【作者】 项文坤；

【导师】 熊锋宝；

【作者基本信息】 南昌大学 ， 内科学， 2009， 硕士

【摘要】 目的:通过检测和分析非萎缩性胃炎、胃癌前病变及胃癌患者血清中SA、EMA和GPDA的浓度,并比较其与胃癌临床生物学行为的关系,以探讨血清SA,EMA和GPDA单项及联合检测对胃癌的诊断价值。方法:采用酶速率法、酶联免疫吸附试验法(ELISA)、连续监测法分别对经电子胃镜及病理检查确诊的30例胃癌患者、25例胃癌前病变患者及35例非萎缩性胃炎的血清SA、EMA、GPDA进行测定,进行两两比较,分析血清SA、EMA和GPDA单项及联合检测胃癌的敏感性,特异性,诊断准确度和阳性似然比。同时分析胃癌患者血清SA、EMA、GPDA与胃癌临床生物学行为的关系。所有资料用SPSS13.0统计学软件进行处理。结果:胃癌组血清SA、GPDA浓度明显高于非萎缩性胃炎、胃癌前病变组(P<0. 05 ),单项检测中以SA较敏感(50.00%),GPDA的特异性(97.14%)和诊断准确度(90.99%)较高,且诊断价值较大(LR+ =11.65)。联合检测SA,GPDA可以提高诊断敏感性(53.33%)。血清EMA对胃癌诊断没有统计学意义(P>0.05)。非萎缩性胃炎组GPDA与年龄有统计学意义(P<0.05), SA浓度在肿瘤分化程度组差别有统计学意义(P<0.05)外,其余各组与临床生物学行为均无统计学意义(P>0. 05)。结论:检测血清SA和GPDA对于胃癌的诊断有重要参考价值。SA和GPDA的联合检测可提高胃癌诊断的准确性。检测血清EMA对胃癌诊断可能没有价值。胃癌患者血清SA, GPDA与胃癌临床生物学行为有一定关系,检测血清SA,GPDA将可能有助于判断胃癌的转移、复发及监测预后。非萎缩性胃炎组血清GPDA与年龄有关。更多还原

【Abstract】 Objective:We intend to analyse and detect the expression of serum SA, EMA and GPDA with non-atrophic gastritis, gastric precancerous lesions and gastric cancer in patients and analyse the relationships among them, and this paper also analyzes the relationship with the biology behavior of gastric carcinoma, in order to evaluate the values of alone and combinative measurements of serum SA, EMA and GPDA in the diagnosis of gastric cancer.Methods:We apply enzyme kinetic assay,continuous monitoring and ELISA methods to detect serum SA,EMA and GPDA in 30 cases of patients with gastric cancer patients ,25 cases of patients with gastric precancerous lesions and 35 cases of patients with non-atrophic gastritis with electronic gastroscope and pathological examination confirmed, compare the relevance of the groups,and then the sensitivity, specificity, diagnosis accuracy and positive likelihood ratio were calculated about alone and combinative measurements of the markers in the diagnosis of gastric cancer. and analyze the relationship between the expressions of them and clinical biology of gastric carcinoma .All dates were processed by SPSS 13.0 analysis software .Results:The serum concentrations of SA and GPDA in gastric carcinoma are remarkably higher than those in non-atrophic gastritis and gastric precancerous lesions (P< 0.05 ). A single detection of SA in the most sensitive (50.00%), GPDA the highest specificity (97.14%), one of the diagnostic accuracy GPDA the highest (90.99%), and the greatest diagnostic value (LR += 11.65). Joint detection SA, GPDA can improve the diagnostic sensitivity (53.33%), serum EMA is not a valuable marker in the diagnostic of gastric cancer(P>0.05). The concentrations of GPDA in non-atrophic gastritis group are age-related (P <0.05) and the concentrations of SA in the invasion stage is obviously higher than the localized stage (P<0.05), There are no obvious correlations between the levels of the other groups with the clinical biology behavior of gastric carcinoma(P>0.05). Conclusion:It has an important reference value for the diagnosis of gastric cancer to detect serum SA and GPDA. the Joint Detection SA and GPDA can improve the accuracy of the diagnosis of gastric cancer. EMA serum possibly has no diagnostic value for gastric cancer. The expressions of SA,GPDA in serum are related to the biology behaviors of gastric carcinoma, and to test the concentrations of SA,GPDA in serum is helpful in judging metastasis and recrudescence, and monitoring prognosis. serum GPDA levels in non-atrophic gastritis group increased with age.更多还原