基质金属蛋白酶9及热休克蛋白60检测对早期胃癌的诊断价值

The Diagnostic Value of Combined Detection of the Plasma MMP-9 and HSP60 in Patients with Early Gastric Cancer

目的探讨血浆基质金属蛋白酶9(MMP-9)与热休克蛋白60(HSP-60)联合检测对早期胃癌患者的诊断价值。方法选取我院收治的临床疑诊早期胃癌136例患者,根据患者确诊诊断分为:对照组(70例,排除胃癌诊断)和研究组(66例,确诊胃癌诊断)。检测并比较两组患者MMP-9、HSP-60、CA19-9、CA72-4以及CEA水平差异。采用Logistic回归分析影响早期胃癌发生的临床因素。运用ROC曲线评估MMP-9与HSP-60对诊断早期胃癌患者的最佳值。结果研究组血浆MMP-9、HSP-60、CA19-9、CA72-4与CEA水平均高于对照组(P均<0.05)。多因素Logistic回归分析结果显示,血浆MMP-9与HSP-60是早期胃癌发生的危险因素(P<0.05)。血浆MMP-9与HSP-60诊断早期胃癌的ROC曲线下面积分别为0.781和0.667(P=0.024,0.011)。当MMP-9≥364.5μg/L和HSP60≥2.84μg/L为cut-off值,对判断早期胃癌发生的灵敏度为53.0%,特异性为81.4%,准确度为67.6%,ROC曲线下面积为0.862。结论血浆MMP-9与HSP-60联合检测对早期胃癌发生具有较好的诊断价值。

Objective To analyze the diagnostic value of combined detection of the plasma matrix metalloproteinase 9（MMP-9） and heat shock protein 60（HSP60） in patients with early gastric cancer（EGC）. Methods We enrolled136 patients with clinical doubtful EGC and divided them into two groups,control group（70 cases,diagnosed withnon-EGC） and research group（66 cases,diagnosed with EGC）. The indexes of plasma levels of MMP-9,HSP-60,CA19-9,CA72-4 and CEA were detected and compared between two groups. The risk factors to the occurrence of EGC were confirmed by multivariate Logistic regression analysis. The best cutoff points of MMP-9 and HSP-60 were confirmed by the areas under the receiver operating curve（ROC）. Results MMP-9,HSP-60,CA19-9,CA72-4 and CEA in research group were significantly higher than that of control group（P〈0. 05）. MMP-9 and HSP-60 were confirmed to be the risk factors of the occurrence of EGC by multivariate Logistic regression analysis. The area under ROC curve for MMP-9 and HSP-60 were 0. 781 and 0. 667 respectively. The values of MMP-9 at 364. 5μg/L and HSP-60 at 2. 84μg/L were chosen as cut-off point for EGA,and the sensitivity was 53. 0%,specificity was81. 4% and accuracy was 67. 6%. Conclusion The combined detection of the plasma MMP-9 and HSP-60 might be valuable in diagnosisof EGC.