Hp阳性胃癌患者血清胃蛋白酶原和硫氧还蛋白-1水平变化的意义

Changes and clinical diagnostic value of serum pepsinogen and thioredoxin-1 levels in Hp-positive patients with gastric cancer

目的探讨幽门螺杆菌(Hp)阳性胃癌患者血清胃蛋白酶原(PG)、硫氧还蛋白-1(Trx1)水平变化及其临床诊断价值。方法选取2019年1-12月重庆市沙坪坝区陈家桥医院收治的129例Hp阳性胃部疾病患者作为研究对象,其中Hp阳性胃良性病变患者92例(良性病变组),Hp阳性胃癌患者37例(胃癌组)。采用酶联免疫吸附法检测所有受检者血清胃蛋白酶原-Ⅰ(PG-Ⅰ)、胃蛋白酶原-Ⅱ(PG-Ⅱ)、Trx1水平,分析PG-Ⅰ、PG-Ⅱ、Trx1水平与Hp阳性胃癌患者临床病理特征的关系,并使用受试者工作特征(ROC)曲线及曲线下面积(AUC)分析PG-Ⅰ、PG-Ⅱ、Trx1对Hp阳性胃癌的诊断价值。结果胃癌组血清PG-Ⅰ水平(62.31±15.84)μg/L低于良性病变组(89.68±20.52)μg/L,血清PG-Ⅱ水平(19.96±3.61)μg/L、Trx1(23.58±5.14)ng/mL高于良性病变组[(14.47±2.03)μg/L、(12.56±3.47)ng/mL],差异均有统计学意义(P均<0.05)。不同TMN分期、肿瘤直径、有无淋巴结转移、有无血管浸润的Hp阳性胃癌患者血清PG-Ⅰ、PG-Ⅱ、Trx1水平比较,差异均有统计学意义(P均<0.05)。ROC曲线分析结果显示,血清PG-Ⅰ、PG-Ⅱ及Trx1联合检测诊断Hp阳性胃癌的AUC为0.905,明显高于PG-Ⅰ、PG-Ⅱ、Trx1单独检测的0.731、0.745、0.759,差异均有统计学意义(P均<0.05)。结论Hp阳性胃癌患者血清PG-Ⅰ水平明显降低,PG-Ⅱ、Trx1水平明显升高,不同临床病理特征胃癌患者血清PG-Ⅰ、PG-Ⅱ、Trx1存在差异,检测三者水平有助于诊断Hp阳性胃癌。

Objective To explore the changes and clinical diagnostic value of serum pepsinogen(PG)and thioredoxin-1(Trx1)levels in Helicobacter pylori(Hp)-positive patients with gastric cancer.Methods A total of 129 Hp-positive patients with gastric diseases admitted to Chenjiaqiao Hospital of Shapingba District of Chongqing were enrolled as the research objects between January and December 2019,including 92 cases with benign gastric lesions(benign lesion group)and 37 cases with gastric cancer(gastric cancer group).The levels of serum pepsinogen-Ⅰ(PG-Ⅰ),pepsinogenase-Ⅱ(PG-Ⅱ)and Trx1 in all objects were detected by enzyme-linked immunosorbent assay(ELISA).The relationship between the leveles of PG-Ⅰ,PG-Ⅱ,Trx1 and clinicopathological characteristics in Hp-positive patients with gastric cancer were analyzed.The diagnostic values of PG-Ⅰ,PG-Ⅱand Trx1 in Hp-positive gastric cancer were analyzed by receiver operating characteristic(ROC)curves and area under the curve(AUC)values-Results The level of serum PG-I in gastric cancer group[(62.31±15.84)μg/L]was lower than that in benign lesion group[(89.68±20.52)μg/L],while levels of serum PG-Ⅱ[(19.96±3.61)μg/L]and Trx1[(23.58±5.14)ng/mL]were higher than those in benign lesion group[(14.47±2.03)μg/L,(12.56±3.47)ng/mL](P all<0.05).The differences in the levels of serum PG-Ⅰ,PG-Ⅱand Trx1 among Hp-positive patients with different TMN staging,tumor diameter,lymph node metastasis and vascular invasion were statistically significant(P all<0.05).The results of ROC curve analysis showed that AUC of serum PG-Ⅰcombined with PG-Ⅱand Trx1 in the diagnosis of Hp-positive gastric cancer was 0.905,significantly greater than that of anyone of them alone(0.731,0.745,0.759)(P all<0.05).Conclusions The level of serum PG-Ⅰwas significantly decreased,while levels of PG-and Trx1 were significantly increased in Hp-positive patients with gastric cancer.There were differences in serum PG-Ⅰ,PG-Ⅱand Trx1 among gastric cancer patients with different clinicopathological characteristics.The detection of the three indexes was conducive to the diagnosis of Hp-positive gastric cancer.