PGⅠ、PGⅡ结合NSE、CA15-3在胃癌早期诊断中的应用分析OA
Application of PGⅠ and PGⅡ combined with NSE and CA15-3 in the early diagnosis of gastric cancer
目的 探讨胃蛋白酶原Ⅰ(PGⅠ)、PGⅡ结合神经元特异性烯醇化酶(NSE)、癌抗原15-3(CA15-3)在胃癌早期诊断中的应用价值.方法 选取2023年1月至2024年10月该院确诊的81例胃癌患者作为恶性组,另选取同期81例胃部良性病变患者作为良性组,比较恶性组与良性组患者血清学指标水平,采用受试者工作特征(ROC)曲线分析血清学指标单独及联合检测对胃癌早期的诊断价值,以病理检查为"金标准",采用ROC分析得到的截断值作为临界值进行诊断.分析恶性组不同病理特征患者血清学水平情况,采用Spearman秩相关系数分析血清学指标与胃癌早期临床病理特征的相关性.结果 恶性组患者血清PGⅠ水平明显低于良性组,PGⅡ、NSE、CA15-3水平均明显高于良性组,差异均有统计学意义(P<0.05);血清PGⅠ、PGⅡ、NSE、CA15-3单独及联合检测诊断胃癌早期的ROC曲线下面积分别为0.716、0.762、0.635、0.641、0.810,灵敏度分别为76.54％、80.25％、67.90％、69.14％、95.06％,特异度分别为77.50％、80.00％、70.00％、68.75％、66.25％,差异均有统计学意义(P<0.05).PGⅠ、PGⅡ、NSE、CA15-3单独及联合检测的Kappa值分别为0.605、0.654、0.506、0.543、0.716,差异均有统计学意义(P<0.05).恶性组不同病理类型患者血清PGⅠ、PGⅡ、NSE、CA15-3水平比较,差异均无统计学意义(P>0.05);恶性组肿瘤直径大于3 cm、淋巴结转移患者血清PGⅠ水平明显低于肿瘤直径小于或等于3 cm、未发生淋巴结转移患者,血清PGⅡ、NSE、CA15-3水平均明显高于肿瘤直径小于或等于3 cm、未发生淋巴结转移患者,差异均有统计学意义(P<0.05).血清PGⅠ与肿瘤直径大于3 cm、淋巴结转移均呈负相关,PGⅡ、NSE、CA15-3与肿瘤直径大于3 cm、淋巴结转移均呈正相关(P<0.05).结论 PGⅠ、PGⅡ结合NSE、CA15-3的联合检测在胃癌早期诊断中具有较高的诊断效能,为胃癌的早期筛查提供了可靠的血清学依据.
Objective To explore the application of pepsinogen Ⅰ(PGⅠ)and PGⅡ combined with neuron-specific enolase(NSE)and cancer antigen 15-3(CA15-3)in the early diagnosis of gastric cancer.Methods A total of 81 patients with gastric cancer and 81 patients with benign gastric lesions in the hospital were enrolled as malignant group and benign group from January 2023 to October 2024,respectively.The se-rological indexes in the two groups were compared,and the diagnostic value of the serological indexes for early gastric cancer was analyzed by receiver operating characteristic(ROC)curves.The serological levels of pa-tients with different pathological characteristics in the malignant group were analyzed,and the correlation be-tween serological indexes and early clinicopathological characteristics of gastric cancer was analyzed by Spearman's rank correlation coefficient.Results The serum PGⅠ level in malignant group was lower than that in benign group,while levels of PGⅡ,NSE and CA15-3 were higher than those in benign group(P<0.05).ROC curve analysis showed that the area under the curve(AUC),sensitivity and specificity of serum PGⅠ,PGⅡ,NSE,CA15-3 alone and their combined detection in the early diagnosis of gastric cancer were 0.716,0.762,0.635,0.641,0.810;76.54％,80.25％,67.90％,69.14％,95.06％;and 77.50％,80.00％,70.00％,68.75％,66.25％,respectively(P<0.05).Taking pathological examination as the gold standard,the cut-off value obtained by ROC analysis was used as the diagnostic criterion.The results showed that Kappa values of PGⅠ,PGⅡ,NSE,CA15-3 and combined detection were 0.605,0.654,0.506,0.543 and 0.716,re-spectively(P<0.05).In the malignant group,there was no significant difference in levels of serum PGⅠ,PGⅡ,NSE and CA15-3 among patients with different pathological types(P>0.05).In the malignant group,PGⅠ level in patients with tumor diameter>3 cm and lymph node metastasis was lower than those with tumor diameter≤3 cm and lymph node non-metastasis,while the levels of serum PGⅡ,NSE,and CA15-3 were higher than those with tumor diameter≤3 cm and lymph node non-metastasis(P<0.05).Spearman rank correlation analysis showed that serum PGⅠ was negatively correlated with tumor diameter>3 cm and lymph node metastasis,while PGⅡ,NSE and CA15-3 were positively correlated with them(P<0.05).Con-clusion The combined detection of PGⅠ,PGⅡ,NSE and CA15-3 has high diagnostic efficiency in the early diagnosis of gastric cancer,providing a reliable serological basis for the early screening of gastric cancer.
张伟;王乐柯
南阳市中心医院核医学科,河南 南阳 473000南阳市中心医院核医学科,河南 南阳 473000
医药卫生
胃肿瘤胃蛋白酶原类癌抗原15-3早期诊断
Gastric cancerPepsinogensCancer antigen 15-3Early diagnosis
《现代医药卫生》 2026 (3)
508-512,5
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