血清DKK1、TK1、PG联合检测在胃癌诊断中的临床价值

Clinical Value of combined Detection of Serum DKK1,TK1 and PG in the Diagnosis of Gastric Cancer

目的探究血清分泌型蛋白Dickkopf-1(DKK1)、细胞质胸苷激酶(TK1)、胃蛋白酶原(PG)联合检测在胃癌诊断中的临床价值。方法回顾性分析103例胃癌患者(胃癌组)及90例胃良性疾病患者(胃良性疾病组)临床资料,并纳入82例同期健康体检者为健康对照组。比较2组一般资料及血清DKK1、TK1、PG水平差异,使用受试者工作特征曲线(ROC曲线)评估血清DKK1、TK1、PG及其联合检测对胃癌的诊断价值,并分析血清DKK1、TK1、PG水平与胃癌患者临床病理特征的关系。结果3组性别、年龄、BMI等一般资料比较,差异无统计学意义(P>0.05)。3组血清DKK1、TK1比较,均为胃癌组>胃良性疾病组>健康对照组(P<0.05);血清PGⅠ比较,则为胃良性疾病组>健康对照组>胃癌组(P<0.05);3组血清PGⅡ比较,差异无统计学意义(P>0.05)。经ROC曲线分析,发现血清DKK1、TK1、PGⅠ及其联合检测对胃癌均具有较高诊断价值(AUC=0.820、0.854、0.863、0.966,P<0.05),血清DKK1、TK1、PGⅠ诊断的cut-off值为3.890 ng/ml、90.755 pmol/ml、48.745 ng/ml,且联合检测诊断价值最高,其灵敏度可达94.17%,特异度可达90.70%。不同性别、年龄胃癌患者血清DKK1、TK1、PGⅠ水平比较,差异无统计学意义(P>0.05);肿瘤直径大、临床分期高及伴血管浸润、淋巴结转移者血清DKK1、TK1水平更高(P<0.05),血清PGⅠ水平更低(P<0.05)。结论血清DKK1、TK1、PGⅠ联合检测不仅对胃癌具有较高诊断价值,且与胃癌恶性程度密切相关,于预后判断也有积极意义。

Objective To explore the clinical value of combined detection of serum secretory protein Dickkopf-1(DKK1),cytoplasmic thymidine kinase(TK1)and pepsinogen(PG)in the diagnosis of gastric cancer.Methods The clinical data of 103 patients with gastric cancer(gastric cancer group)and 90 patients with benign gastric diseases(benign gastric disease group)were retrospectively analyzed.Another 82 cases of healthy subjects who underwent physical examination at the same time period were included as healthy control group.The general data and levels of serum DKK1,TK1 and PG were compared between the 2 groups.The receiver operating characteristic curve(ROC curve)was used to evaluate the diagnostic value of serum DKK1,TK1,PG and their combined detection on gastric cancer,and the relationship between levels of serum DKK1,TK1 and PG and clinicopathological features of patients with gastric cancer was analyzed.Results There were no significant differences in gender,age,BMI and other general data among the three groups(P>0.05).The levels of serum DKK1 and TK1 in the 3 groups showed gastric cancer group>benign gastric disease group>healthy control group(P<0.05).The serum PGI level comparison showed benign gastric disease group>healthy control group>gastric cancer group(P<0.05).There was no significant difference in serum PGII level among the 3 groups(P>0.05).According to ROC curve analysis,serum DKK1,TK1,PGI and their combined detection all had high diagnostic value on gastric cancer(AUC=0.820,0.854,0.863,0.966,P<0.05),and the cut-off values of serum DKK1,TK1 and PGI were 3.890 ng/ml,90.755 pmol/ml and 48.745 ng/ml,and the diagnostic value was the highest in combined detection,and its sensitivity was up to 94.17%and the specificity was up to 90.70%.There were no significant differences in the levels of serum DKK1,TK1 and PGI among gastric cancer patients with different genders and ages(P>0.05).The levels of serum DKK1 and TK1 were higher(P<0.05)while the serum PGI level was lower(P<0.05)among patients with large tumor diameter,high clinical stage,vascular infiltration and lymph node metastasis.Conclusion The combined detection of serum DKK1,TK1 and PGI has high diagnostic value on gastric cancer,and is closely related to the malignant degree of gastric cancer.It also has positive significance in prognosis judgement.