血清胃蛋白酶原Ⅰ、Ⅱ比值对胃癌病灶内恶性生物学行为的评价价值研究

Value of serum pepsinogenⅠand Ⅱ ratio for evaluating malignant biological behaviors in gastric cancer lesions

目的:研究血清胃蛋白酶原Ⅰ、Ⅱ比值(PGR)对胃癌病灶内恶性生物学行为的评价价值。方法:选择本院进行根治性手术的胃癌患者作为研究的胃癌组,同期在三六三医院体检的志愿者作为对照组。采集血清,测定胃蛋白酶原Ⅰ、胃蛋白酶原Ⅱ后计算PGR;采集胃癌病灶并测定癌基因、血管新生基因的表达量。结果:胃癌组患者血清PGR水平明显低于对照组且中高分化胃癌患者的血清PGR水平明显高于低分化胃癌患者,TNMⅢ期胃癌患者的血清PGR水平明显低于TNM I+Ⅱ期胃癌患者,有淋巴结转移胃癌患者的血清PGR水平明显低于无淋巴结转移的胃癌患者;以PGR=3.8为切点,PGR<3.8胃癌患者的胃癌病灶内p53、TXNIP的mRNA表达量明显低于PGR>3.8的胃癌患者,Bcl-2、β-catenin、Survivin、COX-2、HIF-1α、VEGF、c-Met、CNPY2的mRNA表达量明显高于PGR>3.8的胃癌患者。结论:胃癌患者血清中PGR的降低对病理进程及恶性生物学行为具有评估价值。

Objective： To study the value of serum pepsinogenⅠand Ⅱ ratio （PGR） for evaluating the malignant biological behaviors in gastric cancer lesions. Methods： The patients with gastric cancer who underwent radical surgery in 363 Hospital between July 2015 and February 2018 were selected as the gastric cancer group in the study, and the volunteers who had physical examination in 363 Hospital during the same period were selected as the control group. Serum was collected to measure pepsinogen Ⅰ and pepsinogen Ⅱ and then the PGR was calculated; gastric cancer lesions were collected to measure the expression of oncogenes and angiogenesis genes. Results： Serum PGR level of the gastric cancer group was significantly （ P 〈0.05） lower than that of the control group, serum PGR level of the patients with moderately-highly differentiated gastric cancer was significantly （ P 〈0.05） higher than that of the patients with lowly differentiated gastric cancer, serum PGR level of the patients with TNM stage III gastric cancer was significantly （ P 〈0.05） lower than that of the patients with TNM stage I＋II gastric cancer, and serum PGR level of the gastric cancer patients with lymph node metastasis was significantly（ P 〈0.05） lower than that of the gastric cancer patients without lymph node metastasis; PGR=3.8 was taken as the cutoff point, and p53 and TXNIP mRNA expression in the lesions of the gastric cancer patients with PGR 〈 3.8 were significantly （ P 〈0.05） lower than those of the gastric cancer patients with PGR 〉 3.8 while Bcl-2, β-catenin, Survivin, COX-2, HIF-1α, VEGF, c-Met and CNPY2 mRNA expression were significantly （ P 〈0.05） higher than those of the gastric cancer patients with PGR 〉 3.8. Conclusion： The decrease of serum PGR of patients with gastric cancer is valuable for evaluating the pathological process and malignant biological behaviors.