细胞角蛋白18片段检测在胃癌诊断中的临床意义

doi:10.3971/j.issn.1000-8578.2012.04.018

细胞角蛋白18片段检测在胃癌诊断中的临床意义

Clinical Significance of Cytokeratin18 Fragments in Diagnosis of Gastric Cancer

摘要

摘要: 目的评估细胞角蛋白18片段(CK18-3A9）在胃癌诊断中的临床意义。方法采用化学发光法检测236例胃癌(胃腺癌186例、胃印戒细胞癌50例）、慢性胃炎、胃溃疡患者150例和165名健康对照者血清CK18-3A9水平，并用电化学发光免疫分析法测定上述患者血清中CEA、CA199、CA72-4标志物水平。将CK18-3A9与传统的胃癌标志物进行比较分析。结果单项CK18-3A9检测胃癌的敏感度为36.02%、特异性为97.5%，(CEA+CA199+CA72-4）检测胃癌的敏感度为33.47%、特异性为97.5%；CK18-3A9联合(CEA+CA199+CA72-4）检测胃癌的敏感度可提高至55.08%，特异性可保持在97.5%。联合CK18-3A9与(CEA+ CA199+CA72-4）检测胃癌的敏感度高于单项CK18-3A9以及(CEA+CA199+CA72-4）检测，差异均有统计学意义(P<0.05)；但特异性没有明显差异。结论 CK18-3A9片段可作为一种新的胃癌标志物。CK18-3A9检测联合传统的标志物CEA、CA199、CA724可显著提高诊断的敏感度，并保持较高的特异性。

Abstract: Objective To explore clinical significance of Cytokeratin18 Fragments in diagnosis of gastric cancer. Methods CLIA(chemiluminescence immunology analysis) was used to detect the serum level of CK18-3A9 in 236 cases of gastric cancer(186 cases of Gastric adenocarcinoma，50 cases of Signet-ring cell carcinoma)，150 cases of gastritis and gastric ulcer，and 165 healthy persons.ECLIA (electro-chemiluminescence analysis) was used to detect the serum levels of markers(CEA，CA199，CA72-4) in those people. Results The sensitivity and specificity of CK18-3A9 to diagnose gastric cancer were 36.02% and 97.5% respectively.The sensitivity and specificity of combined markers(CEA+CA199+CA72-4) were 33.47% and 97.5% respectively.The combined detection of CK18-3A9 and markers(CEA+CA199+CA72-4) to diagnose gastric cancer could increase the sensitivity up to 55.08% with significant difference (P<0.05)，also with the same specificity. Conclusion The detection of serum CK18-3A9 is helpful in the diagnosis of gastric cancer.Combination of serum CK18-3A9 with other markers(CEA+CA199+CA72-4) would improve the accuracy in diagnosis of gastric cancer.

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