外周血CA724、PG和CA19-9在早期胃癌诊断中的应用

Application of Peripheral Blood CA724,PG with CA19-9 in the Diagnosis of Early Gastric Cancer

目的探讨外周血糖蛋白抗原724(CA724)、胃蛋白酶原(PGⅠ、PGⅡ)和糖蛋白抗原19-9(CA19-9)在早期胃癌诊断中的应用价值。方法选取高度疑似胃癌患者127例为研究对象,比较确诊后不同胃癌分期患者外周血CA724、PG和CA19-9水平,以病理组织活检为“金标准”,比较CA724、PG检测与CA724、PG联合CA19-9检测对胃癌的预测效能。结果127例疑似胃癌患者中有86例确诊为胃癌(Ⅰ~Ⅲ期,排除胃癌晚期),CA724、PG检测灵敏度、准确率为(72.09%、71.65%),低于CA724、CA19-9、PG联合检测(91.86%、90.55%),差异有统计学意义(P<0.05),特异度比较差异无统计学意义(P>0.05);胃癌Ⅰ期血清CA724、CA19-9水平<Ⅱ期<Ⅲ期,胃癌Ⅰ期血清PGⅠ水平和PGⅠ/PGⅡ比值>Ⅱ期>Ⅲ期,差异有统计学意义(P<0.05)。经分析显示,血清肿瘤标志物CA724、CA19-9、PGⅠ、PGⅠ/PGⅡ对胃癌诊断均有一定预测价值,曲线下面积(AUC)分别为0.768、0.795、0.843、0.731;其中CA724联合PG、CA724、CA19-9联合PG联合诊断价值较高,AUC分别为0.863、0.971。结论外周血血清肿瘤标志物CA724、CA19-9及血清PG联合检测可提高检测灵敏度,其水平对胃癌早期辅助诊断、疾病分期和治疗方案均具有指导意义。

Objective To study the application value of peripheral blood glucose protein antigen 724(CA724),pepsinogen(PGⅠ,PGⅡ)combined with glycoprotein antigen 19-9(CA19-9)in the diagnosis of early gastric cancer.Methods 127 patients with highly suspected gastric cancer were selected as the research objects.Compare the CA724,PG and CA19-9 levels in peripheral blood of patients with different gastric cancer stages after diagnosis.Taking pathological tissue biopsy as the gold standard,the predictive efficacy of single test and combined test for gastric cancer were compared.Results With pathological tissue biopsy as the gold standard,86 out of 127 patients with suspected gastric cancer were diagnosed with gastric cancer(stageⅠ~Ⅲ,excluding advanced gastric cancer).The sensitivity,accuracy rate of CA724,PG detection was lower than CA724,CA19-9 and PG combined detection(72.09%、71.65%vs 91.86%、90.55%),while the difference was statistically significant(P<0.05).The difference in specificity was not statistically significant(P>0.05).Serum CA724,CA19-9 levels in gastric cancer stageⅠ<stageⅡ<stageⅢ,serum PGⅠlevel and PGⅠ/PGⅡratio in gastric cancer stageⅠ>stageⅡ>stageⅢ,and the difference was statistically significant(P<0.05).Analysis showed that serum tumor markers CA724,CA19-9,PGⅠ,PGⅠ/PGⅡhad a certain predictive value in the diagnosis of gastric cancer.The areas under the curve were 0.768,0.795,0.843,0.731 respectively;among them,CA724 combined with PG,CA724,CA19-9 combined with PG had higher diagnostic value,and the area under the curve was 0.863 and 0.971 respectively.Conclusion The combined detection of serum tumor markers CA724,CA19-9 and serum PG in peripheral blood can improve the detection sensitivity,and its level has important guiding significance for early diagnosis of gastric cancer,disease staging and treatment plan establishment.