血清AFP AFU CEA和CA19-9检测在胃癌诊断中的应用价值

Application Value of Serum AFP AFU CEA and CA19-9 in the Diagnosis of Gastric Cancer

目的:探讨血清甲胎蛋白(AFP)、α-L-岩藻糖苷酶(AFU)、癌胚抗原(CEA)和糖类抗原19-9(CA19-9)检测在胃癌(GC)中的诊断价值,为早期GC诊断提供参考。方法:选择2018年1月至2019年1月收治的50例GC患者作为GC组,同期收治的胃部良性病变患者50例为对照组,比较两组血清AFP、AFU、CEA和CA19-9表达水平,分析不同临床特征的GC患者血清AFP、AFU、CEA和CA19-9水平变化。结果:GC组AFP、AFU、CEA、CA19-9表达水平较对照组显著增高(P<0.05);ROC曲线分析提示血清AFP、AFU、CEA及CA19-9及四者联合检测诊断GC的曲线下面积分别为0.935、0.943、0.931、0.940、0.998,AFP、AFU、CEA和CA19-9结合检测的灵敏度和特异度、约登指数较其他各项单独检测的高;GC患者血清AFP、AFU、CEA、CA19-9水平随分化程度增高而明显降低,且淋巴结转移GC患者血清AFP、AFU、CEA、CA19-9水平明显高于无淋巴结转移者(均P<0.05);AFP、AFU、CEA、CA19-9联合检测诊断GC患者分化程度、淋巴结转移的曲线下面积、特异度及约登指数较各项指标单独检测的高。结论:GC患者血清AFP、AFU、CEA和CA19-9水平均呈高表达,AFP、AFU、CEA和CA19-9水平联合检测可提高对GC疾病及病情进展的诊断效能。

Objective:To investigate the application value of serum alpha-fetoprotein(AFP),α-L-fucosidase(AFU),carcinoembryonic antigen(CEA)and carbohydrate antigen 19-9(CA19-9)in the diagnosis of gastric cancer(GC),and provide references for early diagnosis of GC.Methods:50 patients with GC admitted to the hospital between January 2018 and January 2019 were included in GC group.50 patients with benign gastric lesions admitted during the same period were selected as the control group.The expression levels of serum AFP,AFU,CEA and CA19-9 were compared between the two groups.The expression levels in patients with GC and different clinical features were analyzed.Results:The expression levels of AFP,AFU,CEA and CA19-9 in GC group were significantly higher than those in the control group(P<0.05).ROC curve analysis indicated that the areas under the curves of serum AFP,AFU,CEA and CA19-9 and the combination of the four for detection of GC were 0.935,0.943,0.931,0.996 and 0.998,respectively.The sensitivity,specificity and yoden index of AFP,AFU,CEA and CA19-9 combined detection were higher than those of other independent detection.Levels of AFP,AFU,CEA and CA19-9 in patients with GC decreased significantly with the increase of differentiation degree,and the levels in patients with lymph node metastasis were significantly higher than those without(all P<0.05).The combined detection of AFP,AFU,CEA and CA19-9 in the diagnosis of GC patients'differentiation,the area under the curve of lymph node metastasis,the specificity and the yoden index were higher than those detected separately.Conclusion:The levels of serum AFP,AFU,CEA and CA19-9 are high in patients with GC.The combined detection of AFP,AFU,CEA and CA19-9 can improve the diagnostic efficiency of GC and its progression.