胃液中α1-抗胰蛋白酶检测在胃癌诊断中的价值研究

The value of alpha 1-antitrypsin detection in gastric juice in the diagnosis of gastric cancer

目的检测胃癌及胃癌高危患者胃液中α1-抗胰蛋白酶(AAT)浓度,探讨胃液中AAT检测在胃癌诊断中的价值。方法入选165例胃癌及胃癌高危患者的胃液,所有入选者行胃镜及组织病理学检查,应用酶联免疫吸附法(ELISA)检测患者胃液中AAT浓度,根据胃镜及组织病理学检查结果将研究对象进行分组,胃癌组30例,消化性溃疡组62例(包括胃溃疡21例、十二指肠球部溃疡41例),胃炎组73例(包括慢性非萎缩性胃炎25例、慢性萎缩性胃炎48例),对照组为健康体检中心的健康体检者共28名。比较各组胃液中AAT浓度高低,确定其用于胃癌诊断的最佳临界值,评价胃液中AAT检测用于胃癌诊断的价值。结果胃癌组胃液中AAT浓度高于其他各组,差异有统计学意义(P <0. 05)。消化性溃疡组胃液中AAT浓度高于对照组和胃炎组,低于胃癌组,差异有统计学意义(P <0. 05)。胃炎组与对照组胃液中AAT浓度比较,差异无统计学意义(P> 0. 05)。AAT浓度检测用于胃癌诊断的效果评价:敏感度为83. 3%、特异度为98. 8%。结论胃癌患者胃液中AAT浓度显著升高。胃液中AAT检测在胃癌诊断中的价值较大,可以考虑作为胃癌标志物用于胃癌筛查。

Objective To investigate the value of AAT detection in gastric juice in the diagnosis of gastric cancer by detecting the expression of AAT in gastric juice of patients with high risk of gastric cancer and gastric cancer. Methods Gastric juice was collected from 165 patients with gastric cancer and high risk of gastric cancer. All patients were subjected to gastroscopy and histopathological examination. Enzyme linked immunosorbent assay（ ELISA） was used to detect the concentration of AAT in gastric juice of all subjects. The subjects were grouped according to the gold standard of gastroscopy and histopathological findings. There were 30 cases of gastric cancer,62 cases of peptic ulcer（ including 21 cases of gastric ulcer,41 cases of duodenal ulcer）,73 cases of gastritis（ including 25 cases of chronic non-atrophic gastritis,48 cases of chronic atrophic gastritis）. The control group came from 28 cases of physical examination in the health examination center of our hospital. The atrophic gastritis group consisted of pathological diagnosis of atypical hyperplasia and intestinal metaplasia. The concentration of AAT in gastric juice of each group was compared,and the best critical value for the diagnosis of gastric cancer was determined. Finally,the value of AAT test in the diagnosis of gastric cancer was evaluated. Results The concentration of AAT in gastric juice of gastric cancer group was higher than that in peptic ulcer group,gastritis group and control group,the difference was statistically significant（ P〈0. 05）. The concentration of AAT in gastric juice of peptic ulcer group was higher than that of control group and gastritis group,lower than that in gastric cancer group,and the difference was statistically significant（ P〈0. 05）. There was no significant difference in the concentration of AAT in gastric juice between gastritis group and control group（ P〉0. 05）. Therefore,the optimal threshold value was calculated for the concentration of AAT in gastric juice and the evaluation index for the diagnosis of gastric cancer,the sensitivity was 83. 3%,specificity was 98. 8%. Conclusion The concentrations of AAT in gastric juice of patients with gastric cancer are significantly increased. The detection of AAT in gastric juice is of great value in the diagnosis of gastric cancer. It can be used as a marker of gastric cancer for screening gastric cancer.