摘要
目的探究胃蛋白酶原Ⅰ/Ⅱ(PGⅠ/PGⅡ)、胃泌素释放肽前体(ProGRP)在胃癌诊断及预后中的价值。方法选取2013年9月-2014年9月厦门大学附属中山医院150例胃癌患者作为胃癌组,另选取同期良性胃部病变患者148例作为良性胃部病变组、健康体检者148名作为对照组。比较三组血清PGⅠ/PGⅡ、ProGRP水平,分析各指标对胃部良恶性病变的鉴别诊断价值。比较不同生存期胃癌患者临床资料及血清PGⅠ/PGⅡ、ProGRP水平,采用多元线性逐步回归分析两者与生存期的相关性,评价两者对生存期>中位生存期(MST)的预测价值。结果胃癌组血清PGⅠ/PGⅡ水平低于良性胃部病变组、对照组,ProGRP水平高于良性胃部病变组、对照组,差异均有统计学意义(P<0.05)。诊断ROC曲线分析显示,血清PGⅠ/PGⅡ、ProGRP联合检测诊断胃部良恶性病变的曲线下面积(AUC)为0.871(95%CI:0.828~0.907),高于两者单独诊断的AUC,差异有统计学意义(P<0.05);敏感度为76.67%,特异度为87.84%。150例胃癌患者,剔除失访6例患者后,MST为43.5个月;生存期≤MST患者病理分型、TNM分期、组织分化程度、肿瘤侵袭范围、血清PGⅠ/PGⅡ、ProGRP与生存期>MST患者比较,差异有统计学意义(P<0.05);多元线性逐步回归分析显示,将病理分型、TNM分期、组织分化程度、肿瘤侵袭范围等其他因素控制后,血清PGⅠ/PGⅡ、ProGRP仍与生存期显著相关(P<0.05)。预测ROC曲线分析显示,血清PGⅠ/PGⅡ、ProGRP联合预测胃癌患者生存期>MST的AUC为0.898,高于两者单独预测的AUC,差异有统计学意义(P<0.05);敏感度为80.56%,特异度为84.72%。结论PGⅠ/PGⅡ、ProGRP在胃癌患者中联合诊断价值较为可靠,且与生存期密切相关,可作为预测生存期的重要因子。
Objective To explore the application value of pepsinogenⅠ/Ⅱ(PGⅠ/PGⅡ)and gastrin-releasing peptide precursor(ProGRP)in the diagnosis and prognosis of gastric cancer.Methods 150 patients with gastric cancer from September 2013 to September 2014 in Zhongshan Hospital Affiliated to Xiamen University were selected as the gastric cancer group;in addition,148 patients with benign gastric lesions in the same period were selected as the benign gastric lesions group,and 148 healthy people as the control group.The serum PGⅠ/PGⅡand ProGRP levels of the three groups were compared,and the diagnostic value of various indicators for benign and malignant gastric lesions was analyzed.The clinical data and serum PGⅠ/PGⅡ,ProGRP levels of patients with different survival periods were compared,and the correlation between the two and survival period was analyzed using multiple linear stepwise regression to evaluate the predictive value of the two for survival period>median survival time(MST).Results The serum PGⅠ/PGⅡlevel of the gastric cancer group was lower than that of the benign gastric lesions group and control group,and the ProGRP level was higher than that of the benign gastric lesions group and control group(P<0.05).Diagnostic ROC curve of analysis,the combined detection of serum PGⅠ/PGⅡand ProGRP for the diagnosis of benign and malignant gastric lesions AUC was0.871(95%CI:0.828-0.907),which was greater than the AUC diagnosed by serum PGⅠ/PGⅡand ProGRP alone(P<0.05),with a sensitivity of 76.67%and a specificity of 87.84%.In 150 patients with gastric cancer,the MST was 43.5 months after excluding 6 cases who were lost to follow-up.Compared with patients with survival time>MST,the pathological classification,TNM stage,tissue differentiation,tumor invasion range,serum PGⅠ/PGⅡ,ProGRP of patients with survival time≤MST were statistically significant(P<0.05);multiple linear stepwise regression analysis,after controlling other factors such as pathological classification,TNM stage,tissue differentiation degree,tumor invasion range,etc.,showed serum PGⅠ/PGⅡ,ProGRP were still significantly correlated with survival time(P<0.05).Predicted ROC curve analysis,the combined detection of serum PGⅠ/PGⅡand ProGRP for the prediction of survival>MST AUC was 0.898,which was greater than the AUC predicted by serum PGⅠ/PGⅡand ProGRP alone(P<0.05),with a sensitivity of 80.56%and a specificity of 84.72%.Conclusions The combined diagnostic value of PGⅠ/PGⅡand ProGRP was more reliable in patients with gastric cancer,and it was closely related to survival time.It could be used as an important predictor of survival time.
作者
王欣欣
于洋
陈美珺
黄松洁
WANG Xin⁃xin;YU Yang;CHEN Mei⁃jun;HUANG Song⁃jie(Laboratory Department,Zhongshan Hospital Affiliated to Xiamen University,Xiamen,Fujian 361000,China)
出处
《热带医学杂志》
CAS
2021年第12期1589-1593,共5页
Journal of Tropical Medicine
基金
2016年福建省医学创新课题资助计划(2016-CX-8)
关键词
胃癌
胃蛋白酶原
胃泌素释放肽前体
生存期
Gastric cancer
Pepsinogen
Gastrin-releasing peptide precursor
MST
作者简介
王欣欣(1978-),女,本科,副高,研究方向:生化;通信作者:黄松洁,E⁃mail:hsj5185460@sina.com
