血清CK18、CEA、CA199联合检测在胃癌诊治中的临床意义

发布时间：2018-01-19 02:24

  本文关键词： 胃癌 角蛋白18 癌胚抗原 糖类抗原199 联合检测　出处：《青岛大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的探讨细胞角蛋白18(CK18)、癌胚抗原(CEA)、糖类抗原199(CA199)联合检测在胃癌诊治中的临床意义。方法采用化学发光微粒子免疫分析法(CMIA)和酶联免疫吸附法(ELISA双抗体夹心法)检测30例健康体检者(对照组)、40例胃良性病变患者(胃良性病变组)和60例胃癌患者(胃癌组)血清中CK18、CEA、CA199水平,应用SPSS22.0统计软件包进行处理。结果①胃癌组血清CK18、CEA、CA199水平均显著高于胃良性病变组和对照组,差异有统计学意义(P?0.01,P?0.05,P?0.01);胃良性病变组三个指标与对照组比较差异无统计学意义(P0.05)。②胃癌组按TNM分期,III、IV期胃癌患者血清CK18,CEA,CA199水平均高于I、II期,差异有统计学意义(P?0.01,P?0.05,P?0.01)。③胃腺癌组与胃非腺癌组血清CK18水平比较,差异有统计学意义(P?0.01);而胃腺癌组与胃非腺癌组CEA、CA199水平比较,差异均无统计学意义(P0.05)。④胃癌患者行根治性手术后,血清CK18、CEA、CA199水平与术前比较,差异有统计学意义(P0.05,P0.05,P0.01);行姑息性手术后血清CK18、CEA、CA199水平与术前比较,差异均无统计学意义(P0.05)。⑤通过CK18、CEA、CA199对胃癌诊断的ROC曲线计算得出三者曲线下的面积分别为:0.879、0.830、0.870,联合CK18和CEA得到AUC=0.899,联合CK18和CA199得到AUC=0.941,联合CEA和CA199得到AUC=0.908,CK18、CEA、CA199三者联合得到AUC=0.945。CK18、CEA、CA199三者联合检测曲线下面积最大。三种指标单独检测对胃癌诊断的敏感性分别为55%、62%、62%,特异性分别为100%、83.3%、86.67%,三者联合检测对胃癌诊断的敏感性为75%,特异性为73.33%。结论①血清CK18、CEA、CA199联合检测有助于提高胃癌诊断的敏感性。②血清CK18、CEA、CA199联合检测可为胃癌的临床分期、手术疗效评估及鉴别诊断提供实验参考依据。
[Abstract]:Objective to investigate cytokeratin 18 (CK18), carcinoembryonic antigen (CEA). Methods chemiluminescence microparticle immunoassay (CMIA) and enzyme-linked immunosorbent assay (Elisa) were used in the diagnosis and treatment of gastric cancer. ELISA double antibody sandwich method was used to detect 30 healthy persons (control group). Serum levels of CK18CEACA199 in 40 patients with benign gastric lesions (benign gastric lesions) and 60 patients with gastric cancer (gastric cancer). Results 1 the serum levels of CK18 and CEACA199 in gastric cancer group were significantly higher than those in benign gastric lesion group and control group. The difference is statistically significant. 0.01,P? 0.05,P? 0.01C; There was no significant difference between the three indexes of benign gastric lesions group and the control group. The serum levels of CK18 and CEA in gastric cancer group were determined by TNM staging. The level of CA199 was higher than that of stage II, and the difference was statistically significant. 0.01,P? 0.05,P? The level of serum CK18 in patients with gastric adenocarcinoma and non-adenocarcinoma was significantly higher than that in patients with gastric adenocarcinoma. 0.01C; However, there was no significant difference in CEA CA199 levels between gastric adenocarcinoma group and non-adenocarcinoma group. After radical operation, serum CK18 CEA levels in gastric cancer patients were not significantly different (P0.05.4). The level of CA199 was significantly higher than that before operation. After palliative operation, the level of serum CK18 CEA CA199 was not significantly different from that before operation (P 0.05%, P 0.05%, P < 0.05). The ROC curve of CA199 for the diagnosis of gastric cancer showed that the areas under the three curves were respectively 0. 0. 879 and 0. 830 0. 870. Combined with CK18 and CEA, AUCN 0.899, CK18 and CA199 0.941, AUC=0.908 combined with CEA and CA199 were obtained. Combined with CK18CCEACA199, CEA was obtained from AUC _ (0.945) CK18C _ (18). The area under the joint detection curve of CA199 was the largest. The sensitivity of the three indexes to the diagnosis of gastric cancer was 55 and 62, and the specificity was 100% and 83. 3% respectively. The sensitivity and specificity of the three methods for the diagnosis of gastric cancer were 75 and 73.33 respectively. Conclusion 1 Serum CK18 CEA. The combined detection of CA199 is helpful to improve the sensitivity of diagnosis of gastric cancer. 2 the combined detection of serum CK18 and CEACA199 may be the clinical stage of gastric cancer. The evaluation of surgical efficacy and differential diagnosis provide experimental reference.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R735.2
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