糖类抗原199、神经元特异性烯醇化酶及幽门螺杆菌IgG抗体联合筛查胃癌的价值

Value of Carbohydrate Antigen 199, Neuron Specific Enolase and Helicobacter Pylori IgG Antibody in Screening Gastric Cancer

目的 研究糖类抗原(CA199)、神经元特异性烯醇化酶(NSE)与幽门螺杆菌IgG抗体(HP-IgG)联合检测对于胃癌诊断筛查的价值。方法 选取郑州市中医院2020年1月至2022年1月收治的133例胃部疾病患者,按照疾病分为肿瘤组(42例)和一般胃部疾病组(萎缩性胃炎和胃溃疡等91例),另选同期体检健康人员46例作为正常对照组,比较3组人员的血清CA199、NSE、HP-IgG表达情况,分析三者联合检测对早期胃癌筛查的诊断效能。结果 肿瘤组和一般胃病组人员的血清CA199、NSE、HP-IgG表达均高于正常对照组,且肿瘤组高于一般胃病组,3组两两对比具有统计学意义(P<0.05)。肿瘤组CA199阳性表达率(54.76%)高于一般胃病组(15.3%),高于正常对照组(4.34%)(P<0.05);肿瘤组NSE阳性表达率(71.42%)高于一般胃病组(13.18%),高于正常对照组(6.52%)(P<0.05);肿瘤组HP-IgG阳性表达率(57.14%)高于一般胃病组(32.96%),高于正常对照组(26.08%)(P<0.05);肿瘤组联合检测阳性表达率(73.80%)高于一般胃病组(20.87%),高于正常对照组(13.04%)(P<0.05)。血清CA199、NSE、HP-IgG和三者联合检测的敏感度分别为88.0%、75.2%、88.0%和88.7%;特异度分别为78.3%、78.3%、71.7%和80.4%,其中联合检测的敏感度和特异度最高,且联合检测的曲线下面积(AUC)最大,诊断价值最高。结论 血清CA199、NSE、HP-IgG三者联合检测可以帮助进行胃癌的早期筛查,且具备较高的灵敏度和特异度。

Objective To study the value of combined detection of carbohydrate antigen 199(CA199), neuron specific enolase(NSE) and helicobacter pylori IgG antibody(HP-IgG) in the diagnosis and screening of gastric cancer.Methods A total of 133 patients with gastric diseases admitted to Zhengzhou Hospital of Traditional Chinese Medicine from January 2020 to January 2022 were selected. They were divided into tumor group(42 cases) and general gastric disease group(91 cases of atrophic gastritis and gastric ulcer).Results The expression of serum CA199, NSE, HP-IgG in tumor group and general stomach disease group was higher than that in normal control group, and the tumor group was higher than that in general stomach disease group. The comparison between the three groups was statistically significant(P<0.05). The positive expression rate of CA199 in tumor group(54.76%) was higher than that in general stomach disease group(15.3%) and normal control group(4.34%)(P<0.05). NSE positive expression rate in tumor group(71.42%) was higher than that in general stomach disease group(13.18%) and normal control group(6.52%)(P<0.05). The positive expression rate of HP-IgG in tumor group(57.14%) was higher than that in general stomach disease group(32.96%) and normal control group(26.08%)(P<0.05). The positive rate of combined detection in tumor group(73.80%) was higher than that in general stomach disease group(20.87%) and normal control group(13.04%)(P<0.05). The sensitivity of serum CA199, NSE, HP-IgG and their combined detection were 88.0%, 75.2%, 88.0% and 88.7%, respectively. The specificity was 78.3%, 78.3%, 71.7% and 80.4%, respectively. The sensitivity and specificity of combined detection were the highest, and the area under curve(AUC) of combined detection was the highest, with the highest diagnostic value.Conclusion The combined detection of serum CA199, NSE and HP-IgG can help in the early screening of gastric cancer with high sensitivity and specificity.