CAJ | 학술논문

目的：通过检测PGⅠ，PGⅡ，TK1，TSGF，CEA与CA724在胃癌患者血清中的表达水平，并进行联合检测比较，探讨上述几项肿瘤标志物单独或联合检测在胃癌中的临床诊断价值。方法收集94例胃癌患者和85例健康体检者血清，速率法检测恶性肿瘤生长因子（TSGF），化学发光法检测 PGⅠ，PGⅡ，TK1，CEA和 CA724表达水平。结果胃癌组PGⅠ检测值及PGⅠ／PGⅡ比值均明显降低，差异具有统计学意义（P 均＜0.01）；PGⅡ变化不明显（P＞0.05）；TK1，TS-GF，CEA和CA724检测值升高，差异具有统计学意义（均P＜0.05）。敏感度指标由高到低分别为PGⅠ，PGⅠ／PGⅡ，TS-GF，TK1，CEA和CA724，其中PGⅠ和PGⅠ／PGⅡ诊断敏感度高于TK1，CEA和CA724单独检测，差异具有统计学意义（均P＜0.05）；特异度指标由高到低分别为 PGⅠ／PGⅡ，CEA，PGⅠ，CA724，TK1和 TSGF（此研究中 PGⅠ和 CA724特异度相同），其中PGⅠ／PGⅡ，CEA单项诊断特异度高于TSGF，差异具有统计学意义（均P＜0.05）；准确度指标由高到低分别为PGⅠ，PGⅠ／PGⅡ，CEA，TK1，CA724和TSGF，其中PGⅠ，PGⅠ／PGⅡ单项诊断准确度高于 CA724和 TSGF，差异有统计学意义（均P＜0.05）。TSGF，TK1联合 PGⅠ／PGⅡ，PGⅠ检测，可提高诊断敏感度（P＜0.05）；加入 CEA， CA724联合检测后敏感度更高，高达82.98％；联合检测使诊断特异度有所降低，但仍高达84.71％；联合检测可提高胃癌诊断准确度，最高达83.80％。此研究中PGⅠ＋PGⅠ／PGⅡ＋TSGF＋TK1＋CEA联合检测组合，在加或不加 CA724情况下三项诊断效率指标均无变化。结论 PGⅠ／PGⅡ，PGⅠ在胃癌诊断中的临床应用价值最高，且高于目前广泛应用的CEA和CA724。组合PGⅠ＋PGⅠ／PGⅡ＋TSGF＋TK1＋CEA对胃癌诊断的敏感度最高。临床中若将PGⅠ，PGⅠ／PGⅡ，TSGF，TK1和CEA这几项指标联合检测可有效提高胃癌的诊断效率。目的：通過檢測PGⅠ，PGⅡ，TK1，TSGF，CEA與CA724在胃癌患者血清中的錶達水平，併進行聯閤檢測比較，探討上述幾項腫瘤標誌物單獨或聯閤檢測在胃癌中的臨床診斷價值。方法收集94例胃癌患者和85例健康體檢者血清，速率法檢測噁性腫瘤生長因子（TSGF），化學髮光法檢測 PGⅠ，PGⅡ，TK1，CEA和 CA724錶達水平。結果胃癌組PGⅠ檢測值及PGⅠ／PGⅡ比值均明顯降低，差異具有統計學意義（P 均＜0.01）；PGⅡ變化不明顯（P＞0.05）；TK1，TS-GF，CEA和CA724檢測值升高，差異具有統計學意義（均P＜0.05）。敏感度指標由高到低分彆為PGⅠ，PGⅠ／PGⅡ，TS-GF，TK1，CEA和CA724，其中PGⅠ和PGⅠ／PGⅡ診斷敏感度高于TK1，CEA和CA724單獨檢測，差異具有統計學意義（均P＜0.05）；特異度指標由高到低分彆為 PGⅠ／PGⅡ，CEA，PGⅠ，CA724，TK1和 TSGF（此研究中 PGⅠ和 CA724特異度相同），其中PGⅠ／PGⅡ，CEA單項診斷特異度高于TSGF，差異具有統計學意義（均P＜0.05）；準確度指標由高到低分彆為PGⅠ，PGⅠ／PGⅡ，CEA，TK1，CA724和TSGF，其中PGⅠ，PGⅠ／PGⅡ單項診斷準確度高于 CA724和 TSGF，差異有統計學意義（均P＜0.05）。TSGF，TK1聯閤 PGⅠ／PGⅡ，PGⅠ檢測，可提高診斷敏感度（P＜0.05）；加入 CEA， CA724聯閤檢測後敏感度更高，高達82.98％；聯閤檢測使診斷特異度有所降低，但仍高達84.71％；聯閤檢測可提高胃癌診斷準確度，最高達83.80％。此研究中PGⅠ＋PGⅠ／PGⅡ＋TSGF＋TK1＋CEA聯閤檢測組閤，在加或不加 CA724情況下三項診斷效率指標均無變化。結論 PGⅠ／PGⅡ，PGⅠ在胃癌診斷中的臨床應用價值最高，且高于目前廣汎應用的CEA和CA724。組閤PGⅠ＋PGⅠ／PGⅡ＋TSGF＋TK1＋CEA對胃癌診斷的敏感度最高。臨床中若將PGⅠ，PGⅠ／PGⅡ，TSGF，TK1和CEA這幾項指標聯閤檢測可有效提高胃癌的診斷效率。
목적：통과검측PGⅠ，PGⅡ，TK1，TSGF，CEA여CA724재위암환자혈청중적표체수평，병진행연합검측비교，탐토상술궤항종류표지물단독혹연합검측재위암중적림상진단개치。방법수집94례위암환자화85례건강체검자혈청，속솔법검측악성종류생장인자（TSGF），화학발광법검측 PGⅠ，PGⅡ，TK1，CEA화 CA724표체수평。결과위암조PGⅠ검측치급PGⅠ／PGⅡ비치균명현강저，차이구유통계학의의（P 균＜0.01）；PGⅡ변화불명현（P＞0.05）；TK1，TS-GF，CEA화CA724검측치승고，차이구유통계학의의（균P＜0.05）。민감도지표유고도저분별위PGⅠ，PGⅠ／PGⅡ，TS-GF，TK1，CEA화CA724，기중PGⅠ화PGⅠ／PGⅡ진단민감도고우TK1，CEA화CA724단독검측，차이구유통계학의의（균P＜0.05）；특이도지표유고도저분별위 PGⅠ／PGⅡ，CEA，PGⅠ，CA724，TK1화 TSGF（차연구중 PGⅠ화 CA724특이도상동），기중PGⅠ／PGⅡ，CEA단항진단특이도고우TSGF，차이구유통계학의의（균P＜0.05）；준학도지표유고도저분별위PGⅠ，PGⅠ／PGⅡ，CEA，TK1，CA724화TSGF，기중PGⅠ，PGⅠ／PGⅡ단항진단준학도고우 CA724화 TSGF，차이유통계학의의（균P＜0.05）。TSGF，TK1연합 PGⅠ／PGⅡ，PGⅠ검측，가제고진단민감도（P＜0.05）；가입 CEA， CA724연합검측후민감도경고，고체82.98％；연합검측사진단특이도유소강저，단잉고체84.71％；연합검측가제고위암진단준학도，최고체83.80％。차연구중PGⅠ＋PGⅠ／PGⅡ＋TSGF＋TK1＋CEA연합검측조합，재가혹불가 CA724정황하삼항진단효솔지표균무변화。결론 PGⅠ／PGⅡ，PGⅠ재위암진단중적림상응용개치최고，차고우목전엄범응용적CEA화CA724。조합PGⅠ＋PGⅠ／PGⅡ＋TSGF＋TK1＋CEA대위암진단적민감도최고。림상중약장PGⅠ，PGⅠ／PGⅡ，TSGF，TK1화CEA저궤항지표연합검측가유효제고위암적진단효솔。
Objective To investigate the serum levels of PGⅠ,PGⅡ,TK1,TSGF and CEA,CA724 in gastric cancer and eval-uate the application value of combined detection the above tumor markers in diagnosis of gastric cancer.Methods The serum levels of TSGF were measured in 94 patients with gastric cancer and 85 healthy control by rate method.PGⅠ,PGⅡ,TK1 and CEA,CA724 were detected by electrochemiluminescence method.Results PGⅠand PGⅠ/PGⅡwere lower than healthy control in serum of patients with gastric cancer (both P<0.05).There was no difference in PGⅡ (P>0.05),and other tumor markers were all higher than healthy control (all P<0.05).The sensitivity of PGⅠ,PGⅠ/PGⅡ were better than TK1,CEA and CA724 (all P<0.05),the specificity of PGⅠ/PGⅡ,CEA were better than TSGF (both P<0.05),the accuracy of PGⅠ,PGⅠ/PGⅡ were better than CA724 and TSGF alone (all P<0.05).When combined TSGF,TK1 and PGⅠ/PGⅡ,PGⅠ,the sensitivity was better than combined PGⅠ/PGⅡand PGⅠ alone (P<0.05).Then when added CEA, CA724,this sensitivity improved up to 82.98%.Although the combined detection would show a lower specificity,it still keep high to 84.71%.Combined detection improved the accuracy in diagnosis of gastric cancer,up to 83.80%.In this re-search,There was no difference in sensitivity,specificity and accuracy between the group of PGⅠ+PGⅠ/PGⅡ+TSGF+TK1+CEA and the group of PGⅠ+PGⅠ/PGⅡ+TSGF+TK1+CEA+CA724.Conclusion Compared with CEA and CA724 popular used in clinic,PGⅠ/PGⅡand PGⅠshowed a better application value.The group of PGⅠ+PGⅠ/PGⅡ+TSGF+TK1+CEA showed the best sensitivity.Combined detection of serum levels of PGⅠ,PGⅠ/PGⅡ,TSGF,TK1 ,CEA can significantly raise the sensitivity and accuracy in diagnosis of gastric cancer.