CA19-9、CA72-4、CEA、PGⅠ和PGⅡ联合检测对胃癌诊断效能的分析

Diagnostic performance of a combination test panel including CA19-9,CA72-4,CEA,PG I and PGⅡin gastric cancer

目的探讨糖链抗原19-9(CA19-9)、CA72-4和癌胚抗原(CEA)与胃蛋白酶原(PG)Ⅰ和Ⅱ联合检测在胃癌诊断中的临床应用价值。方法连续收集北京积水潭医院消化科收治的50例胃癌(GC)和50例胃良性病变(NGD)患者的血清标本。应用胃癌生物标志物抗体芯片定量检测患者血清中CA19-9、CA72-4、CEA、PGⅠ和PGⅡ的浓度。计算其单独及联合检测用于胃癌诊断的效能。结果上述五项指标在GC组中的浓度均显著高于NGD组(P<0.05)。其单独检测用于胃癌诊断的ROC曲线下面积(AUC)在0.586(95%CI:0.471~0.701)至0.811(95%CI:0.719~0.902)范围内波动, 即CA72-4最低, PGⅡ最高。CA19-9、CA72-4和CEA三者联合检测的AUC略低于PGⅠ和PGⅡ两者联合检测, 分别为0.797(95%CI:0.710~0.885)和0.814(95%CI:0.724~0.905), 而上述所有指标联合检测的AUC最高, 可进一步升至0.875(95%CI:0.800~0.943)。结论应用抗体芯片法联合检测传统血清学肿瘤标志物和胃蛋白酶原对辅助胃癌诊断具有潜在价值, 值得进一步推广和应用。

Objective To investigate the clinical value of combination test panel including carbohydrate antigen 19-9(CA19-9),CA72-4,carcinoembryonic antigen(CEA),pepsinogens(PG)ⅠandⅡin diagnosing gastric cancer(GC).Methods The serum samples of 50 GC patients and 50 others with non-neoplastic gastric disease(NGD)admitted to the Department of Gastroenterology,Beijing Jishuitan Hospital were included consecutively in the study.The serum levels of CA19-9,CA72-4,CEA,PGⅠand PGⅡwere tested quantitatively by the GC biomarker quantibody microarray kits.The efficiency of these biomarkers detected alone or in combinations in diagnosing GC was calculated.Results The levels of these five indicators in the GC group were significantly higher than those in the NGD group(P<0.05).The area under the ROC curve(AUC)for these indicators detected alone in diagnosing GC ranged between 0.586(95%CI:0.471-0.701)and 0.811(95%CI:0.719-0.902),lowest with CA72-4 and highest with PGⅡ.The AUC of combination test panel including CA19-9,CA72-4 and CEA was slightly lower than the panel including PGsⅠandⅡ[0.797(95%CI:0.710-0.885)vs 0.814(95%CI:0.724-0.905)].The AUC of the combination test panel including all the indicators above was the highest,which further rose to 0.875(95%CI:0.800-0.943).Conclusion Combined detection of conventional serological tumor markers and pepsinogens by quantibody microarray kits has potential value in assisting the diagnosis of GC,which justifies widespread use in practices.