摘要
目的探讨幽门螺杆菌(Hp)、RAS蛋白激活样因子2(RASAL2)、钙黏蛋白1(CDH1)及肿瘤抑制基因P53(TP53)对胃癌前病变与早期胃癌的鉴别诊断价值。方法选取2021年6月至2023年6月收治的早期胃癌52例,根据1:1选例原则另选取同期胃癌前病变52例、胃炎52例,分别纳入胃癌组、癌前组、胃炎组。比较3组及不同病理特征的早期胃癌患者Hp、RASAL2、CDH1、TP53阳性表达率,比较胃癌组Hp阳性、阴性患者RASAL2、CDH1、TP53阳性表达率,采用Spearman相关分析探讨各指标阳性表达与早期胃癌患者部分病理特征的相关性,采用受试者工作特征(ROC)曲线分析联合检测对早期胃癌及胃癌前病变的鉴别诊断价值。结果3组Hp、CDH1、TP53阳性表达率胃癌组>癌前组>胃炎组,RASAL2阳性表达率胃癌组<癌前组<胃炎组,差异有统计学意义(P<0.05,P<0.01)。胃癌组Hp阳性患者CDH1、TP53阳性表达率高于Hp阴性患者,RASAL2阳性表达率低于Hp阴性患者(P<0.05,P<0.01);早期胃癌患者Hp、RASAL2、CDH1、TP53阳性表达率在肿瘤浸润深度及淋巴结转移方面比较差异有统计学意义(P<0.05,P<0.01)。Hp、CDH1、TP53阳性表达与早期胃癌肿瘤浸润深度、淋巴结转移均呈正相关,RASAL2阳性表达与之呈负相关(P<0.01)。ROC曲线分析结果显示,Hp、RASAL2、CDH1、TP53联合诊断胃癌前病变的曲线下面积(AUC)为0.904(95%CI:0.846,0.945),联合诊断早期胃癌的AUC为0.894(95%CI:0.819,0.946)。结论Hp、CDH1、TP53在早期胃癌组织中阳性表达率较高,RASAL2阳性表达率较低,联合检测对胃癌前病变及早期胃癌具有一定鉴别诊断价值,可作为临床鉴别诊断胃癌前病变、早期胃癌的辅助指标。
Objective To investigate the value of Helicobacter pylori(Hp),RAS protein activator-like factor 2(RAS-AL2),cadherin 1(CDH1)and tumor suppressor gene P53(TP53)in differential diagnosis of gastric precancerous lesions and early gastric cancer.Methods Fifty-two patients with early gastric cancer admitted from June 2021 to June 2023 were selected,and another 52 patients with gastric precancerous lesions and 52 patients with gastritis were selected at a ratio of 1:1 according to the selection principle,and were included in the gastric cancer group,pre-cancer group and gastritis group,re-spectively.The positive expression rates of Hp,RASAL2,CDHI and TP53 in the three groups and in early gastric cancer pa-tients with different pathological characteristics were compared,and the positive expression rates of RASAL2,CDH1 and TP53 in patients with Hp positive and negative gastric cancer in the gastric cancer group were compared.Spearman correlation anal-ysis was used to explore the correlation between the positive expression rates of each index and several pathological character-istics of early gastric cancer.Receiver operating characteristic(ROC)curve was used to analyze the value of combined detec-tion in the differential diagnosis of early gastric cancer and gastric precancerous lesions.Results The positive expression rate of Hp,CDH1 and TP53 was the highest in gastric cancer group,followed by pre-cancer group and gastritis group,while the positive expression rate of RASAL2 was the lowest in gastric cancer group,fllowed by pre-cancer group and gastritis group,suggesting significant differences(P<0.05,P<0.01).The positive expression rates of CDH1 and TP53 in Hp-positive patients than those in Hp-negative patients in early gastric cancer group,while the positive expression rates of RASAL2 were lower than those in Hp-negative patients(P<0.05,P<0.01).The positive expression rates of Hp,RASAL2,CDH1 and TP53 in early gas-tric cancer patients were significantly different in terms of the depth of tumor invasion and presence of ly
作者
马越
陈伟
刘宝英
付丹丹
周彤
MA Yue;CHEN Wei;LIU Baoying;FU Dandan;ZHOU Tong(Department of Gastroenterology,Hebei CNPC Center Hospital,Langfang,Hebei 065000,China;Department of Surgery,Hebei CNPC Center Hospital,Langfang,Hebei 065000,China;Department of Otorhinolaryngology,Hebei CNPC Center Hospital,Langfang,Hebei 065000,China)
出处
《临床误诊误治》
CAS
2024年第11期39-45,共7页
Clinical Misdiagnosis & Mistherapy
基金
廊坊市科技支撑计划项目(2022013023)。
