口服胃肠超声检查联合血清肿瘤标记物对中老年胃癌的诊断价值

Diagnostic value of oral gastrointestinal ultrasound combined with serum tumor markers in elderly gastric cancer

目的探讨并分析口服胃肠超声联合血清肿瘤标记物在中老年胃癌患者中的诊断价值。方法选取我院2018年9月~2019年12月97例疑似中老年胃癌患者作为研究对象,所有患者均进行口服胃肠超声和血清CEA、CA72-4、CA19-9检测,以最终的病理结果作为对照,比较所有患者超声检测结果分析其超声特征,并分析超声及血清CEA、CA72-4、CA19-9联合诊断的灵敏度、特异度、准确性。结果97例疑似患者中经病理证实86例为胃癌患者,以病理结果为金标准,口服超声、血清CEA、CA72-4、CA19-9、超声联合血清检出胃癌例数分别为72、53、56、61、81例,对应检出率分别为83.72%、61.63%、65.11%、70.93%、94.19%;口服超声、血清CEA、血清CA72-4、血清CA19-9单一诊断结果与病理检查结果比较,差异均有统计学意义(P<0.05);口服超声、血清CEA、血清CA72-4、血清CA19-9联合诊断结果与病理检查结果比较,差异无统计学意义(P>0.05);联合检测诊断胃癌灵敏度、特异度、准确度分别为94.19%(81/86)、90.91%(10/11)、93.81%(91/97),其灵敏度与准确度明显高于口服超声、CEA、CA72-4、CA19-9单一诊断(P<0.05)。结论口服胃肠超声联合血清肿瘤标记物在诊断老年人胃癌方面要比单一使用超声诊断率更高,对临床诊断具有积极作用。

Objective To investigate and analyze the diagnostic value of oral gastrointestinal ultrasound combined with serum tumor markers in elderly gastric cancer patients.Methods From September 2018 to December 2019,97 suspected middle-aged and elderly gastric cancer patients admitted to our hospital were selected as research objects.All patients were treated by oral gastrointestinal ultrasound and serum CEA,CA72-4,CA19-9.The final pathological results were used as control.The ultrasonic features of all patients were analyzed by comparing the ultrasound results,and the sensitivity,specificity and accuracy of the combined diagnosis of ultrasound and serum CEA,CA72-4,CA19-9 were analyzed.Results Of 97 suspected patients,86 were confirmed by pathology as gastric cancer patients.Taking pathological results as a gold standard,the number of gastric cancer cases detected by oral ultrasound,serum CEA,CA72-4,CA19-9 and ultrasound combined with serum were 72,53,56,61 and 81 respectively,and the corresponding detection rates were 83.72%,61.63%,65.11%,70.93%and 94.19%respectively.The single diagnosis results of oral ultrasound,serum CEA,serum CA72-4 and serum CA19-9 were statistically significant compared with the pathological examination results(P<0.05).There was no significant difference between the combined diagnostic results of oral ultrasound,serum CEA,serum CA72-4 and serum CA19-9 and pathological examination results(P>0.05).The sensitivity,specificity and accuracy of combined detection for diagnosis of gastric cancer were 94.19%(81/86),90.91%(10/11)and 93.81%(91/97),respectively.The sensitivity and accuracy of combined detection were significantly higher than those of single diagnosis of oral ultrasound,CEA,CA72-4 and CA19-9(P<0.05).Conclusion Oral gastrointestinal ultrasound combined with serum tumor markers has a higher diagnostic rate for gastric cancer in the elderly than ultrasound alone and has a positive effect on clinical diagnosis.