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。
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.
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