本文關(guān)鍵詞： 胃癌 角蛋白18 癌胚抗原 糖類抗原199 聯(lián)合檢測　出處：《青島大學(xué)》2015年碩士論文　論文類型：學(xué)位論文

【摘要】：目的探討細(xì)胞角蛋白18(CK18)、癌胚抗原(CEA)、糖類抗原199(CA199)聯(lián)合檢測在胃癌診治中的臨床意義。方法采用化學(xué)發(fā)光微粒子免疫分析法(CMIA)和酶聯(lián)免疫吸附法(ELISA雙抗體夾心法)檢測30例健康體檢者(對照組)、40例胃良性病變患者(胃良性病變組)和60例胃癌患者(胃癌組)血清中CK18、CEA、CA199水平,應(yīng)用SPSS22.0統(tǒng)計軟件包進(jìn)行處理。結(jié)果①胃癌組血清CK18、CEA、CA199水平均顯著高于胃良性病變組和對照組,差異有統(tǒng)計學(xué)意義(P?0.01,P?0.05,P?0.01);胃良性病變組三個指標(biāo)與對照組比較差異無統(tǒng)計學(xué)意義(P0.05)。②胃癌組按TNM分期,III、IV期胃癌患者血清CK18,CEA,CA199水平均高于I、II期,差異有統(tǒng)計學(xué)意義(P?0.01,P?0.05,P?0.01)。③胃腺癌組與胃非腺癌組血清CK18水平比較,差異有統(tǒng)計學(xué)意義(P?0.01);而胃腺癌組與胃非腺癌組CEA、CA199水平比較,差異均無統(tǒng)計學(xué)意義(P0.05)。④胃癌患者行根治性手術(shù)后,血清CK18、CEA、CA199水平與術(shù)前比較,差異有統(tǒng)計學(xué)意義(P0.05,P0.05,P0.01);行姑息性手術(shù)后血清CK18、CEA、CA199水平與術(shù)前比較,差異均無統(tǒng)計學(xué)意義(P0.05)。⑤通過CK18、CEA、CA199對胃癌診斷的ROC曲線計算得出三者曲線下的面積分別為:0.879、0.830、0.870,聯(lián)合CK18和CEA得到AUC=0.899,聯(lián)合CK18和CA199得到AUC=0.941,聯(lián)合CEA和CA199得到AUC=0.908,CK18、CEA、CA199三者聯(lián)合得到AUC=0.945。CK18、CEA、CA199三者聯(lián)合檢測曲線下面積最大。三種指標(biāo)單獨(dú)檢測對胃癌診斷的敏感性分別為55%、62%、62%,特異性分別為100%、83.3%、86.67%,三者聯(lián)合檢測對胃癌診斷的敏感性為75%,特異性為73.33%。結(jié)論①血清CK18、CEA、CA199聯(lián)合檢測有助于提高胃癌診斷的敏感性。②血清CK18、CEA、CA199聯(lián)合檢測可為胃癌的臨床分期、手術(shù)療效評估及鑒別診斷提供實驗參考依據(jù)。
[Abstract]:Objective to investigate cytokeratin 18 (CK18), carcinoembryonic antigen (CEA). Methods chemiluminescence microparticle immunoassay (CMIA) and enzyme-linked immunosorbent assay (Elisa) were used in the diagnosis and treatment of gastric cancer. ELISA double antibody sandwich method was used to detect 30 healthy persons (control group). Serum levels of CK18CEACA199 in 40 patients with benign gastric lesions (benign gastric lesions) and 60 patients with gastric cancer (gastric cancer). Results 1 the serum levels of CK18 and CEACA199 in gastric cancer group were significantly higher than those in benign gastric lesion group and control group. The difference is statistically significant. 0.01,P? 0.05,P? 0.01C; There was no significant difference between the three indexes of benign gastric lesions group and the control group. The serum levels of CK18 and CEA in gastric cancer group were determined by TNM staging. The level of CA199 was higher than that of stage II, and the difference was statistically significant. 0.01,P? 0.05,P? The level of serum CK18 in patients with gastric adenocarcinoma and non-adenocarcinoma was significantly higher than that in patients with gastric adenocarcinoma. 0.01C; However, there was no significant difference in CEA CA199 levels between gastric adenocarcinoma group and non-adenocarcinoma group. After radical operation, serum CK18 CEA levels in gastric cancer patients were not significantly different (P0.05.4). The level of CA199 was significantly higher than that before operation. After palliative operation, the level of serum CK18 CEA CA199 was not significantly different from that before operation (P 0.05%, P 0.05%, P < 0.05). The ROC curve of CA199 for the diagnosis of gastric cancer showed that the areas under the three curves were respectively 0. 0. 879 and 0. 830 0. 870. Combined with CK18 and CEA, AUCN 0.899, CK18 and CA199 0.941, AUC=0.908 combined with CEA and CA199 were obtained. Combined with CK18CCEACA199, CEA was obtained from AUC _ (0.945) CK18C _ (18). The area under the joint detection curve of CA199 was the largest. The sensitivity of the three indexes to the diagnosis of gastric cancer was 55 and 62, and the specificity was 100% and 83. 3% respectively. The sensitivity and specificity of the three methods for the diagnosis of gastric cancer were 75 and 73.33 respectively. Conclusion 1 Serum CK18 CEA. The combined detection of CA199 is helpful to improve the sensitivity of diagnosis of gastric cancer. 2 the combined detection of serum CK18 and CEACA199 may be the clinical stage of gastric cancer. The evaluation of surgical efficacy and differential diagnosis provide experimental reference.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R735.2
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本文編號：1442223