摘要
【目的】探讨血清胃蛋白酶原比值(PGR)联合糖蛋白抗原19-9(CA19-9)及糖蛋白抗原72-4(CA72-4)在胃良性疾病与胃癌中的鉴别诊断价值。【方法】收集并整理128例疑似胃癌患者的一般资料,检测比较患者血清PGR水平及肿瘤标志物水平(CA19-9和CA72-4),采用Logistic回归分析探讨影响胃癌的相关因素。绘制受试者工作特征曲线(ROC),以曲线下面积(AUC)评价血清PGR、CA19-9及CA72-4水平对胃癌的诊断价值。【结果】128例疑似胃癌患者中确诊胃癌80例(62.50%,胃癌组),剩余48例(37.50%)均未确诊胃癌(非胃癌组)。胃癌组既往胃病史比例高于非胃癌组,PGR水平低于非胃癌组,CA19-9及CA72-4水平高于非胃癌组,且差异均具有统计学意义(P<0.05)。多因素分析结果显示,存在既往胃病史、CA19-9及CA72-4表达水平高及PGR表达水平低均为胃癌的相关因素(P<0.05);ROC分析显示,血清PGR、CA19-9、CA72-4及三者联合诊断胃癌的灵敏度分别为61.25%、58.75%、63.75%、73.75%,特异度分别为58.33%、56.52%、60.42%、75.00%,AUC分别为0.824、0.815、0.894、0.916,且血清PGR、CA19-9、CA72-4单一诊断效能低于三者联合诊断效能(P<0.05)。【结论】存在既往胃病史的患者胃癌发病率更高,且胃癌患者PGR表达水平偏低,CA19-9及CA72-4表达水平偏高,血清PGR、CA19-9及CA72-4均对胃癌具有临床诊断效能,且三者联合诊断效能更高。
【Objective】To explore the value of serum pepsinogen ratio(PGR)combined with glycoprotein antigen 19-9(CA19-9)and glycoprotein antigen 72-4(CA72-4)in the differential diagnosis of benign gastric diseases and gastric cancer.【Methods】The data of 128 patients with suspected gastric cancer were collected and sorted.The levels of PGR and tumor markers(CA19-9 and CA72-4)were analyzed by Logistic regression to explore the related factors affecting gastric cancer.A receiver operating characteristic curve(ROC)was drawn,and the area under the curve(AUC)was used to evaluate the diagnostic value of serum PGR,CA19-9 and CA72-4 levels for gastric cancer.【Results】Among 128 patients with suspected gastric cancer,80(62.50%)were diagnosed as the gastric cancer group,and the remaining 48(37.50%)were the non-gastric cancer group.The gastric cancer group had a lower proportion of previous gastric diseases than the non-gastric cancer group,and the PGR level was lower than that of the non-gastric cancer group,while the levels of CA19-9 and CA72-4 were higher than those in the non-gastric cancer group.The differences were statistically significant(P<0.05).The results of multivariate analysis showed that the existence of past history of gastric disease,high expression levels of CA19-9 and CA72-4,and low expression levels of PGR were all related factors for gastric cancer(P<0.05).ROC analysis showed that the sensitivity of serum PGR,CA19-9,CA72-4 and the combined diagnosis of gastric cancer was 61.25%,58.75%,63.75%,and 73.75%,respectively,the specificity was 58.33%,56.52%,60.42%,and 75.00%,respectively.The area under curve(AUC)was 0.824,0.815,0.894,and 0.916,respectively,and the single diagnostic efficacy of serum PGR,CA19-9 or CA72-4 was lower than the combined diagnostic efficacy of the three(P<0.05).【Conclusion】Patients with a history of gastric disease have a higher incidence of gastric cancer.The expression level of PGR in patients with gastric cancer is low,and the expression levels of CA19-9 and CA72-4 are high.Serum PGR,CA19-9 and CA72-4 have clinical diagnostic value for gastric cancer diagnosis,and the combined diagnosis efficiency of the three parameters is even higher.
作者
田晓花
贾海娟
TIAN Xiao-hua;JIA Hai-juan(Department of Gastroenterology,Weinan First Hospital,Weinan 714000)
出处
《医学临床研究》
CAS
2022年第4期579-581,585,共4页
Journal of Clinical Research
