CAJ | 학술논문

目的：探讨血清肿瘤标志物癌胚抗原（CEA）、糖类抗原724（CA724）、铁蛋白（SF）、胃蛋白酶原Ⅰ（PGⅠ）、胃蛋白酶原Ⅱ（PGⅡ）及其比值（PGI／PGII）对胃癌的诊断价值。方法对46例健康对照者（健康对照组），45例慢性萎缩性胃炎患者和39例胃癌患者，分别进行血清CEA，CA724，PGⅠ，PGⅡ及 SF含量的检测。CEA，CA724采用电化学发光法进行检测；PGⅠ和PGⅡ采用化学发光法进行检测；SF采用散射比浊法进行检测。计算 PGI／PGII比值，并对检测结果进行统计分析。结果①与正常对照组相比，胃癌组除 SF差异无统计学意义外，其余指标差异均具有统计学意义（P＜0.05），萎缩性胃炎组PGⅠ，PGⅡ和 SF差异有统计学意义（P＜0.05）；与萎缩性胃炎组相比，胃癌组的 CEA，CA724显著升高，PGⅠ显著下降，并且差异具有统计学意义（P＜0.05）。②用于评价胃癌的 ROC 曲线下面积由大到小依次为 CEA，SF， CA724，PGI／PGII，PGⅡ，PGⅠ；CEA，CA724，PGI／PGII和 SF曲线下面积差异无统计学意义（P＞0．05），PGⅠ，PGⅡ差异有统计学意义（P＜0.05）。③不同肿瘤标志物单项与联合检测对胃癌诊断的敏感度、特异度、阳性预测值及阴性预测值存在差异。结论血清肿瘤标志物CEA，CA724，PGⅠ，PGⅡ和 SF对胃癌的诊断具有重要的参考价值但各指标单独及联合检测对胃癌的诊断价值各不相同；血清PG含量及其比值与胃黏膜病变密切相关。
목적：탐토혈청종류표지물암배항원（CEA）、당류항원724（CA724）、철단백（SF）、위단백매원Ⅰ（PGⅠ）、위단백매원Ⅱ（PGⅡ）급기비치（PGI／PGII）대위암적진단개치。방법대46례건강대조자（건강대조조），45례만성위축성위염환자화39례위암환자，분별진행혈청CEA，CA724，PGⅠ，PGⅡ급 SF함량적검측。CEA，CA724채용전화학발광법진행검측；PGⅠ화PGⅡ채용화학발광법진행검측；SF채용산사비탁법진행검측。계산 PGI／PGII비치，병대검측결과진행통계분석。결과①여정상대조조상비，위암조제 SF차이무통계학의의외，기여지표차이균구유통계학의의（P＜0.05），위축성위염조PGⅠ，PGⅡ화 SF차이유통계학의의（P＜0.05）；여위축성위염조상비，위암조적 CEA，CA724현저승고，PGⅠ현저하강，병차차이구유통계학의의（P＜0.05）。②용우평개위암적 ROC 곡선하면적유대도소의차위 CEA，SF， CA724，PGI／PGII，PGⅡ，PGⅠ；CEA，CA724，PGI／PGII화 SF곡선하면적차이무통계학의의（P＞0．05），PGⅠ，PGⅡ차이유통계학의의（P＜0.05）。③불동종류표지물단항여연합검측대위암진단적민감도、특이도、양성예측치급음성예측치존재차이。결론혈청종류표지물CEA，CA724，PGⅠ，PGⅡ화 SF대위암적진단구유중요적삼고개치단각지표단독급연합검측대위암적진단개치각불상동；혈청PG함량급기비치여위점막병변밀절상관。
Objective To investigate the serum levels of tumor markers CEA,CA724,PGⅠ,PGⅡ,PGI/PGII and SF in gas-tric cancer.Methods The serum levels of CEA,CA724,PGⅠ,PGⅡ,PGI/PGII and SF were detected in 46 healthy con-trols,45 atrophic gastritis patients and 39 gastric cancer patients.Serum levels of CEA,CA724 were measured by ELC meth-od,PGⅠ,PGⅡ by time resolved fluorescence immunoassay (TRFIA)and SF by immunoturbidimetry(ITM).Results ①Compared to the healthy controls,the statistical contrast of serum levels of CEA,CA724,PGⅠ,PGⅡ and PGI/PGII except SF was significant in gastric cancer patients(P<0.05),only PGⅠ,PGⅡ,SF had significant difference in atrophic gastritis patients (P<0.05).Compared to atrophic gastritis patients,the serum levels of CEA,CA724 were significantly higher,but PGⅠwas lower in gastric cancer patients(P<0.05).②When CEA,CA724,PGⅠ,PGⅡ,PGI/PGII and SF were used to di-agnose gastric cancer individually,the sequence of the area under ROC curve was CEA,SF,CA724,PGI/PGII,PGⅡ and PGⅠ.Only the areas of PGⅠ,PGⅡunder ROC curve had significant statistical difference (P<0.05).③The sensitivity,speci-ficity,PPV and NPV were different when these indexes were used to diagnize gastric cancer individually or incorporatedly. Conclusion The serum levels of tumor markers CEA,CA724,PGⅠ,PGⅡ,PGI/PGII and SF had important reference value for the diagnosis of gastric cancer although the diagnostic value was different individually or incorporatedly;the content of serum PG and the ratio of PGI/PGII were closely related to the gastric mucosa.