CST4联合CEA、CA72-4、CA19-9在胃癌诊断与疗效评估中的价值

Value of CST4 combined with CEA,CA72-4 and CA19-9 in the diagnosis and efficacy evaluation of gastric cancer

目的 探讨血清肿瘤标志物人半胱氨酸蛋白酶抑制剂S(CST4)、癌胚抗原(CEA)、糖类抗原72-4(CA72-4)及糖类抗原19-9(CA19-9)联合检测对提高胃癌诊断性能的价值及CST4含量与肿瘤负荷的关系。方法 收集胃癌患者术前血清标本236例,其中术后血清标本136例。健康体检者69例。采用酶联免疫吸附测定法(ELISA)检测CST4、CEA、CA72-4、CA19-9含量。结果 236例胃癌患者术前CST4、CEA、CA72-4和CA19-9的平均含量分别为78.60 U/ml、2.35 ng/ml、2.96 U/ml和9.25U/ml,显著高于健康体检者的46.77 U/ml、1.49 ng/ml、2.02 U/ml和4.69 U/ml(P均<0.05);胃癌患者术前CST4、CEA、CA72-4和CA19-9的阳性率分别为20.34%、20.76%、14.41%和11.44%,显著高于健康体检者的7.25%、4.35%、4.35%和1.45%(P均<0.05)。ROC曲线显示,CST4、CEA、CA72-4和CA19-9联合检测的灵敏度为0.42,AUC为0.74(95%CI:0.68~0.78),均高于单项检测的灵敏度及AUC。136例患者术后CST4平均含量为26.65 U/ml,显著低于术前的47.82 U/ml(P<0.001)。结论 CST4、CEA、CA72-4和CA19-9的联合检测能够提高胃癌的诊断性能,对胃癌的诊断和疗效观察具有一定的临床价值。

Objective To investigate the potential enhancement of diagnostic accuracy in gastric cancer through the combined detection of serum tumor markers(CST4,CEA,CA72-4,CA19-9).We also examined CST4 levels in both preoperative and postoperative gastric cancer patients to evaluate the correlation between CST4 levels and tumor burden.Methods Preoperative serum specimens were collected from 236 patients with gastric cancer,including 136 postoperative specimens,and 69 cases of healthy people.Serum level of CST4,CEA,CA72-4 and CA19-9 were detected by enzyme-linked immunosorbent assay(ELISA).Results The average preoperative contents of CST4,CEA,CA72-4 and CA19-9 in the gastric cancer group were 78.60 U/ml,2.35 ng/ml,2.96 U/ml and 9.25 U/ml,respectively,which were significantly higher than those in the control group with 46.77 U/ml,1.49 ng/ml,2.02 U/ml and 4.69 U/ml(all P<0.05).The positive rates of preoperative CST4,CEA,CA72-4 and CA19-9 in the gastric cancer group were 20.34%,20.76%,14.41%and 11.44%,respectively,significantly higher than those in healthy people with 7.25%,4.35%,4.35%and 1.45%(all P<0.05).ROC curves showed that the sensitivity for the combined detection of CST4 with CEA,CA72-4,and CA19-9 was 0.42,and the AUC was 0.74(95%CI:0.68-0.78),which were higher than the sensitivity and AUC of single detection.There was a significant difference in CST4 levels between gastric cancer patients before(47.82 U/ml)and after(26.65 U/ml)surgery(P<0.05).Conclusion The combined detection of CST4,CEA,CA72-4,CA19-9 can improve the diagnostic performance of gastric cancer,and has certain clinical value for the diagnosis and efficacy observation of gastric cancer.