摘要
目的:观察幽门螺杆菌(Hp)感染胃癌组织间变性淋巴瘤激酶(ALK)、鼠类肉瘤滤过性病毒致癌同源体B1(BRAF)、人类表皮生长因子受体2(Her-2)表达,并分析其对Hp感染胃癌预测不良预后的价值。方法:选取2019年10月至2022年11月福建医科大学附属南平市第一医院收治的106例Hp感染胃癌患者,比较Hp感染胃癌组织、癌旁组织ALK、BRAF、Her-2表达阳性率差异,分析胃癌组织ALK、BRAF、Her-2表达与Hp感染胃癌临床特征、病理表现的关系。随访1年,根据患者术后复发或病亡将其分为预后良好组(61例)、预后不良组(45例),比较不同预后Hp感染胃癌组织ALK、BRAF、Her-2表达;分析Hp感染胃癌组织ALK、BRAF、Her-2表达对不良预后的预测效能及预警价值。结果:Hp感染胃癌组织ALK、BRAF、Her-2表达阳性率(17.92%、67.92%、25.47%)高于癌旁组织(2.83%、7.55%、4.72%)(χ^(2)=12.984、82.230、17.814,P<0.05);Hp感染胃癌组织ALK、BRAF、Her-2表达阳性率在组织分化程度、浸润程度、TNM分期、淋巴结转移中比较差异明显(P<0.05);106例Hp感染胃癌患者经随访统计,纳入45例预后不良组(32例复发,13例病亡),61例纳入预后良好组。预后不良组Hp感染胃癌组织ALK、BRAF、Her-2表达阳性率(35.56%、93.33%、46.67%)高于预后良好组(4.92%、49.18%、9.84%)(χ^(2)=16.523、23.172、18.504,P<0.05);Hp感染胃癌组织ALK、BRAF、Her-2表达阳性联合评估不良预后的AUC最大,为0.901(95%CI:0.827~0.950)(P<0.05),敏感度为86.67%,特异度为93.44%,预测效能优于ALK、BRAF、Her-2表达单独检测。ALK、BRAF、Her-2阳性所致Hp感染胃癌不良预后的RR值分别为2.526(1.771~3.604)、6.611(2.205~19.821)、2.560(1.733~3.781)(P<0.05)。结论:Hp感染胃癌组织ALK、BRAF、Her-2表达与组织分化程度、浸润程度、TNM分期、淋巴结转移联系密切,对Hp感染胃癌不良预后有较高预测效能与预警价值。
Objective:To observe the expression of anagenic lymphoma kinase(ALK),murine sarcoma viral oncogenic homology B1(BRAF)and human epidermal growth factor receptor 2(Her-2)in gastric cancer infected by Helicobacter pylori(Hp),and to analyze their prediction value of poor prognosis in HP-infected gastric cancer.Methods:A total of 106 patients with Hp-infected gastric cancer admitted to the the First Hospital of Nanping Affiliated to Fujian Medical University from October 2019 to November 2022 were selected to compare the differences in the positive rates of ALK,BRAF,and Her-2 expression in Hp-infected gastric cancer tissues and paracancerous tissues,and to analyze the relationship between the expression of ALK,BRAF,and Her-2 in gastric cancer tissues and the clinical features and pathological manifestations of Hp-infected gastric cancer.After 1 year of follow-up,the patients were divided into good prognosis group(61 cases)and poor prognosis group(45 cases)according to their postoperative recurrence or death,and the ALK,BRAF,Her-2 expression of Hp-infected gastric cancer tissues with different prognosis were compared;the predictive efficacy and early warning value of ALK,BRAF,Her-2 expression of Hp-infected gastric cancer tissues on poor prognosis were analyzed.Results:The positive rates of ALK,BRAF,and Her-2 expression in Hp-infected gastric cancer tissues(17.92%,67.92%,and 25.47%)were higher than those in adjacent tissues(2.83%,7.55%,and 4.72%)(χ^(2)=12.984,82.230,and 17.814,P<0.05).Significant differences were observed in the positive rates of ALK,BRAF,and Her-2 expression in Hp-infected gastric cancer tissues across different levels of tissue differentiation,infiltration,TNM staging,and lymph node metastasis(P<0.05).Among 106 patients with Hp-infected gastric cancer who underwent follow-up,45 were included in the poor prognosis group(32 relapsed and 13 died),and 61 were included in the good prognosis group.The positive rates of ALK,BRAF,and Her-2 expression in Hp-infected gastric cancer tissues in the poor prognos
作者
吴敏敏
陈明光
刘继英
WU Minmin;CHEN Mingguang;LIU Jiying(The First Hospital of Nanping Affiliated to Fujian Medical University,Fujian Nanping 353100,China)
出处
《河北医学》
CAS
2024年第12期2073-2078,共6页
Hebei Medicine
基金
福建医学科技青年培育项目,(编号:20FBQN2020017)。
