血清生长分化因子-15与老年胃黏膜病变的关系

The correlation between the serum level of growth differentiation factor-15 and gastric mucosal diseases in elderly patients

目的探讨血清生长分化因子-15（GDF-15）与老年胃黏膜病变的关系。方法选择在我院行胃镜检查的老年患者245例，按病理诊断标准分为4组：非萎缩性胃炎组（对照组）63例、慢性萎缩性胃炎组（萎缩性胃炎组）67例、上皮内瘤变组30例和胃癌组85例。采用酶联免疫吸附试验（ELISA）测定患者血清GDF-15水平。结果对照组、萎缩陛胃炎组、上皮内瘤变组和胃癌组患者血清GDF-15水平分别为（0．71±0．24）ng／ml、（0．87±0．29）ng／ml、（1．07±0．32）ng／ml和（1．52±0．49）ng／ml。此外，胃癌组中早期胃癌组、进展期胃癌组患者的血清GDF-15水平分别为（1．27±0．46）ng／ml、（1．58±0．53）ng／ml。胃癌组患者血清GDF-15水平较对照组、萎缩性胃炎组、上皮内瘤变组明显升高（P〈0．01）。进展期胃癌组血清GDF-15水平较早期胃癌组明显升高（P〈0．05）。结论在老年胃黏膜病变患者中，血清GDF-15水平的变化对癌前状态和早期胃癌的诊断具有临床意义，胃癌患者血清GDF-15水平明显升高，提示GDF-15可能成为一种预测胃癌的血清生物标志物。

Objective To investigate the relationship between the serum level of growth differentiation factor-15（GDF-15） and gastric mucosal diseases in elderly patients. Methods A total of 245 elderly patients undergoing gastroscopy check were enrolled and divided into 4 groups ： non-atrophic gastritis group （63 cases）, chronic atrophic gastritis group （ 67 cases ）, intraepithelial neoplasia group （ 30 cases ） and gastric cancer group （ 85 cases ） according to pathological diagnosis. The serum level of GDF-15 was detected by ELISA and was compared among the groups. Results The serum level of GDF-15 in the non-atrophic gastritis group,chronic atrophic gastritis group, intraepithelial neoplasia group and gastric cancer group was （0.71 ±0. 24） ng/ml, （0. 87 ±0. 29） ng/ml, （1.±＋ 0. 32） ng/ml and（1.52 ±0. 49） ng/ml, respectively. The serum level of GDF-15 in the early gastric cancer group and advanced gastric carcinoma group was （ 1.27 ±0. 46 ） ng/ml and （ 1.58 ±0. 53 ） ng/ml, respectively. The serum level of GDF-15 in gastric cancer group versus other groups was significantly higher（ all P 〈0.01 ）. The serum level of GDF-15 in advanced gastric carcinoma group versus the early gastric cancer group was obviously higher（ P 〈 0.05 ）. Conclusion In the elderly patients with gastric mueosal diseases, the high level of serum GDF-15 may indicate a severe gastric disease such as the precancerous condition and the early gastric cancer. The level of serum GDF-15 in the gastric cancer patients increases obviously,and it suggests that GDF-15 may serve as a serum biomarker for gastric cancer.