蔡振鑫

[摘要]目的探討胃功能三项联合肿瘤标志物（TM）在胃早癌筛查体检中的临床价值及对准确率的影响。方法将2019年1月至2020年12月在惠州市第一人民医院检验科诊断为胃癌患者40例作为研究组，另选取同一时期胃良性疾病患者80例为参照组，胃黏膜正常的健康受检者72例为正常组，比较三组血清胃功能三项、TM 相关指标水平及其灵敏度、特异度、准确度。结果参照组的 PG Ⅰ、PG Ⅱ、PGR、G-17水平与正常组比较，差异无统计学意义（ P >0.05）;研究组 PG Ⅰ、PG Ⅱ、PGR、G-17水平与正常组、参照组比较，差异有统计学意义（ P <0.05）;研究组 CEA、CA199、CA724、CA242水平均高于正常组、参照组（ P <0.05）;胃功能三项与 TM 相关指标联合检测的灵敏度、特异度、准确度均高于单一检测（ P <0.05）。结论血清胃功能三项与 TM 相关指标水平高低与胃癌发生有着紧密的关联，血清胃功能三项与肿瘤标志物联合检测准确率更高，可为临床筛查、诊断提供依据。

[关键词]胃功能三项;肿瘤标志物;胃癌;筛查

[中图分类号] R735.2  [文献标识码] A   [文章编号]2095-0616（2021）23-0159-04

Clinical value of combined detection of three items of gastric function and tumor markers in early screening of gastric cancer

CAI  Zhenxin

Department of Clinical Laboratory， Huizhou First Hospital， Guangdong， Huizhou 516000， China

[Abstract] Objective To explore the clinical value of combined detection of three items of gastric function and tumor markers （TM） in early screening of gastric cancer （GC） its influence on accuracy. Methods A total of 40 patients with GC diagnosed in the Clinical Laboratory of Huizhou First Hospital from January 2019 to December 2020 were selected as the study group， 80 patients with benign gastric diseases in the same period were selected as the control group， and 72 healthy subjects with normal gastric mucosa were selected as the normal group. Three items of gastric function in serum， TM related indexes and the sensitivity， specificity and accuracy were compared among the three groups. Results There was no statistically significant difference in the levels of PG Ⅰ ， PG Ⅱ ， PGR and G-17 between the control group and the normal group （P >0.05）. The levels of PG Ⅰ ， PG Ⅱ ， PGR and G-17 in study group were significantly different from those in normal group and control group， with statistically significant differences （P <0.05）. The levels of CEA， CA199， CA724 and CA242 in study group were higher than those in normal group and control group （P <0.05）. The sensitivity， specificity and accuracy of combined detection of three items of gastric function and TM related indexes were higher than those of single detection （P <0.05）. Conclusion The level of three items of gastric function in serum and TM-related indicators are closely related to the occurrence of GC， and the combined detection of three items of gastric function and tumor markers exhibit higher accuracy， which can provide basis for clinical screening and diagnosis.

[Key words] Three items of gastric function; Tumor markers; Gastric cancer; Screening

胃癌也就是发生在胃部的癌症，一般起源于胃黏膜细胞。根据最新的统计数据显示，在全球范围内胃癌发病率占恶性肿瘤的第五位，其病死率位居第三位，而在我国，胃癌的发病率和病死率远高于世界平均水平[1]。在胃癌的临床诊断中，电子胃镜活检是诊断胃癌的“金标准”，但具有一定的侵入性[2]。准确、便捷、快速应是胃癌诊断的发展方向。研究发现[3-4]血清胃功能三项胃蛋白酶原Ⅰ（pepsiongenⅠ，PG Ⅰ）、胃蛋白酶原Ⅱ（pepsinogen Ⅱ，PG Ⅱ）、血清胃泌素-17（gastrin-17，G-17）具有较高的临床诊断价值，不同腫瘤标记物（tumormarker，TM）指标在胃癌早期筛查价值也逐渐显现。本研究旨在探讨血清胃功能三项联合 TM 检测在胃癌早期筛查中的临床价值，现报道如下。

1资料与方法

1.1一般资料

研究组：选取2019年1月至2020年12月于惠州市第一人民医院检验科检查并经电子胃镜活检确诊为胃癌患者40例，其中男25例，女15例，年龄46～77岁，平均（56.21±8.46）岁。