联合检测血清胃蛋白酶原、Hp抗体、CEA、CA724在胃癌筛查的临床研究

Clinical research on serum pepsinogen,Hp antibody,CEA and CA724 combined detection in the gastric cancer screening

目的探讨血清胃蛋白酶原Ⅰ(PGⅠ)、胃蛋白酶原Ⅱ(PGⅡ)、PGⅠ/PGⅡ比值、幽门螺杆菌(Hp)抗体、糖类抗原724(CA724)、癌胚抗原(CEA)联合检测在胃癌筛查的临床价值研究。方法选取2021年7月至2023年11月在玉林市第一人民医院就诊的100例胃癌患者为胃癌组、80例萎缩性胃炎患者为萎缩性胃炎组及同期80例非萎缩性胃炎为对照组。检测并比较三组研究对象血清中PGⅠ、PGⅡ、PGⅠ/PGⅡ比值、Hp抗体、CEA、CA724水平,用受试者工作特征(ROC)曲线评估以上指标在胃癌中的诊断价值。结果胃癌组、萎缩性胃炎组的PGⅠ、PGⅠ/PGⅡ比值水平均低于对照组,差异有统计学意义(P<0.05)。胃癌组的PGⅡ及Hp抗体水平均高于对照组,但胃癌组Hp抗体水平低于萎缩性胃炎组,差异有统计学意义(P<0.05)。胃癌组的CEA、CA724水平均高于其余两组,差异有统计学意义(P<0.05)。采用Spearman相关分析,结果显示PGⅠ/PGⅡ比值与PGⅠ呈正相关(r=0.229,P<0.05),与PGⅡ、Hp抗体、CA724呈负相关(r=-0.560,P<0.05;r=-0.236,P<0.05;r=-0.223,P<0.05)。联合检测血清PGⅠ、PGⅡ、Hp抗体、CEA、CA724诊断胃癌的曲线下面积(AUC=0.844)均大于各单项诊断AUC。结论联合检测血清PGⅠ、PGⅡ、PGⅠ/PGⅡ比值、Hp抗体、CEA、CA724可提高胃癌的诊断价值。

Objective To investigate the clinical value research of serum pepsinogenⅠ(PGⅠ),pepsinogenⅡ(PGⅡ),PGⅠ/PGⅡratio,antibody against Helicobacter pylori(Hp),carbohydrate antigen 724(CA724)and carcinoembryonic antigen(CEA)combined detection in the gastric cancer screening.Methods A total of 100 patients with gastric cancer treated in the First People’s Hospital of Yulin from July 2021 to November 2023 were selected as the gastric cancer group,80 patients with atrophic gastritis as the atrophic gastritis group and 80 patients with non-atrophic gastritis during the same period as the control group.The serum levels of PGⅠ,PGⅡ,PGⅠ/PGⅡratio,Hp antibody,CEA and CA724 of the three groups of subjects were detected and compared.Receiver operating characteristic(ROC)curve was used to evaluate the diagnostic value of the above indexes in the gastric cancer.Results The levels of PGⅠand PGⅠ/PGⅡratio in the gastric cancer group and the atrophic gastritis group were lower than those in the control group,and the differences were statistically significant(P<0.05).The levels of PGⅡand Hp antibody in the gastric cancer group were higher than those in control group,but the levels of Hp antibody in the gastric cancer group were lower than those in the atrophic gastritis group,and the differences were statistically significant(P<0.05).The levels of CEA and CA724 in the gastric cancer group were higher than those in the other two groups,and the differences were statistically significant(P<0.05).Spearman correlation analysis showed that PGⅠ/PGⅡratio was positively correlated with PGⅠ(r=0.229,P<0.05),and negatively correlated with PGⅡ,Hp antibody and CA724(r=-0.560,P<0.05,r=-0.236,P<0.05,r=-0.223,P<0.05).The area under the curve(AUC=0.844)of combined detection of serum PGⅠ,PGⅡ,Hp antibody,CEA and CA724 in the diagnosis of gastric cancer were all larger than those of each single diagnosis of AUC.Conclusion Combined detection of serum PGⅠ,PGⅡ,PGⅠ/PGⅡratio,Hp antibody,CEA and CA724 can improve the diagnostic value of gastric cancer.