生长分化因子15和胃癌抗原724在胃癌患者血清中的变化及临床意义

Changes and clinical significance of growth differentiation factor 15 and gastric cancer antigen 724 in serum of patients with gastric cancer

目的探讨生长分化因子15(GDF15)和胃癌抗原724(CA724)在胃癌患者血清中的变化及临床意义。方法随机从2016年7月-2017年12月来北京京煤集团总医院就诊的胃癌患者、胃良性病变患者以及健康体检者中分别抽取84例作为研究对象,并分为A、B、C组。GDF15水平通过双抗体夹心酶联免疫吸附试验测定,CA724水平通过电化学发光法测定。分析不同组间GDF15和CA724水平的变化以及与临床病理特征的关系。结果 3组血清GDF15和CA724水平,A组最高、B组其次,C组最低,组间差异有统计学意义(P <0.05)。A组患者中,淋巴结转移及临床分期越高的患者,GDF15表达越高(P <0.05),淋巴结转移的患者,CA724表达更高(P <0.05)。单独应用GDF15诊断胃癌的曲线下面积(AUC)、敏感性、特异性和临界点分别为0.838(95%CI:0.728,0.940)、0.584、0.836和0.23 ng/ml;单独应用CA724的AUC、敏感性、特异性和临界点分别为0.890(95%CI:0.807,0.970)、0.902、0.658和6.02 u/ml;联合使用GDF15和CA724诊断胃癌的AUC、敏感性和特异性分别为0.923(95%CI:0.845,0.992)、0.925和0.864,与单独应用GDF15或CA724检测胃癌比较,AUC、敏感性和特异性均增加。结论 GDF15和CA724水平对鉴别胃部病变性质具有重要指导意义,GDF15和CA724联合检测有助于提高胃癌的检出率。

Objective To analyze the changes and clinical significance of growth differentiation factor 15(GDF15) and gastric cancer antigen 724(CA724) in serum of patients with gastric cancer. Methods Totally 84 patients with gastric cancer(A group), 84 patients with benign gastric lesions(B group) and 84 healthy people(C group) were selected in our hospital from July 2016 to December 2017. The serum GDF15 and CA724 of all subjects were respectively measured by enzyme linked immunosorbent assay and electrochemiluminescence. The changes of GDF15 and CA724 levels and their relationship with clinicopathological characteristics were analyzed. Results The highest serum levels of GDF15 and C A724 was in group A, the second was in group B and the lowest was in group C(P < 0.05). In group A, the higher the lymph node metastasis and clinicopathological stage were, the higher the expression of GDF15 was, and the difference was statistically significant(P < 0.05). In patients with lymph node metastasis, the expression of CA724 was higher, and the difference was statistically significant(P < 0.05). The area under the curve(AUC), sensitivity, 95% CI, sensitivity, specificity and critical point in GDF15 diagnose of the gastric cancer were 0.838(95% CI: 0.728, 0.940), 0.584, 0.836 and 0.23 ng/ml, respectively. The AUC, 95% CI, sensitivity, specificity and critical point in CA724 diagnose of the gastric cancer were 0.890(95% CI: 0.807, 0.970), 0.902, 0.658 and 6.02 U/ml, respectively. The AUC, sensitivity and specificity in combination of GDF15 and CA724 were 0.923(95% CI: 0.845, 0.992), 0.925 and 0.864, respectively. The AUC, sensitivity and specificity had significantly increased in combination of GDF15 and CA724 compared with the detection of gastric cancer by GDF15 or CA724 alone. Conclusion Detection of GDF15 and CA724 is of great significance in differentiating the nature of gastric lesions. Combined detection of GDF15 and CA724 is helpful to improve the detection rate of gastric cancer and guide the correct evaluation of patients’ condition and prognosis.