几种不同方法学检测胃蛋白酶原 I，II 临床应用探讨

摘要

Objective To study the clinical value of gastric cancer auxiliary diagnosis of three kinds of detection methods,using the chemiluminescent immunoassay (CLIA),flow type fluorescent light emitting method (FFIA)and enzyme linked immunosorbent assay (ELISA)to detect Pepsinogen I (PGI),Pepsinogen II (PGII).Methods With the method of comparison and correlation analysis,the consistency and correlation of the three methods are compared.The clinical serum samples of patients diagnosed with gastric cancer were tested and the critical values of PGI and PGI /PGII (PGR)were determined by using ROC curve to evaluate the sensitivity and specific-ity of the three methods.Results The results of PGI and PGII in serum samples were tested by three different methods.And PGR was calculated according to the results of PGI and PGII.It was found that there were significant differences in the two indexes of PGI and PGR between gastric cancer group and non gastric cancer group,and there was no significant difference in PGII between the two groups. The comparative study found that the correlation coefficient between PGII and PGI was good,and the correlation coefficient r was in the range of 0.9612 ~0.9789,and the correlation coefficients of PGR among different methodology was in the range of 0.8602 ~0.9109. The sensitivities and specificities of CLIA,FFIA,ELISA were 67.6%,61.8%,58.8%,and 96.6%,94.7% and 96.6%,respectively. Conclusions There is good correlation among CLIA,FFIA,and ELISA detection of PGI,and PGII.Clinical evaluation indicates that PGI combined with PGR can effectively improve the diagnostic specificity and positive predictive value of gastric cancer,which has a good clinical value.%目的：使用化学发光法（CLIA），流式荧光发光法（FFIA），酶联免疫法（ELISA）三种不同的方法检测血清胃蛋白酶原 I （PGI）、胃蛋白酶原 II（PGII），探讨三种检测方法用于胃癌辅助诊断的临床价值。方法通过方法学比对与相关分析，比较三种方法的一致性与相关性。通过检测确诊为胃癌患者的临床血清样本，利用 ROC 曲线确定 PGI 与 PGI ／PGII（PGR）临界值，评价三种方法的灵敏度与特异度。结果三种方法测试不同组别血清样本中 PGI、PGII，根据 PGI、PGII 结果计算 PGR。发现胃癌组与非胃癌组间 PGI、PGR 两个指标差异有统计学意义，PGII 差异无统计学意义。方法学比对发现，不同方法学之间 PGI、PGII 相关性良好，相关系数 r 为：0．9612～0．9789，不同方法学之间 PGR 相关系数为：0．8602～0．9109。对三种方法进行 ROC曲线分析，确定 ROC 曲线最佳临界值后，分析 PGI、PGR 组合用于胃癌诊断，化学发光法、流式荧光发光法、酶联免疫法灵敏度分别为67．6％，61．8％，58．8％，特异度分别为96．6％、94．7％、96．6％。结论化学发光法，流式荧光发光，酶联免疫法检测PGI、PGII 存在较好的相关性。通过临床评估，PGI 结合 PGR 可以有效提高胃癌的诊断特异度与阳性预测值，具有较好的临床价值。