Hp抗体分型联合CA125、CA724水平检测在胃癌中的临床价值

Clinical value of Helicobacter pylori antibody typing combined with carbohydrate antigen 125 and carbohydrate antigen 724 levels in the diagnosis of gastric cancer

目的分析幽门螺杆菌(Hp)抗体分型和糖类抗原(CA)125、CA724水平与胃癌严重程度及预后的关系。方法将2017年12月至2019年1月收治的89例胃癌患者作为观察组,50例胃良性病变患者作为对照组;采用免疫印迹法检测患者Hp分型,采用Cobas e601型电化学发光仪检测患者血中CA125、CA724水平;采用Logistic回归模型分析Hp分型,CA125、CA724水平与胃癌严重程度的关系,绘制受试者工作特征(ROC)曲线分析Hp分型、CA125、CA724单独及联合应用在预测患者预后中的价值。结果观察组Hp分型阳性率,CA125、CA724水平明显高于对照组,差异有统计学意义(χ^2=16.440,P<0.001;t=45.201,P<0.001;t=9.080,P<0.001);高分化组、中分化组及低分化组Hp分型,CA125、CA724水平比较,差异有统计学意义(P<0.05),高分化组Hp分型阳性率、CA125及CA724水平最高。Hp分型、CA125及CA724是患者胃癌病情严重程度的独立影响因素(P<0.05);复发或死亡组患者Hp分型阳性率明显高于稳定组,且血中CA125及CA724水平明显高于稳定组,差异有统计学意义(χ^2=3.860,P=0.049;t=5.897,P<0.001;t=11.576,P<0.001);除与Hp分型灵敏度相当,Hp分型、CA125及CA724联合应用在判断患者预后时的灵敏度、特异度及ROC曲线下面积均明显高于各项指标单独应用(P<0.05)。结论Hp分型,CA125、CA724水平是胃癌严重程度的独立影响因素,且Hp分型、CA125及CA724的联合检测可明显提高判断预后的价值。

Objective To analyze the relationship between Helicobacter pylori(Hp)antibody typing and carbohydrate antigen(CA)125 and CA724 levels on the severity and prognosis of gastric cancer.Methods A total of 89 patients with gastric cancer admitted from December 2017 to January 2019 were selected as observation group,and 50 patients with benign gastric lesions were recruited as control group.Hp typing was detected by immunoblotting and CA125,CA724 detected by Cobas e601 electrochemical luminometer.The relationships between Hp antibody typing,CA125,CA724 levels and severity of gastric cancer were analyzed by Logistic regression model.Receiver operating characteristic(ROC)curve analysis was performed.Hp antibody typing,CA125,CA724 alone and in combination were used to predict the prognosis of patients.Results The positive rate of Hp antibody,CA125 and CA724 levels in the observation group were significantly higher than those in control group,and the differences were statistically significant(χ^2=16.440,P<0.001;t=45.201,P<0.001;t=9.080,P<0.001).The positive rate of Hp antibody typing,the levels of CA125 and CA724 in the highly differentiated group,moderately differentiated group and poorly differentiated group were significantly different(P<0.05),the high-differentiation group had the highest positive rate of Hp antibody,CA125 and CA724 level.Hp antibody typing,CA125 and CA724 were the independence factors affecting the severity degree of gastric cancer(P<0.05).The positve rate of Hp antibody typing in patients with relapse or death was significantly higher than that in stable patients,and the levels of CA125 and CA724 in blood were significantly higher than those in stable patients,and the differences were statistically significant(χ^2=3.860,P=0.049;t=5.897,P<0.001;t=11.576,P<0.001).Except for the sensitivity of Hp typing,the sensitivity,specificity and under area of ROC of Hp antibody typing,CA125 and CA724 combined in the prediction of prognosis were significantly higher than those of each index(P<0.05).Conclusion Hp antibody typing,CA125,CA724 are independent factors affecting the severity of gastric cancer,and the combined detection of Hp typing,CA125 and CA724 levels could significantly improve the value of judgment prognosis.