Comparison of the Validity of Three Biomarkers for Gastric Cancer Screening Carcinoembryonic Antigen, Pepsinogens, and High Sensitive C-reactive Protein
Comparison of the Validity of Three Biomarkers for Gastric Cancer Screening Carcinoembryonic Antigen, Pepsinogens, and High Sensitive C-reactive Protein
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DOI：
10.1097/mcg.0b013e318135427c
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发表时间：
2009-01-01
影响因子：
2.9
通讯作者：
Lim, Jong-Baeck
中科院分区：
文献类型：
--
作者：
Chung, Hye Won;Kim, Ju Won;Lim, Jong-Baeck
目的：为了寻找一种理想的血清标志物作为胃癌筛查工具，我们评估了3种生物标志物的有效性，即癌胚抗原（CEA）、胃蛋白酶原（pg）和高敏c反应蛋白（hsCRP）。方法：对378例正常、慢性萎缩性胃炎、肠化生、腺瘤、早期胃癌（EGC）、晚期胃癌（AGC）无转移、晚期胃癌（M-1） 7组患者进行CEA、PGs、hsCRP的平均血清水平测定，并比较这3种生物标志物的敏感性和特异性。结果：CEA和hsCRP在正常组、高危组（慢性萎缩性胃炎、肠化生、腺瘤）和EGC组间无显著差异。而在AGC组合并肠型癌中，CEA水平相对较高（P < 0.01）。弥漫性癌AGC组hsCRP较高（P < 0.01）。PG I II比值在正常组、高危组、癌组（包括EGC组）间差异无统计学意义（P < 0.01）。此外，与年级呈负相关（gamma(s) = -0.480, P < 0.01）。然而，与肠型相比，PG I/II比值在弥漫性癌中的效果相对较差。在弥漫性癌中，血清hsCRP和PG I/II比值联合检测的敏感性（77%）高于单独检测PG I/II比值（61%）。结论：血清hsCRP与PG I/II比值的联合检测可作为胃癌高发人群的筛查工具，有助于筛选出需要进一步采用内镜等特异性侵入性筛查手段的高危人群。
Purpose: To identify a desirable serum marker for screening tools for gastric cancer, we evaluated the validity of 3 biomarkers, namely, carcinoembryonic antigen (CEA), pepsinogens (PGs), and high sensitive C-reactive protein (hsCRP).Methods: We estimated the mean serum levels of CEA, PGs, and hsCRP and compared the sensitivity and specificity of these 3 biomarkers in 378 subjects who were classified into 7 groups: normal, chronic atrophic gastritis, intestinal metaplasia, adenoma, early gastric cancer (EGC), advanced gastric cancer (AGC) without metastasis, and AGC with metastasis (M-1).Results: There were no significant differences among the normal, high-risk (chronic atrophic gastritis, intestinal metaplasia, and adenoma), and EGC groups for CEA and hsCRP. However, the levels of CEA were relatively higher in the AGC group with intestinal-type cancer (P < 0.01). Likewise, hsCRP was relatively higher in the AGC group with diffuse-type cancer (P < 0.01). For the PG I II ratio, there was no significant difference among the normal, high-risk, and cancer groups, including EGC (P < 0.01). In addition, there was a negative correlation with grades (gamma(s) = -0.480, P < 0.01). However, the PG I/II ratio was relatively less effective in diffuse-type cancere compared with intestinal-type cancer. The combination of serum hsCRP and the PG I/II ratio had a higher sensitivity (77%) than did the PG I/II ratio alone (61%) in diffuse-type cancers.Conclusions: The combination of serum hsCRP adn PG I/II ratio would be helpful as a screening tool for gastric cancer in high incidence populations and may help to select high-risk subjects in need of further specific invasive screening tools such as endoscopy.