标题：血清胃蛋白酶原联合肿瘤标志物CA242、CA199、CEA诊断胃癌的价值

      作者：杨华，冉妮娜，薛娟，侯静芳    西安市第一医院老年消化内科，陕西 西安 710002

      卷次： 2021年32卷20期

      【摘要】 目的 探讨血清胃蛋白酶原、糖类抗原242 (CA242)、糖类抗原199 (CA199)、癌胚抗原(CEA)联合诊断胃癌的价值。方法 选择西安市第一医院2018年3月至2020年3月收治的92例胃癌患者作为A组，抽取同期收治的92例胃良性病变患者作为B组，另选取同期在我院行健康体检且结果正常者92例作为C组，检测并比较三组受检者的血清胃蛋白酶原指标[胃蛋白酶原Ⅰ(PGⅠ)、胃蛋白酶原Ⅱ (PGⅡ)、PGⅠ/PGⅡ]和CEA、CA242、CA199水平，同时比较胃癌不同分期患者胃蛋白酶原、CA242、CA199、CEA水平，使用ROC曲线分析上述指标单一检测与联合检测诊断胃癌的敏感性、特异性。结果 血清 PGⅠ、PGⅡ在C、B、A三组受检者中依次降低，PGⅠ/PGⅡ、CEA、CA242、CA199则依次升高，差异均有统计学意义(P<0.05)；血清PGⅠ、PGⅡ在胃癌Ⅰ期、Ⅱ期、Ⅲ期及Ⅳ期胃癌患者中依次降低，PGⅠ/PGⅡ、CEA、CA242、CA199则依次升高，差异均有统计学意义(P<0.05)；单一检测、联合检测对胃癌均具有一定的诊断价值，但联合诊断胃癌的敏感性、特异性更高。结论 血清胃蛋白酶原在胃癌患者中显著降低且与胃癌分期关系密切，胃蛋白酶原+肿瘤标志物CA242、CA199、CEA在胃癌的诊断中具有较高的应用价值。
      【关键词】 胃癌；敏感性；特异性；准确性；胃蛋白酶原；肿瘤标志物
      【中图分类号】 R735.2 【文献标识码】 A 【文章编号】 1003—6350（2021）20—2607—03

Value of serum pepsinogen combined with tumor markers CA242, CA199, and CEA in the diagnosis of gastriccancer.
YANG Hua, RAN Ni-na, XUE Juan, HOU Jing-fang. Department of Geriatric Gastroenterology, Xi'an No.1Hospital, Xi'an 710002, Shaanxi, CHINA
【Abstract】 Objective To explore the value of serum pepsinogen, carbohydrate antigen 242 (CA242), CA199and carcinoembryonic antigen (CEA) in the combined diagnosis of gastric cancer. Methods The 92 patients with gas-tric cancer admitted to Xi'an No.1 Hospital from March 2018 to March 2020 were selected as group A, 92 patients withbenign gastric lesions admitted in the same period were selected as group B, and 92 person who underwent physical ex-am during the same period with normal results were selected as group C. The levels of serum pepsinogen index such aspepsinogenⅠ (PGⅠ), pepsinogenⅡ (PGⅡ), PGⅠ/PGⅡ, and the levels of CEA, CA242, CA199 were detected andcompared among the three groups; and the levels of pepsinogen, CA242, CA199, and CEA were compared in patientswith different stages of gastric cancer. ROC curve was used to analyze the sensitivity and specificity of the above indi-cators in the single detection and combined detection to diagnose gastric cancer. Results Serum levels of PGⅠ andPGⅡ decreased sequentially in the three groups (C, B and A), while the ratio of PGⅠ/PGⅡ and the levels of CEA,CA242 and CA199 increased in turn, with statistically significant differences (P<0.05). Serum levels of PGⅠ and PGⅡdecreased sequentially in patients with gastric cancer stage Ⅰ, Ⅱ, Ⅲ and Ⅳ, while the ratio of PG Ⅰ/PG Ⅱ and thelevels of CEA, CA242 and CA199 increased in turn (P<0.05). Both single detection and combined detection had cer-tain diagnostic value for gastric cancer, but combined test had higher sensitivity and specificity for the diagnosis of gas-tric cancer. Conclusion Serum pepsinogen is significantly decreased in patients with gastric cancer and is closely relat-ed to the stage of gastric cancer. Pepsinogen + tumor markers (CA242, CA199, CEA) have high application value in thediagnosis of gastric cancer.
      【Key words】 Gastric cancer; Sensitivity; Specificity; Accuracy; Pepsinogen; Tumor markers