Gastric Cancer:血清标志物在胃癌及癌前病变中的作用

2019-08-04 不详 MedSci原创

有研究表明,蒙古国的胃癌死亡率最高。癌症的早期检测和高风险患者的分期筛查至关重要。因此,本项研究的目的是验证血清标志物是否可以对患者进行分层以进一步管理。

背景
有研究表明,蒙古国的癌死亡率最高。癌症的早期检测和高风险患者的分期筛查至关重要。因此,本项研究的目的是验证血清标志物是否可以对患者进行分层以进一步管理

方法
研究人员将所有受试者进行内窥镜检查和组织学检查以确定高风险和癌患者。同时进行快速尿素酶试验,培养和组织学试验以诊断幽门螺杆菌感染。通过ELISA测量血清胃蛋白酶原(PG)I和II以及抗幽门螺杆菌 IgG。ROC曲线分析用于提取最佳截止点。

结果
本项研究共纳入752名非癌症患者和50名连续胃癌患者。胃癌患者中慢性胃炎(72%:36/50 vs. 56.4%:427/752),胼a体萎缩(42.0%:21/50 vs. 18.2%:137/752)和肠上皮化生(IM)(64.0%:32/50 VS. 21.5%:162/752)的显着高于非癌症患者。因此,慢性胃炎,胃体萎缩和IM被认为是胃癌高风险疾病。预测高风险状态的最佳血清标志物是PGI/II<3.1(敏感性67.2%,特异性61%),PGI/II进一步降至<2.2(敏感性66%,特异性65.1%)和PGI<28 ng/mL(敏感性70%,特异性70%)是胃癌的最佳预测指标。诊断幽门螺旋杆菌感染的最佳临界点是抗幽门螺杆菌IgG>8U/mL。多变量分析显示,抗幽门螺杆菌 IgG>8U/mL和PGI/II<3.1增加了高风险状态的风险,PGI/II<3.1仍然增加了患胃癌的风险。

结论
使用PGI/II <3.1临界值的血清诊断是预测胃癌高风险患者的有力血清学指标。

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    2020-05-23 skhzy
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    2020-05-02 许安
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