血清胃蛋白酶原Ⅰ及胃泌素17等指标在胃癌化疗疗效评价中的应用研究

目的探讨血清胃蛋白酶原Ⅰ(PGⅠ)、癌胚抗原(CEA)、胃泌素17(G-17)在胃癌化疗疗效评价中的应用价值。方法随机选择2014年2月至2016年6月于本院确诊的胃癌化疗患者90例。所有患者均接受2个疗程的多西他赛/顺铂/5-氟尿嘧啶(DCF)方案化疗。参照世界卫生组织制定的化疗疗效客观评价标准,将患者分为有效组和无效组。于化疗前后检测并比较血清CEA、PGⅠ、G-17水平。根据血清指标水平变化评价化疗效果。采用受试者工作特征曲线(ROC曲线)分析血清PGⅠ、CEA、G-17对化疗疗效的评价效能。结果血清指标变化结果显示,29例患者化疗有效,占32.22%。客观评价有效组患者化疗后血清CEA及G-17水平明显低于无效组,且较化疗前明显降低,无效组则较化疗前明显升高(P0.05)。血清PGⅠ水平呈相反变化趋势(P0.05)。ROC曲线分析结果显示,血清PGⅠ以70μg/L为临界值,CEA以7.35μg/L为临界值,G-17以14.22pmol/L为临界值时,三者联合检测评价胃癌患者化疗效果的ROC曲线下面积、灵敏度、特异度均优于三者单独检测(P0.05)。结论血清PGⅠ、CEA、G-17联合检测评价胃癌化疗疗效的准确性高、特异性强、灵敏度高,可作为胃癌化疗疗效评价的参考指标。

Application of serum PGⅠ,CEA and G-17 in assessment of chemotherapy effect in patients with gastric cancer

Objective To discuss the application value of serum pepsinogen Ⅰ(PGⅠ),carcinoembryonic antigen(CEA) and gastrin-17(G-17) in assessment of chemotherapy curative effect in patients with gastric cancer.Methods From Feb.2014 to Jun.2016,a total of 90 patients with gastric cancer were selected,and treated with docetaxe/cisplatin/5-fluorouracil(DCF) scheme for two courses.All patients were divided into effective group and ineffective group,according to the assessment criterion,proclaimed by World Health Organization.Serum levels of CEA,PGⅠand G-17 were detected before and after treatment.Curative effect was also assessed according to the changes of CEA,PGⅠand G-17.Receiver operating characteristic curve(ROC curve) was used to analyze the performance of PGⅠ,CEA and G-17 in the assessment of curative effect.Results Chemotherapy was effective in 29 cases,accounting for 32.22%.After chemotherapy,serum CEA and G-17 level of effective group were lower than ineffective group,while PGⅠ level was higher(P<0.05).ROC curve analysis showed that the area under ROC curve,sensitivity and specificity of combined detection for the assessment of curative effect were higher than single detection of serum PGⅠ,CEA and G-17,taking 70 g/L,7.35 g/L and 14.22 pmol/L as cut-off value(P<0.05).Conclusion Combined detection of serum PGⅠ,CEA and G-17 could be with high accuracy,specificity and sensitivity for the assessment of chemotherapy effect in patients with gastric cancer.