目的 探讨单克隆胃癌7抗原(MG7-Ag)、胃泌素-17(G-17)和糖类抗原19-9(CA19-9)联合检测对胃癌的诊断价值。方法 选取2022-01-01至2024-01-01扬州大学医学院附属沭阳中医院收治的胃病患者262例。疾病分布为慢性非萎缩性胃炎74例(28.25%)、慢性萎缩性胃炎62例(23.66%)、胃溃疡42例(16.03%)、上皮瘤变43例(16.41%)及胃癌41例(15.65%)。从慢性非萎缩性胃炎、慢性萎缩性胃炎、上皮瘤变和胃癌患者中随机各取41例进行后续研究。比较各组患者血清MG7-Ag、G-17及CA19-9水平差异;针对不同疾病进展阶段,采用二分类logistic回归模型构建三指标联合诊断模型,并以模型输出的预测概率作为联合检测指标,采用受试者工作特征(ROC)曲线评价单项及联合检测的诊断效能。结果 胃癌组患者血清中MG7-Ag、G-17和CA19-9的水平均高于癌前病变组,差异有统计学意义(P＜0.05)。在胃癌诊断中,联合检测的AUC为0.970,高于MG7-Ag(0.909)、G-17(0.680)和CA19-9(0.852)的单一检测(P＜0.05),且敏感度(97.6%)和特异度(87.8%)达到最优。在癌前病变阶段(慢性萎缩性胃炎及上皮瘤变),联合检测虽未显著增加AUC值,但整体改善了敏感度和特异度的综合表现。结论 MG7-Ag、G-17 和 CA19-9 联合检测在胃癌诊断中具有较高应用价值,其诊断效能优于单项指标。
Abstract
Objective To investigate the diagnostic value of combined detection of monoclonal gastric cancer 7 antigen (MG7-Ag), gastrin-17 (G-17) and carbohydrate antigen 19-9 (CA19-9) for gastric cancer. Methods A retrospective analysis was conducted on 262 patients with gastric diseases admitted to Shuyang Hospital of traditional Chinese Medicine Affiliated to Medical College of Yangzhou University from January 1,2022 to January 1,2024, including 74 cases of chronic non-atrophic gastritis(28.25%), 62 cases of chronic atrophic gastritis(23.66%), 42 cases of gastric ulcer(16.03%), 43 cases of gastric intraepithelial neoplasia (16.41%), and 41 cases of gastric cancer(15.65%). Forty-one patients were randomly selected from each of the chronic non-atrophic gastritis, chronic atrophic gastritis, gastric intraepithelial neoplasia, and gastric cancer groups for further analysis. The differences in serum levels of MG7-Ag, G-17, and CA19-9 were illustrated. For different stages of disease progression, a binary logistic regression model was constructed for the combined diagnosis of the three indicators, and the predicted probability output by the model was used as the combined detection indicator. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic performance of individual and combined detection. Results The levels of MG7-Ag, G-17, and CA19-9 were significantly higher in the gastric cancer group than those in the precancerous lesion group, and the differences were statistically significant (P<0.05). In gastric cancer diagnosis, the combined test achieved an AUC of 0.970, significantly higher than the single test of MG7-Ag (0.909), G-17 (0.680), and CA19-9 (0.852) (P<0.05), with optimal sensitivity (97.6%) and specificity (87.8%). In precancerous lesion stages (chronic atrophic gastritis and intraepithelial neoplasia), although combined detection did not significantly increase the AUC value, it improved the overall performance of sensitivity and specificity. Conclusions The combined detection of MG7-Ag, G-17, and CA19-9 has high value in the diagnosis of gastric cancer, and its diagnostic efficacy is superior to that of individual indicators.
关键词
MG7-Ag /
G-17 /
CA19-9 /
诊断 /
胃癌
Key words
MG7-Ag /
G-17 /
CA19-9 /
diagnosis /
gastric cancer
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