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两种血清学方法在胃癌及其癌前病变筛查中的比较

[Comparison of two serological methods in screening gastric cancer and its precancerous condition].

作者信息

Li M Y, Zhang D Q, Lu X, Chen W C

机构信息

Department of Gastroenterology, The First Affiliated Hospital of Soochow University, Suzhou 215006, China.

出版信息

Zhonghua Nei Ke Za Zhi. 2018 Dec 1;57(12):907-911. doi: 10.3760/cma.j.issn.0578-1426.2018.12.006.

Abstract

To compare the diagnostic value of the old "ABC" method [serum pepsinogen(PG) combined with (Hp) IgG antibody] and the new "ABC" method [serum pepsinogen plus gastrin-17(G-17)] in screening gastric cancer and its precancerous condition. Serum PG, G-17 and Hp-IgG were quantified by enzyme-linked immunosorbent assay (ELISA) in 278 subjects. Subjects were grouped according to the criteria of two methods. The gastroscopy and pathological biopsy were gold standard. The positive rate of old "ABC" method was 74.46% (207/278), which was 54.68% of new "ABC" method (151/278). For the diagnosis of gastric cancer, the sensitivity and specificity of the old "ABC" method were 90.74% and 29.46% respectively, with diagnostic coincidence rate 41.37%. The sensitivity and specificity of the new "ABC" method were 92.59% and 54.46% respectively, with diagnostic coincidence rate 61.87%. As to the diagnosis of pre-cancerous state, the sensitivity and specificity of the old "ABC" method were 75.81% and 36.00%, with diagnostic coincidence rate 58.03%. The sensitivity and specificity of the new "ABC" method were 62.10% and 75.00%, with diagnostic coincidence rate 67.86%. Compared with the old "ABC" method, the new "ABC" method has higher sensitivity, specificity and diagnostic coincidence rate for the diagnosis of gastric cancer, yet higher specificity and lower sensitivity for the diagnosis of precancerous conditions.

摘要

比较旧的“ABC”法[血清胃蛋白酶原(PG)联合幽门螺杆菌(Hp)IgG抗体]和新的“ABC”法[血清胃蛋白酶原加胃泌素-17(G-17)]在筛查胃癌及其癌前病变中的诊断价值。采用酶联免疫吸附测定(ELISA)对278例受试者的血清PG、G-17和Hp-IgG进行定量检测。根据两种方法的标准对受试者进行分组。胃镜检查及病理活检为金标准。旧“ABC”法的阳性率为74.46%(207/278),新“ABC”法为54.68%(151/278)。对于胃癌诊断,旧“ABC”法的灵敏度和特异度分别为90.74%和29.46%,诊断符合率为41.37%。新“ABC”法的灵敏度和特异度分别为92.59%和54.46%,诊断符合率为61.87%。对于癌前状态诊断,旧“ABC”法的灵敏度和特异度分别为75.81%和36.00%,诊断符合率为58.03%。新“ABC”法的灵敏度和特异度分别为62.10%和75.00%,诊断符合率为67.86%。与旧“ABC”法相比,新“ABC”法在胃癌诊断中具有更高的灵敏度、特异度和诊断符合率,但在癌前状态诊断中具有更高的特异度和更低的灵敏度。

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