摘要
背景:胃癌是人类最常见的恶性肿瘤之一,已有研究显示胃液固有荧光光谱检测对于胃癌的诊断具有一定意义。目的:评价胃液固有荧光光谱、pH值和潜血检测用于胃癌诊断的临床价值。方法:随机选取719例行胃镜检查者的胃液标本,有效例数为712例(其中胃癌24例,重度异型增生1例)。将胃液离心、过滤、稀释10倍,使用荧光分光光度计进行固有荧光光谱检测;使用试纸检测胃液pH值和潜血。结果:稀释胃液固有荧光光谱有P1、P2、P3和P4四个峰,胃癌组P2、P4的荧光强度P2FI、P4FI显著高于各胃内良性病变组(P<0.05)。参照既往研究结果,以P2FI≥111.80(发射光波长为320～360nm)作为恶性病变判定标准,以胃镜活检标本病理检查结果作为金标准,胃液固有荧光光谱检测诊断胃癌的敏感性为70.8%,特异性为80.3%。胃癌组的胃液pH值显著高于除胃溃疡组外的其他胃内良性病变组(P<0.05),但其胃液潜血阳性率与各胃内良性病变组相比无显著差异(P>0.05)。在45岁以上的受检者中,以P2FI≥111.80或胃液pH≥5作为恶性病变判定标准,其诊断胃癌的敏感性为83.3%,特异性为71.4%。结论:胃液固有荧光光谱检测如要推广应用于胃癌的筛查和诊断,还需进行进一步的临床研究加以验证。但在高危人群中进行包括胃液固有荧光光谱和pH值检测在内的胃液检测。
Gastric cancer is one of the most common malignant tumors of human being. It has been reported that the detection of gastric juice autofluorescence spectra may be valuable in the diagnosis of gastric cancer. Aims: To study the clinical value of gastric juice autofluorescence spectra, pH and occult blood test in the diagnosis of gastric cancer. Methods: Seven hundred and nineteen gastric juice specimens were randomly collected from the patients underwent gastroscopy. There were 712 valid cases, including 24 patients with gastric cancer and 1 high-grade dysplasia. After centrifugation and filtration, the gastric juice specimens were 10 fold diluted, then the autofluorescence spectra were detected by spectrofluorometer. The gastric juice pH and occult blood were tested by indicator paper. Results: Four peaks (P1, P2, P3 and P4) were found in the autofluorescence spectra of diluted, gastric juice specimens, and the fluorescence intensity of P2 and P4 (P2FI and P4FI) were greater in gastric cancer patients than those with gastric benign lesions (P<0.05). Based on our prior study, when P2FI≥111.80 was set for gastric malignancies (the emission wavelength ranged from 320 nm to 360 nm), and the pathological diagnosis of gastroscopic biopsy specimens was used as gold standard, the sensitivity and specificity of gastric juice autofluorescence spectra detection in the diagnosis of gastric cancer were 70.8% and 80.3%, respectively. The gastric juice pH of the gastric cancers was distinctively higher than that of other gastric benign lesions, except gastric ulcers (P<0.05). However, there was no significant difference in the positivity rate of gastric juice occult blood between gastric cancers and gastric benign lesions (P>0.05). For the subjects over 45 years old, the sensitivity and specificity in the diagnosis of gastric cancer were 83.3% and 71.4%, respectively, if P2FI≥111.80 or gastric juice pH≥5 were set. Conclusions: Further clinical studies should be performed to identify the detection of gastric juice autofluorescence spectra as a method in the screening and diagnosis of gastric cancer. However, in high risk group of gastric cancer the detection of gastric juice autofluorescence spectra and pH will be a simple, economical and effective method for screening of gastric cancer.
出处
《胃肠病学》
2004年第4期213-216,共4页
Chinese Journal of Gastroenterology
关键词
胃液
胃癌
固有荧光光谱
诊断
潜血
FI
良性病变
结论
参照
血检
Stomach Neoplasms
Gastric Juice
Spectrometry, Fluorescence
Hydrogen-Ion Concentration
Occult Blood
