新型癌症标志物VDBP在胃癌中的表达水平及其与PG和GLU联合检测对早期胃癌的诊断效能研究
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摘要
目的探讨维生素D结合蛋白(VDBP)在胃癌中的表达水平,阐明胃蛋白酶原(PG)、凝集素(GLU)与早期胃癌的关系以及三者联合检测对早期胃癌的诊断价值,为临床胃癌的早期诊断及预防提供指导。方法 2017年4月—2018年7月,选取165例胃癌患者、160例胃良性疾病患者及160例同期健康检查健康者,测定血清VDBP、PG及GLU含量并计算上述指标诊断胃癌的灵敏度与特异度。采用酶联免疫吸附试验(ELISA)对血清VDBP、PG、GLU进行测定。结果胃癌组各项指标的检测结果与良性胃病组及健康对照组比较,差异均有统计学意义(均P<0.05)。胃癌患者血清PG I、PG I/PG II、GLU和VDBP阳性检出率均高于胃良性病组和健康对照组,差异有统计学意义(P<0.05)。在对胃癌进行诊断时,血清PG I诊断的特异度为92.54%,准确度为90.65%,高于PG I/PG II(特异度88.24%、准确度87.34%)、GLU(特异度80.37%、准确度85.29%)和VDBP(特异度89.96%、准确度88.39%)对胃癌的诊断效果。而VDBP对胃癌的诊断灵敏度为92.24%,高于PG I、PG I/PG II和GLU对胃癌诊断的灵敏度80.15%、83.41%和85.79%。在PG I/PG II、GLU、VDBP联合检测对胃癌进行诊断时,血清PG I/PG II合并GLU、VDBP对胃癌检测的灵敏度为96.49%,高于血清PG I/PG II合并GLU对胃癌的诊断灵敏度(89.58%),即三者联合检测对胃癌的灵敏度高于单独检测的灵敏度。结论 VDBP在胃癌患者低表达,早期胃癌患者胃蛋白酶原(PG)降低,凝集素(GLU)水平增高,血清VDBP与PG及GLU联合检测优于单项检测的诊断价值,这对胃癌的早期诊断及预防指导具有重要参考价值。
Objective To investigate the expression level of vitamin D binding protein(VDBP) in gastric cancer,elucidate the relationship between pepsinogen(PG),clusterin(GLU) and early gastric cancer,explore the diagnostic value of combined detection of three for early gastric cancer,and provide the guidance for early diagnosis and prevention of gastric cancer. Methods A total of165 patients with gastric cancer,160 patients with benign gastric diseases and 160 patients with healthy physical examination were selected from April 2017 to July 2018.The serum levels of VDBP,PG and GLU were measured,and the sensitivity and specificity of the above indicators were calculated. Serum VDBP,PG,and GLU were measured by enzyme-linked immunosorbent assay(ELISA). Results The differences in various indexes were statistically significant between gastric cancer group and benign gastric disease group,normal control group(all P<0.05). The positive rates of serum PG I,PG I/PG Ⅱ,GLU and VDBP in gastric cancer group were higher than those in benign gastric disease group and normal control group,and the differences were statistically significant(P<0.05). In the diagnosis of gastric cancer,the specificity(92.54%) and accuracy of serum PG I(90.65%) were higher than those of PG I/PGⅡ(specificity of 88.24%,accuracy of 87.34%),GLU(specificity of 80.37%,accuracy of 85.29%)and VDBP(specificity of 89.96%,accuracy of 88.39%). The diagnostic sensitivity of VDBP for gastric cancer was 92.24%, which was higher than that of PG I(80.15%),PG I/PGⅡ(83.41%) and GLU(85.79%). When PG I/PGⅡ,GLU and VDBP were combined to detect gastric cancer,the sensitivity of serum PG I/PGⅡcombined with GLU and VDBP for gastric cancer detection was 96.49%,which was higher than that of serum PG I/PGⅡcombined with GLU for gastric cancer diagnosis(89.58%),that is,the sensitivity of the combined detection of the three was higher than that of the single detection. Conclusion VDBP is lowly expressed in patients with gastric cancer. PG is significantly decreased in early gastric cancer patients,and the level of GLU is significantly increased. The combined detection of serum VDBP,PG and GLU is superior to the single-detection,which has important reference value for early diagnosis and prevention of gastric cancer.
Objective To investigate the expression level of vitamin D binding protein(VDBP) in gastric cancer,elucidate the relationship between pepsinogen(PG),clusterin(GLU) and early gastric cancer,explore the diagnostic value of combined detection of three for early gastric cancer,and provide the guidance for early diagnosis and prevention of gastric cancer. Methods A total of165 patients with gastric cancer,160 patients with benign gastric diseases and 160 patients with healthy physical examination were selected from April 2017 to July 2018.The serum levels of VDBP,PG and GLU were measured,and the sensitivity and specificity of the above indicators were calculated. Serum VDBP,PG,and GLU were measured by enzyme-linked immunosorbent assay(ELISA). Results The differences in various indexes were statistically significant between gastric cancer group and benign gastric disease group,normal control group(all P<0.05). The positive rates of serum PG I,PG I/PG Ⅱ,GLU and VDBP in gastric cancer group were higher than those in benign gastric disease group and normal control group,and the differences were statistically significant(P<0.05). In the diagnosis of gastric cancer,the specificity(92.54%) and accuracy of serum PG I(90.65%) were higher than those of PG I/PGⅡ(specificity of 88.24%,accuracy of 87.34%),GLU(specificity of 80.37%,accuracy of 85.29%)and VDBP(specificity of 89.96%,accuracy of 88.39%). The diagnostic sensitivity of VDBP for gastric cancer was 92.24%, which was higher than that of PG I(80.15%),PG I/PGⅡ(83.41%) and GLU(85.79%). When PG I/PGⅡ,GLU and VDBP were combined to detect gastric cancer,the sensitivity of serum PG I/PGⅡcombined with GLU and VDBP for gastric cancer detection was 96.49%,which was higher than that of serum PG I/PGⅡcombined with GLU for gastric cancer diagnosis(89.58%),that is,the sensitivity of the combined detection of the three was higher than that of the single detection. Conclusion VDBP is lowly expressed in patients with gastric cancer. PG is significantly decreased in early gastric cancer patients,and the level of GLU is significantly increased. The combined detection of serum VDBP,PG and GLU is superior to the single-detection,which has important reference value for early diagnosis and prevention of gastric cancer.
引文
[1]刘林,路荣,陈莹,等.胃镜联合血清胃蛋白酶原诊断高危Hp相关性胃癌的价值研究[J].海南医学院学报,2018,24(2):185-187.
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[18]冯娟,夏维波.维生素D结合蛋白研究进展[J].国际内分泌代谢杂志,2016,36(3):209-213.
[19]黄永珍.血清胃蛋白酶原检测在早期胃癌诊断中的意义[J].检验医学与临床,2011,8(24):3013-3014.
[20]钟秋连,黄华艺.维生素D结合蛋白与肿瘤的关系研究进展[J].中华检验医学杂志,2014,8(11):828-831.
[21]张雷,李利华,潘绍义,等.维生素D结合蛋白基因rs2282679 A/C多态性与维生素D缺乏的关系[J].中华内分泌代谢杂志,2013,29(10):846-848.
[2]徐汪松,王丹.肿瘤标志物单项及联合检测对胃癌的诊断价值[J].安徽医药,2013,17(3):470-471.
[3]杨卫.血清肿瘤标志物CEA、CA19-9、CA242、CA724联合检测对胃癌的诊断效果分析[J].数理医药学杂志,2018,3(1):47-48.
[4]杨潇,吕燕娜.脱落细胞联合Th17细胞、肿瘤坏死因子和白介素水平检测对胃癌的诊断价值[J].实用癌症杂志,2018,24(2):191-193.
[5]刘淼.CEA、CA19-9及CA72-4联合检测在胃癌诊断中的意义[J].临床医学研究与实践,2018,37(11):103-104.
[6]冀文丽,王勤英.检测维生素D结合蛋白在重型肝炎中的意义[J].中国药物与临床,2008,8(3):246-247.
[7]崔玥.胃癌应用CA724、CEA、CA242、CA199肿瘤标志物联合检验的价值评价[J].中国医药指南,2018,3(15):119-120.
[8]TH LOOG,NC SOON,NM NIK,et al. Serum pepsinogen and gastrin-17 as potential biomarkers for pre-malignant lesions in the gastric corpus[J].Biomed Rep,2017,7(5):460-468.
[9]林惠忠,陈磊,李晓川,等.胃蛋白酶原及其亚群与CA72-4联合检测对早期胃癌诊断及预后判断的意义[J].中华外科杂志,2004,42(24):1505-1508.
[10]柳晖,刘菲.血清胃蛋白酶原和幽门螺杆菌感染与阿司匹林相关胃十二指肠损伤的相关性研究[J].胃肠病学,2018,8(1):8-12.
[11]徐巧莲,万小勇,杜燕,等.血清胃蛋白酶原检测在胃癌筛查中的价值[J].胃肠病学,2012,17(10):614-617.
[12]鲁伟,俞瑾,谈潘莉,等.胃蛋白酶原在胃癌诊断中的临床价值[J].浙江实用医学,2015,20(3):176-190.
[13]徐娟,孙雪飞,陈立新,等.血清胃蛋白酶原用于胃癌及癌前疾病的筛查[J].现代临床医学,2017,43(2):108-109.
[14]鲁品,马颖才.血清胃蛋白酶原在胃癌癌前病变、筛查及预后应用中的研究进展[J].中华胃肠内镜电子杂志,2016,3(2):79-82.
[15]王慧萍,郑舟军.凝集素在胃癌及萎缩性胃炎中表达的研究[J].浙江医学,1998,12(2):74-76.
[16]吕农华,徐萍,王崇文.PHA和PNA在胃癌分型和诊断中的价值[J].江西医药,1997,6(1):1-3.
[17]师金花,王琦,武希润,等.维生素D代谢过程与胃癌关系的研究进展[J].中华临床医师杂志(电子版),2017,12(8):1432-1435.
[18]冯娟,夏维波.维生素D结合蛋白研究进展[J].国际内分泌代谢杂志,2016,36(3):209-213.
[19]黄永珍.血清胃蛋白酶原检测在早期胃癌诊断中的意义[J].检验医学与临床,2011,8(24):3013-3014.
[20]钟秋连,黄华艺.维生素D结合蛋白与肿瘤的关系研究进展[J].中华检验医学杂志,2014,8(11):828-831.
[21]张雷,李利华,潘绍义,等.维生素D结合蛋白基因rs2282679 A/C多态性与维生素D缺乏的关系[J].中华内分泌代谢杂志,2013,29(10):846-848.