血清程序化细胞死亡分子5蛋白表达对胃癌早期预测价值及临床意义

The value of serum programmed cell death molecule 5 protein expression in early prediction of gastric cancer and its clinical significance

目的探讨血清程序化细胞死亡分子5(PDCD5)蛋白表达对胃癌的早期预测价值及临床意义。方法选取2014年3月至2016年3月四川省岳池县人民医院收治的103例胃癌患者(胃癌组),同期在医院体检的80例健康人群作为对照组。采用酶联免疫吸附试验法检测血清PDCD5蛋白水平,受试者工作特征曲线评价血清PDCD5蛋白对胃癌的诊断效能。按照血清PDCD5蛋白水平分为低水平患者50例和高水平患者53例。χ^2检验分析血清PDCD5蛋白水平与胃癌患者临床资料的关系。单因素和多因素Cox回归模型分析影响胃癌生存预后的独立危险因素;Kaplan-Meier法绘制不同血清PDCD5蛋白水平胃癌患者生存曲线。结果胃癌组血清PDCD5蛋白水平明显低于对照组[(0.82±0.30)mg/L比(1.26±0.39)mg/L],差异有统计学意义(t=8.628,P<0.01)。胃癌患者血清PDCD5蛋白水平与肿瘤TNM分期、肿瘤浸润程度有关(P<0.05),与性别、年龄、体质量指数、肿瘤直径、淋巴结转移、肿瘤类型、肿瘤分化程度等无关(P>0.05)。血清PDCD5蛋白诊断胃癌的曲线下面积为0.810(95%CI 0.747~0.873),敏感度为71.8%,特异度为76.3%(Z=9.641,P<0.01)。血清PDCD5蛋白水平是胃癌患者不良预后的独立危险因素(P<0.05)。血清PDCD5蛋白低水平患者和高水平患者5年生存率分别为32.0%和62.3%,低水平患者5年生存率明显低于高水平患者,差异有统计学意义(χ^2=18.422,P<0.01)。结论胃癌患者血清PDCD5蛋白水平显著降低,低血清PDCD5蛋白水平是患者不良预后的独立危险因素。

Objective To investigate the value of serum programmed cell death molecule 5(PDCD5)protein expression in early prediction of gastric cancer and its clinical significance.Methods A total of 103 patients with gastric cancer who were treated in Yuechi County People′s Hospital in Sichuan Province from March 2014 to March 2016 and 80 healthy people who underwent physical examinations(control group)in the same period were selected as subjects.The serum level of PDCD5 protein were detected by enzyme-linked immunosorbent assay.The diagnostic performance of serum PDCD5 protein on gastric cancer was evaluated by receiver operating characteristic curve.The patients with gastric cancer were divided into low-level group(50 cases)and high-level group(53 cases)according to serum PDCD5 protein level.The relationship between serum PDCD5 protein level and clinical data in patients with gastric cancer was analyzed byχ^2 test.Univariate and multivariate Cox regression models were used to analyze independent risk factors for survival and prognosis of gastric cancer.Kaplan-Meier method was used to map survival curves of gastric cancer patients with different levels of serum PDCD5 protein.Results Serum PDCD5 protein level in gastric cancer group was significantly lower than that in control group:(0.82±0.30)mg/L vs.(1.26±0.39)mg/L,and there was statistical difference(t=8.628,P<0.01).Serum PDCD5 protein level in patients with gastric cancer was related to tumor TNM stage and tumor invasion(P<0.05),but not related to gender,age,body mass index(BMI),tumor size,lymph node metastasis,tumor type and tumor differentiation(P<0.05).The area under curve(AUC)of serum PDCD5 protein in the diagnosis of gastric cancer was 0.810(95%CI 0.747 to 0.873),with a sensitivity of 71.8%,and a specificity of 76.3%(Z=9.641,P<0.01).Serum PDCD5 protein level was an independent risk factor for poor prognosis in patients with gastric cancer(P<0.05).The 5-year survival rate in low-level group was significantly lower than that in high-level group:32.0%vs.62.3%,and there was statistical difference(χ^2=18.422,P<0.01).Conclusions The serum PDCD5 protein level in patients with gastric cancer is significantly decreased.Low serum PDCD5 protein level is independent risk factors for poor prognosis of patients with gastric cancer.