| Objective The purpose of study was to explore the serum pepsinogen,CEA,CA72-4 combination detection the value for the diagnosis and differential diagnosis of gastric cancer.Methods A total of 198 gastric disease patients were enrolled,the patients included those with superficial gastritis,gastric ulcer,gastric cancer,gastric atrophic gastritis.Serum PGI,PGII,PGR and CEA,CA72-4 levels were detected by ELISA.Analysis of PG I,PG II,CEA,CA72-4 separate and joint testing the sensitivity of the diagnosis of gastric cancer and specific degrees.Results Compared with chronic non-atrophic gastritis group(control group),gastric cancer group had lower PGI and PGR and higher CEA and CA72-4,with statistical significance(P <0.05(P> 0.05).The levels of PG and PG in gastric ulcer groupⅠ Ⅱ were significantly higher than those in control group(P> 0.05).There was no significant difference in PGR,CEA and CA72-4(P> 0.05).Compared with atrophic gastritis group,CEA and CA72-4 levels in gastric cancer group were significantly increased(P < 0.05).The changes of PG and PGR were not statistically significant(P> 0.05).Therefore,single PG could not differentiate between gastric cancer and atrophic gastritis,and the combination of tumor markers should be further clarified.Gastric cancer group and gastric ulcer group(control group),PG Ⅰand PGR decreased,CEA and CA72-4 increased,the changes were significant(P <0.05).PGI,PGR,CEA,CA72-4 sensitivity and specificity for the detection of gastric cancer were detected separately.The sensitivity and specificity of PG Ⅰfor diagnosing gastric cancer were 60.4% 72.6%.The sensitivity and specificity of PGR in diagnosis of gastric cancer were 62.5% and 75.7% respectively when the optimal threshold was PGR≤4.59.The best critical value of CEA in diagnosing gastric cancer was CEA≥15.5,the sensitivity and specificity were 54.2% and 46.3% respectively.The sensitivity and specificity of CA72-4 for diagnosing gastric cancer were 53.6% and 48.7% respectively,and the sensitivity and specificity of PGR were the highest.PGI + PGI / PGII had the highest sensitivity and specificity of 67.1% and 77.3%,respectively.The combination of the three indicators showed the highest sensitivity and specificity in PGI / PGII + CEA + CA72-4,Respectively,73.6% and 78.7% respectively.The combined sensitivity and specificity of the four indicators were the highest,85.6% and 92.5% respectively.Prompt four joint detection can improve the diagnosis and differential diagnosis of gastric cancerConclusion PG,CEA,CA72-4 joint detection was helpful to diagnosis and differential diagnosis of gastric cancer,also could be used as an index of gastric cancer screening. |
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