巨噬细胞抑制因子-1对胃癌辅助诊断的临床价值分析

Clinical value of macrophage inhibitory factor-1 in the diagnosis of gastric cancer

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.