respectively.In addition,the coincidence rate was 79.5%and 88.0%,the positive predictive value was 56.2%and 81.0%,respectively,and the negative predictive values were 56.2%and 89.9%,respectively.The sensitivity,specificity,coincidence rate,positive predictive value and negative predictive value of serum G17 and TK1 levels in the diagnosis of gastric cancer were 86.0%,96.0%,93.5%,87.7%and 95.4%,respectively.Conclusion The serum levels of G17 and TK1 are good indicators for the diagnosis of gastric cancer.The combination detection of the two indexes can improve the diagnostic efficacy of gastric cancer,which is worthy of clinical application.