胃充盈超声造影联合血清胸苷激酶-1用于老年胃癌术前分期诊断的应用价值

Application value of gastric-filling contrast-enhanced ultrasonography combined with serum TK-1 in the diagnosis of preoperative staging of gastric cancer of the elderly

目的:探究胃充盈超声造影联合血清胸苷激酶-1(TK1)对老年胃癌术前分期诊断的应用价值。方法:选取在医院经胃镜活检确诊为胃癌的136例患者,均于术前行胃充盈超声造影检查,并采用化学发光免疫法进行血清TK1水平检测,分析胃充盈超声造影及胃充盈超声造影联合血清TK1检查对胃癌术前分期诊断的准确率。结果:胃充盈超声造影对胃癌侵犯深度(T分期)、淋巴结转移(N分期)及远处转移(M分期)诊断的准确率分别为79.41%、82.35%和82.35%。肿瘤低分化、胃癌侵犯深度T3~T4期、Ⅲ~Ⅳ期、淋巴结转移及远处转移患者血清中TK1表达水平明显高于高、中分化、T1~T2期、Ⅰ~Ⅱ期、无淋巴结转移以及无远处转移患者,差异有统计学意义(t=5.171,t=7.065,t=5.128,t=7.431,t=4.052;P<0.05)。胃充盈超声造影联合血清TK1检测对胃癌T、N、M分期诊断的准确率分别为90.44%、93.38%和94.12%,均高于胃充盈超声造影单独诊断(χ^(2)=6.462,χ^(2)=7.760,χ^(2)=9.067;P<0.05)。结论:胃充盈超声造影联合血清TK1对胃癌T、N、M分期诊断的准确度高于胃充盈超声造影单独诊断,对提高老年胃癌术前分期诊断准确性有重要意义。

Objective:To explore application value of gastric-filling contrast-enhanced ultrasonography combined with serum thymidine kinase-1(TK1)in the diagnosis of preoperative staging of gastric cancer of the elderly.Methods:136 patients with gastric cancer who were confirmed by gastroscopy in hospital were selected,and all of them were examined by contrast-enhanced ultrasonography before surgery.The serum TK1 levels of them were detected by chemiluminescent immunoassay,and the accuracies of gastric-filling contrast-enhanced ultrasonography,gastric-filling contrast-enhanced ultrasonography combined with serum TK1 for the diagnosis of preoperative staging of gastric cancer were further analyzed.Results:The accuracies of gastric-filling contrast-enhanced ultrasonography for invasion depth of gastric cancer(T stage),lymph node metastasis(N stage)and distant metastasis(M stage)were 79.41%,82.35%and 82.35%,respectively.The expression levels of serum TK1 in patients with low differentiation,invasion depth of gastric cancer at T3-T4 stage,at III-IV stage,lymph node metastasis and distant metastasis were significantly higher than those of patients with high and middle differentiation,at T1-T2 stage,at I-II stage,non-lymph node metastasis and non-distant metastasis(t=5.171,t=7.065,t=5.128,t=7.431,t=4.052,P<0.05),respectively.The accuracies of gastric filling contrastenhanced ultrasonography combined with serum TK1 for the diagnosis of T,N,M stages were 90.44%,93.38%and 94.12%respectively,which was significantly higher than that of single diagnosis of gastric-filling contrast-enhanced ultrasonography(χ^(2)=6.462,χ^(2)=7.760,χ^(2)=9.067,P<0.05),respectively.Conclusion:The accuracy of gastric filling contrast-enhanced ultrasonography combined with serum TK1 for the diagnosis of T,N,M stages of gastric cancer is higher than that of the single diagnosis of gastric-filling contrast-enhanced ultrasonography,which has great significance in improving the diagnostic accuracy of preoperative staging of gastric cancer in the elderly.