胃癌患者血清CA724，NSE和 PGR水平联合检测对肿瘤临床病理分期及淋巴结转移的诊断价值

目的　探讨血清糖类抗原 724（CA724）、神经元特异性烯醇化酶（ NSE）和胃蛋白酶原比值（ PGR）在胃癌诊断、临床分期及淋巴结转移中的临床应用价值。方法　采用电化学发光法及酶联免疫吸附法（ ELISA）测定 2017年 4月 ~2019年 4月入住于陕西省人民医院的 84例胃癌患者（胃癌组）及 80例胃良性病变患者（良性病变组）血清中 CA724，NSE和 PGR水平，观察上述指标在各组患者中的表达水平，评价其在胃癌临床分期和淋巴结转移中的应用价值，并分析这三项指标联合检测的诊断效能。结果　胃癌组血清 CA724和 NSE水平与良性病变组对比，明显较高， PGR水平与良性病变组对比，明显较低，差异均有统计学意义（ t=63.327，48.026，7.146，均 P＜ 0.05）；胃癌组中， III~IV期患者血清 CA724和 NSE水平与 I~II期患者对比，明显较高， PGR水平与 I~II期患者对比，明显较低，差异均有统计学意义（ t=46.687，47.916，16.358，均 P＜ 0.05）；胃癌组中，淋巴结转移者血清 CA724和 NSE水平与未转移者对比，明显较高， PGR水平与未转移者对比，明显较低，差异均有统计学意义（ t=49.679，30.872，22.573，均 P＜ 0.05）； CA724, NSE和 PGR三项联合检测准确度、特异度、灵敏度分别为 92.68%, 88.75%和 96.43%，与单项检测对比，均明显较高，差异均有统计学意义（χ2=5.096~20.993，均 P＜ 0.05）。结论　CA724, NSE 和 PGR在胃癌患者中表达异常，且与胃癌临床分期及淋巴结转移有一定关联，三者联合检测，有助于胃癌的鉴别诊断。

Diagnostic Value of Combined Detection of Serum CA724,NSE and PGR Levels in Patients with Gastric Cancer for Tumor Clinical Pathological Stage and Lymph Node Metastasis

Objective To investigate the clinical value of serum CA724,NSE and PGR in the diagnosis,clinical staging and lymph node metastasisof gastric cancer.Methods Serum levels of CA724,NSE and PGR in 84 patients with gastric cancer(gastric cancer group)and 80 patients with benign gastric lesions(benign lesiongroup)were measured by electrochemiluminescence and enzyme-linked immunosorbent assay(ELISA)from Apr 2017 to Apr 2019,observed the expression of the three indicators in gastric cancer and benign gastric lesions group,and analyzed the diagnostic efficacy of the combined detection of three indicators.Results Compared with the benign lesion group,the levels of CA724 and NSE in the gastric cancer group were significantly higher,and the PGR level was significantly lower,the differences were statistically significant(t=63.327,48.026,7.146,all P<0.05).In the gastric cancer group,compared with the patients with stage Ⅰ~Ⅱ,the levels of CA724 and NSE in patients with stage Ⅲ~Ⅳ were significantly higher,and the level of PGR was significantly lower,the differences were statistically significant(t=46.687,47.916,16.358,all P<0.05).In the gastric cancer group,compared with the non-metastatic patients,the levels of CA724 and NSE in patients with lymph node metastasis were significantly higher,and the PGR level was significantly lower,the differences were statistically significant(t=49.679,30.872,22.573,all P<0.05).The accuracy,specificity and sensitivity of the combined detection of CA724,NSE and PGR were 92.68%,88.75%and 96.43%,respectively,which were significantly higher than the single test,the differences were statistically significant(χ^2=5.096~20.993,all P<0.05).Conclusion CA724,NSE and PGR were abnormally expressed in thepatientswithgastric cancer,and which associated with tumorclinical pathological stage and lymph node metastasis.The combined detection of the three indicators is helpful for thediagnosis of gastric cancer.