巨噬细胞抑制因子-1对胃癌辅助诊断的临床价值分析
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摘要
目的探究巨噬细胞抑制因子-1(MIC-1)对胃癌尤其是早期胃癌的临床诊断价值。方法回顾性选取于2017年1月至2018年1月湖北民族学院附属民大医院住院及门诊病人,其中不同胃癌分期患者76例,胃部良性病变患者90例,正常健康人群82例。检测并记录各组MIC-1、癌胚抗原(CEA)和糖类抗原199(CA199)值,分析比较各组值有无显著差异及其对鉴别胃癌和胃部良性病变的诊断价值,分析MIC-1、EA、CA199在胃癌不同分期中阳性比例。结果 MIC-1、CEA、CA199值胃癌组与良性疾病组及健康对照组比较,差异均具有统计学意义(P<0.05),胃癌患者组MIC-1、CEA、CA199水平均高于胃部良性病变组和健康对照组,具有统计学差异(P<0.05);ROC曲线分析显示,以520.1 pg/ml为截点值,MIC-1水平在鉴别诊断胃癌和胃部良性病变的敏感度为89.0%,特异度为80.0%,曲线下面积为0.874,均优于CEA和CA199对胃癌的诊断价值;MIC-1在早期胃癌患者I期和II期诊断阳性率分别为37.5%(3/8)、33.3%(5/15),远高于CEA和CA199在早期胃癌中的阳性率。结论 MIC-1对胃癌尤其是早期胃癌的诊断价值较高,可为胃癌的早期诊疗提供新思路。
Objective To explore the clinical diagnostic value of macrophage inhibitory factor-1(MIC-1) in gastric cancer,especially early gastric cancer,so as to provide reference for the diagnosis and treatment of this type of disease. Methods We selected inpatients and outpatients in our hospital from January 2017 to January 2018. Among them,76 patients with different gastric cancer staging,90 patients with benign stomach lesions,and 82 normal healthy people. The MIC-1,CEA,and CA199 values of each group were detected and recorded. The differences in the values of each group and their diagnostic value for gastric cancer were analyzed and compared. The diagnostic differences of MIC-1 in different stages of gastric cancer were analyzed. Results The MIC-1,CEA,and CA199 values were significantly different between the gastric cancer group and the benign disease group and the healthy control group(P < 0. 05). The levels of MIC-1,CEA,and CA199 in gastric cancer patients were higher than those in benign gastric lesions and healthy controls,with statistical differences(P < 0. 05). ROC curve analysis showed that with a cutoff value of 520. 1 pg/ml,the sensitivity of MIC-1 levels in the differential diagnosis of gastric cancer and benign gastric lesions was89. 0%,the specificity was 80. 0%,and the area under the curve was 0. 874,which was superior to the diagnostic value of CEA and CA199 in gastric cancer. The positive rate of MIC-1 in patients with early gastric cancer at stage I and stage II was 37. 5%(33%) and 33. 3%(5/15),which was much higher than the positive rate of CEA and CA199 in early gastric cancer. Conclusion MIC-1 has a high diagnostic value for gastric cancer,especially early gastric cancer,and can provide new ideas for early diagnosis and treatment of gastric cancer.
Objective To explore the clinical diagnostic value of macrophage inhibitory factor-1(MIC-1) in gastric cancer,especially early gastric cancer,so as to provide reference for the diagnosis and treatment of this type of disease. Methods We selected inpatients and outpatients in our hospital from January 2017 to January 2018. Among them,76 patients with different gastric cancer staging,90 patients with benign stomach lesions,and 82 normal healthy people. The MIC-1,CEA,and CA199 values of each group were detected and recorded. The differences in the values of each group and their diagnostic value for gastric cancer were analyzed and compared. The diagnostic differences of MIC-1 in different stages of gastric cancer were analyzed. Results The MIC-1,CEA,and CA199 values were significantly different between the gastric cancer group and the benign disease group and the healthy control group(P < 0. 05). The levels of MIC-1,CEA,and CA199 in gastric cancer patients were higher than those in benign gastric lesions and healthy controls,with statistical differences(P < 0. 05). ROC curve analysis showed that with a cutoff value of 520. 1 pg/ml,the sensitivity of MIC-1 levels in the differential diagnosis of gastric cancer and benign gastric lesions was89. 0%,the specificity was 80. 0%,and the area under the curve was 0. 874,which was superior to the diagnostic value of CEA and CA199 in gastric cancer. The positive rate of MIC-1 in patients with early gastric cancer at stage I and stage II was 37. 5%(33%) and 33. 3%(5/15),which was much higher than the positive rate of CEA and CA199 in early gastric cancer. Conclusion MIC-1 has a high diagnostic value for gastric cancer,especially early gastric cancer,and can provide new ideas for early diagnosis and treatment of gastric cancer.
引文
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[11]张炜.姑息性手术对晚期胃癌生存率及生活质量的临床影响[J].中国医药指南,2016,14(32):122-122.
[12]李军,施毅卿,姜松耀.内镜辅助胃癌黏膜下剥离术治疗胃癌前病变及早期胃癌效果分析[J].临床和实验医学杂志,2018,17(6):637-640.
[13]赵博超.胃镜活检与外科病理检查对早期胃癌诊断价值比较[J].临床医药文献电子杂志,2016,3(35):7031,7034.
[14]沈迪,王小兵,车轶群,等.血清巨噬细胞抑制因子-1在肺癌诊断中的临床应用[J].中国肿瘤,2015,24(5):421-425.
[15]阳昕,王志东.巨噬细胞抑制因子-1与癌症相关恶病质[J].肿瘤防治研究,2013,40(3):308-311.
[16]李振业,牟永告.巨噬细胞抑制因子-1与肿瘤关系的研究进展[J].广东医学,2012,33(5):702-705.
[17]王腾,田海梅,李茉,等.血清巨噬细胞抑制因子-1在肝癌患者中的临床诊断价值[J].癌症进展,2016,14(4):328-331.
[18]李倩,侯亚平.巨噬细胞抑制因子1在消化道肿瘤中的研究进展[J].医学综述,2014,20(3):432-434.
[19]罗玉凤.血清癌胚抗原、糖类抗原724和糖类抗原199对胃癌的早期诊断价值[J].检验医学与临床,2017,14(23):3557-3558,3566.
[20]聂双发,李磊,胡晓峰,等.血清CEA、CA199、CA72-4和CA125水平在胃癌临床病理分期中的价值分析[J].医学临床研究,2017,34(7):1404-1406.
[2]常敏,张久聪,周琴,等.胃癌流行病学研究进展[J].胃肠病学和肝病学杂志,2017,26(9):966-969.
[3]孙金锋,霍丙胜,郎岩,等.早期胃癌的胃镜诊断与临床分析[J].影像研究与医学应用.2017,1(7):200-201.
[4]吴佳,杨力,陶伟,等.血清巨噬细胞抑制因子-1检测对胃癌的诊断价值[J].宁夏医科大学学报,2014,36(6):638-640.
[5]陶光丽,任传路,丁庆莉.巨噬细胞抑制因子-1、恶性肿瘤生长因子与CA19-9联合检测对胰腺癌的临床诊断价值[J].检验医学与临床,2015,12(2):215-216.
[6]谢艳茹,吴敏华,周月芬,等.胃癌化疗前后血清巨噬细胞抑制因子-1水平的变化及其临床意义[J].中国医药导报,2018,15(2):92-95.
[7]贾敬好,王静,杨海芳,等.肺癌诊断中血清巨噬细胞抑制因子-1浓度检测的临床价值[J].中国医药导刊,2017,19(4):415-416.
[8]蔡尚党,陈建设,娄宁,等.血清癌胚抗原、糖类抗原199、242及巨噬细胞抑制因子-1表达在老年结直肠癌患者诊断中的价值[J].中国老年学杂志,2016,36(14):3474-3475,3476.
[9]殷青辉,李海坤,叶斌,等.胃癌早期淋巴结转移的傅里叶红外光谱研究[J].赣南医学院学报,2016,36(3):367-369,383.
[10]吕泽坚,王俊江,李勇.腹腔镜远端胃癌根治性淋巴结清扫规范化实施探讨[J].中华胃肠外科杂志,2017,20(8):857-861.
[11]张炜.姑息性手术对晚期胃癌生存率及生活质量的临床影响[J].中国医药指南,2016,14(32):122-122.
[12]李军,施毅卿,姜松耀.内镜辅助胃癌黏膜下剥离术治疗胃癌前病变及早期胃癌效果分析[J].临床和实验医学杂志,2018,17(6):637-640.
[13]赵博超.胃镜活检与外科病理检查对早期胃癌诊断价值比较[J].临床医药文献电子杂志,2016,3(35):7031,7034.
[14]沈迪,王小兵,车轶群,等.血清巨噬细胞抑制因子-1在肺癌诊断中的临床应用[J].中国肿瘤,2015,24(5):421-425.
[15]阳昕,王志东.巨噬细胞抑制因子-1与癌症相关恶病质[J].肿瘤防治研究,2013,40(3):308-311.
[16]李振业,牟永告.巨噬细胞抑制因子-1与肿瘤关系的研究进展[J].广东医学,2012,33(5):702-705.
[17]王腾,田海梅,李茉,等.血清巨噬细胞抑制因子-1在肝癌患者中的临床诊断价值[J].癌症进展,2016,14(4):328-331.
[18]李倩,侯亚平.巨噬细胞抑制因子1在消化道肿瘤中的研究进展[J].医学综述,2014,20(3):432-434.
[19]罗玉凤.血清癌胚抗原、糖类抗原724和糖类抗原199对胃癌的早期诊断价值[J].检验医学与临床,2017,14(23):3557-3558,3566.
[20]聂双发,李磊,胡晓峰,等.血清CEA、CA199、CA72-4和CA125水平在胃癌临床病理分期中的价值分析[J].医学临床研究,2017,34(7):1404-1406.