【摘要】 目的 探讨血清Dickkopf相关蛋白1(DKK-1)、肿瘤相关胰蛋白酶原-2(TAT-2)联合胃蛋白酶原(PG)、胃泌素-17(G-17)在胃癌早期诊断中的临床价值。方法 选取2021年10月至2022年10月在该院行胃镜检查发现胃黏膜病变的患者125例作为研究对象，其中癌前病变31例(癌前病变组)、早期胃癌32例(早期胃癌组)、进展期胃癌32例(进展期胃癌组)、慢性非萎缩性胃炎30例(对照组)。检测所有患者血清中DKK-1、TAT-2、PG及G-17水平，采用受试者工作特征(ROC)曲线探讨其在胃癌早期诊断中的临床价值。结果 与对照组比较，癌前病变组、早期胃癌组、进展期胃癌组PG-Ⅰ水平逐渐降低，PG-Ⅱ、G-17、DKK-1、TAT-2水平逐渐升高，差异均有统计学意义(P<0.05),但早期胃癌组与进展期胃癌组TAT-2水平比较，差异无统计学意义(P>0.05)。血清DKK-1水平与胃癌患者肿瘤最大径、淋巴结转移、分化程度及临床分期有关(P<0.05)。ROC曲线分析结果显示，PG-Ⅰ、PG-Ⅱ、G-17、DKK-1、TAT-2诊断胃癌的曲线下面积(AUC)分别为0.726、0.862、0.789、0.870、0.914(P<0.05),新ABC法+DKK-1、新ABC法+TAT-2诊断胃癌的AUC分别为0.979、0.980(P<0.05),所有指标联合诊断胃癌的AUC为0.993。结论 PG、G-17作为一种传统的血清学标志物，诊断价值确切，DKK-1、TAT-2水平随胃黏膜病变的不同表现差异明显，上述所有指标联合诊断对胃癌有较高的价值。更多还原

【Abstract】 Objective To investigate the clinical value of serum Dickkopf-related protein 1(DKK-1),tumor-associated trypsinogen-2(TAT-2) combined with pepsinogen(PG) and gastrin-17(G-17) in the early diagnosis of gastric cancer.Methods A total of 125 patients with gastric mucosal lesions detected by gastroscopy in the hospital from October 2021 to October 2022 were selected as the research objects, including 31 cases of precancerous lesions(precancerous lesion group),32 cases of early gastric cancer(early gastric cancer group),32 cases of advanced gastric cancer(advanced gastric cancer group),and 30 cases of chronic non-atrophic gastritis(control group).The levels of DKK-1,TAT-2,PG and G-17 in serum of all patients were detected, and the clinical value in early diagnosis of gastric cancer was analyzed by receiver operating characteristic(ROC) curve.Results Compared with the control group, the levels of PG-Ⅰ in precancerous lesion group, early gastric cancer group and advanced gastric cancer group were gradually decreased, while the levels of PG-Ⅱ,G-17,DKK-1 and TAT-2 were gradually increased, and the differences were statistically significant(P<0.05).However, there was no significant difference in the level of TAT-2 between early gastric cancer group and advanced gastric cancer group(P>0.05).The serum DKK-1 level was correlated with tumor size, lymph node metastasis, differentiation degree and clinical stage(P<0.05).ROC curve analysis showed that the area under the curve(AUC) of PG-Ⅰ,PG-Ⅱ,G-17,DKK-1 and TAT-2 were 0.726,0.862,0.789,0.870 and 0.914,respectively(P<0.05).The AUC of the new ABC method +DKK-1 and the new ABC method +TAT-2 in the diagnosis of gastric cancer were 0.979 and 0.980,respectively(P<0.05).The AUC of the combination of all indicators in the diagnosis of gastric cancer was 0.993.Conclusion PG and G-17,as a traditional serological marker, have accurate diagnostic value.The levels of DKK-1 and TAT-2 are significantly different with the different manifestations of gastric mucosal lesions.The combination of all the above indicators has high value in the diagnosis of gastric cancer.更多还原