血清TK1、CEA、CA19-9检测对胃癌的诊断价值及与其临床病理特征的相关性研究

Diagnostic Value of Serum TK1,CEA and CA19-9 Detection on Gastric Cancer and Their Correlation with Clinicopathological Features of Gastric Cancer

目的分析血清细胞质胸苷激酶1(TK1)、癌胚抗原(CEA)、糖类抗原19-9(CA19-9)检测在胃癌临床诊断中的应用及其与胃癌临床病理特征的相关性。方法研究对象为62例胃癌患者(胃癌组)、60例胃良性病变患者(良性对照组)。所有受试者均检测血清TK1、CEA、CA19-9水平,分析血清TK1、CEA、CA19-9水平与胃癌病理特征的相关性,比较2组受试者血清TK1、CEA、CA19-9水平差异,应用受试者工作曲线(ROC曲线)评价上述指标对胃癌的诊断价值。结果胃癌患者随肿瘤直径增大、TNM分期增加、分化程度降低、浸润深度加深血清TK1、CEA、CA19-9水平呈上升趋势(P<0.05)。胃癌组血清TK1、CEA、CA19-9水平高于良性对照组(P<0.05)。血清TK1、CEA、CA19-9水平与受试者是否患胃癌密切相关(P<0.05)。TK1 ROC曲线显示AUC 0.796(P<0.05),临界值为1.75 pmol/L,敏感性、特异性分别为0.686、0.800。CEA ROC曲线显示AUC 0.641(P<0.05),临界值为4.32μg/L,敏感性、特异性分别为0.500、0.840。CA19-9 ROC曲线显示AUC 0.689(P<0.05),临界值为34.35 U/mL,敏感性、特异性分别为0.700、0.630。三者联合预测AUC为0.920,敏感性、特异性分别为0.771、0.900,优于各自单独预测(P<0.05)。结论相较于胃良性病变患者,胃癌患者血清TK1、CEA、CA19-9水平显著升高,且与胃癌临床病理特征密切相关,TKI对胃癌诊断AUC大于CEA、CA19-9,联合检测对胃癌诊断有重要意义。

Objective To analyze the application of serum cytoplasmic thymidine kinase 1(TK1),carcinoembryonic antigen(CEA)and carbohydrate antigen 19-9(CA19-9)in the diagnosis of gastric cancer and their correlation with clinicopathological features of gastric cancer.Methods The subjects were 62 patients with gastric cancer(gastric cancer group)and 60 patients with benign gastric lesions(benign control group).The levels of serum TK1,CEA and CA19-9 were detected among all subjects,and the correlation between levels of serum TK1,CEA and CA19-9 and pathological features of gastric cancer was analyzed.The differences in serum levels of TK1,CEA and CA19-9 were compared between the 2 groups.Receiver operating characteristic curve(ROC curve)was used to evaluate the diagnostic value of the above indicators on gastric cancer.Results The levels of serum TK1,CEA and CA19-9 in gastric cancer patients were increased with the increase of tumor diameter,increase of TNM stage,decrease of differentiation degree and deepening of infiltration depth(P<0.05).The levels of serum TK1,CEA and CA19-9 in gastric cancer group were higher than those in benign control group(P<0.05).The levels of serum TK1,CEA and CA19-9 were closely related to presence or absence of gastric cancer in the subjects(P<0.05).ROC curve of TK1 showed AUC was 0.796(P<0.05),and the critical value,sensitivity and specificity were 1.75 pmol/L,0.686 and 0.800 respectively.ROC curve of CEA showed AUC was 0.641(P<0.05),and the critical value,sensitivity and specificity were 4.32μg/L,0.500 and 0.840 respectively.ROC curve of CA19-9 showed AUC was 0.689(P<0.05),and the critical value,sensitivity and specificity were 34.35 U/mL,0.700 and 0.630 respectively.The AUC of the three combined prediction was 0.920,and the sensitivity and spec-ificity were 0.771 and 0.900,which were better than those of their respective predictions(P<0.05).Conclusion Compared with patients with benign gastric lesions,the levels of serum TK1,CEA and CA19-9 in patients with gastric cancer are significantly increased,and are closely related to the clinicopathological features of gastric cancer.The AUC of TKI diagnosis of gastric cancer is greater than that of CEA and CA19-9.Combined detection is of great significance for the diagnosis of gastric cancer.