诊断学理论与实践

诊断学理论与实践 ›› 2018, Vol. 17 ›› Issue (04): 428-432.doi: 10.16150/j.1671-2870.2018.04.014

• 论著 • 上一篇    下一篇

血清骨桥蛋白和组织多肽特异抗原联合检测在胃癌辅助诊断中的临床应用

张华1, 李永兴1, 乐嫣1, 王文毓2, 项明洁1   

  1. 1.上海交通大学医学院附属瑞金医院卢湾分院放免检验科,上海 200020;
    2.上海交通大学医学院医学检验系17届,上海 200020
  • 收稿日期:2017-12-01 出版日期:2018-08-25 发布日期:2018-08-25
  • 通讯作者: 项明洁 E-mail: mjxiang123456@126.com

Use of combined detection of serum OPN and TPS in diagnosis of gastric cancer

ZHANG Hua1, LI Yongxing1, LE Yan1, WANG Wenyu2, XIANG Mingjie1   

  1. 1. Department of Radioimmunoassay Center and Clinical Lab, Luwan Branch, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200020, China;
    2. Shanghai Jiao Tong University School of Medicine Medical Test of the 17 th, Shanghai 200020, China
  • Received:2017-12-01 Online:2018-08-25 Published:2018-08-25

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摘要： 目的：研究血清骨桥蛋白（osteopontin,OPN）和组织多肽特异抗原（tissue polypeptide specific antigen,TPS）联合检测在胃癌诊断中的价值。方法：采用酶联免疫吸附试验检测70例经病理确诊的胃癌患者、70例浅表性胃炎患者、76例萎缩性胃炎患者及50名正常对照者的血清OPN和TPS水平。结果：胃癌患者的血清OPN[（1 610.02±1 088.30） pg/mL]及TPS水平[（148.54±88.20） U/L]明显高于浅表性胃炎、萎缩性胃炎患者及正常对照者（P<0.05）,而浅表性胃炎患者、萎缩性胃炎患者与正常对照者间的血清OPN、TPS差异无统计学意义（P>0.05）。Ⅲ~Ⅳ期胃癌患者的血清OPN水平[（2 261.8±1 330.3） pg/mL]高于Ⅰ~Ⅱ期胃癌患者[（1531.1±850.5） pg/mL]（P<0.05）,有淋巴结转移的胃癌患者血清OPN水平[（2 688.2±1 174.3） pg/mL]高于无淋巴结转移的患者[（1 281.3±818.4） pg/mL]（P<0.05）;而Ⅲ~Ⅳ期胃癌患者的血清TPS水平[（100.26±64.17） U/L]低于Ⅰ~Ⅱ期胃癌患者[（198.23±98.51） U/L]（P<0.05）,有淋巴结转移的胃癌患者血清TPS水平[（95.46±46.98） U/L]低于无淋巴结转移的患者[（179.58±100.27） U/L]（P<0.05）。OPN、TPS、癌胚抗原（carcinoembryonic antigen,CEA）平行联合检测的受试者工作特征（receiver operating characteristc,ROC）曲线下面积最大为0.849,其约登指数最大时（53.3%）的灵敏度为71.4%,特异度为81.9%。结论：血清OPN、TPS、 CEA的联合检测有助于提高胃癌与良性胃病的鉴别水平。

关键词: 骨桥蛋白, 组织多肽特异抗原, 胃癌, 诊断, 联合检测

Abstract: Objective: To assess the diagnostic value of combined detection of serum osteopontin (OPN) and tissue polypeptide specific antigen (TPS) in patients with gastric cancer (GC). Methods: Seventy patients with GC, 70 patients with superficial gastritis (SG) and 76 patients with atrophic gastritis (AG) were enrolled, and all these patients were pathologically confirmed; 50 healthy volunteers were served as controls. Serum OPN and TPS were detected by enzyme-linked immunosorbent assay (ELISA). The diagnostic value of OPN, TPS and CEA alone and in combination for GC were evalua-ted via sensitivity and specificity. Results: Serum levels of OPN and TPS were significantly increased (P<0.05) in GC patients than those in AG and SG patients and healthy controls. There was no significant difference (P>0.05) betweenserum levels of OPN and TPSin AG and SG patients and in healthy controls. The serum level of OPN in patients with GC on Ⅲ-Ⅳ stage was higher than that in patients on Ⅰ-Ⅱ stage (P<0.05). The serum level of OPN in GC patients with lymph node metastasis was higher than that in patients without lymph node metastasis (P<0.05). The serum level of TPS in patients with GC on Ⅲ-Ⅳ stage was lower than that in patients on Ⅰ-Ⅱ (P<0.05), and the serum level of TPS in GC patients with lymph node metastasis was lower than that in patients without lymph node metastasis (P<0.05). The area under the ROC (receiver operating characteristic) curve of combined detection of OPN, TPS and CEA was 0.849, the sensitivity was 71.4% and the specificity was 81.9% when the Youden Index was 53.3%. Conclusions: Combined detection of OPN, TPS and CEA may be useful in the differential diagnosis of GC and benign gastric diseases.

Key words: Osteopontin, Tissue polypeptide specific antigen, Gastric cancer, Diagnosis, Combined detection

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