外周血循环肿瘤细胞及血清胃蛋白酶原Ⅰ检测在早期胃癌诊断中的价值

Diagnostic value of peripheral blood circulating tumor cells and serum pepsinogen I for early gastric cancer

目的探讨外周血循环肿瘤细胞(CTC)及血清胃蛋白酶原(PG)Ⅰ检测在早期胃癌(EGC)诊断中的价值。方法选取2021年1月至2022年12月陕西省肿瘤医院收治的胃黏膜病变患者102例的临床资料进行病例对照研究,依据患者的诊断结果分为良性病变组54例、EGC组48例。对比两组患者的一般资料,对比两组患者的CTC及血清PGⅠ阳性率,比较单独使用CTC及血清PGⅠ对EGC的诊断效能,分析EGC诊断的独立影响因素,计算CTC及血清PGⅠ对EGC的诊断预测价值。结果两组性别、年龄差异均无统计学意义(均P>0.05)。EGC组CTC、血清PGⅠ阳性率分别为79.17%(38/48)、70.83%(34/48),均显著高于良性病变组的14.81%(8/54)、20.37%(11/54),差异均有统计学意义(χ^(2)=42.50、26.25,均P<0.001)。单独使用CTC、血清PGⅠ对EGC的诊断灵敏度、特异度、阳性预测值、阴性预测值差异均无统计学意义(均P>0.05)。logistic多因素分析结果显示,CTC、血清PGⅠ阳性是EGC患者诊断的独立危险因素(OR=20.20、8.57,均P<0.001)。采用CTC、血清PGⅠ以及logisitc回归模型的P值预测概率对患者的诊断结果进行预测,约登指数分别为0.643、0.504、0.633。结论CTC联合血清PG I对EGC的诊断有重要价值,2种检测手段对EGC发病风险评价具有重要意义。

Objective To evaluate the diagnostic value of peripheral blood circulating tumor cells(CTC)and serum pepsinogen(PG)I for early gastric cancer(EGC).Methods A case-control study was conducted utilizing the clinical data of 102 patients with gastric mucosal lesions treated at Shaanxi Provincial Cancer Hospital between January 2021 and December 2022.Based on the diagnostic outcomes,these patients were categorized into a benign lesion group(n=54)and an EGC group(n=48).Patient demographics were compared between the two groups.Additionally,CTC and PG I-positive rates were compared between the two groups.The diagnostic effectiveness of CTC and serum PG I alone in identifying EGC was evaluated.Independent factors influencing EGC diagnosis were analyzed,and the predictive diagnostic value of CTC and serum PG I for EGC was calculated.Results There was no statistically significant difference in gender and age between the two groups(both P>0.05).The positivity rates of CTC and serum PG I in the EGC group were 79.17%(38/48)and 70.83%(34/48),respectively,which were significantly higher than those in the benign lesion group[14.81%(8/54),20.37%(11/54),χ^(2)=42.50,26.25,both P<0.001].The diagnostic sensitivity,specificity,positive predictive value,and negative predictive value of CTC and serum PG I alone did not show statistically significant differences in diagnosing EGC(all P>0.05).Multivariate logistic regression analysis revealed that CTC and serum PG I positivity were independent risk factors for EGC(OR=20.20,8.57,both P<0.05).Using CTC,serum PG I,and the P-value prediction probability derived from the logistic regression model,the Jordan indices for predicting the diagnosis of EGC were 0.643,0.504,and 0.633,respectively.Conclusion The combination of CTC and PG I is highly significant for the diagnosis of EGC,and two detection methods are crucial for accurate risk assessment of EGC.