胸苷激酶1在胃癌诊断及预后评估中的意义

Significance of thymidine kinase 1 in clinical diagnosis and prognosis prediction of gastric cancer

目的了解胸苷激酶1(TK1)在诊断胃癌及评估患者预后的意义。方法对60例胃癌患者(胃癌组)以及胃溃疡(胃溃疡组)、萎缩性胃炎(萎缩性胃炎组)、胃息肉(胃息肉组)各20例患者的血清TK1水平进行检测,分析血清TK1对胃癌的诊断效能;检测胃癌组织及良性胃病变组织中TK1阳性表达情况,分析胃癌患者临床特征与胃癌组织内TK1阳性表达间的关系;绘制5 a生存曲线,分析胃癌组织内TK1阳性与阴性表达者的生存情况。结果胃癌组患者的血清TK1水平明显高于其他3组(P<0.01);血清TK1超过95.59μg/L时诊断胃癌的效能最高,曲线下面积(AUC)为0.750,95%CI为0.658~0.842,灵敏度、特异度分别为83.3%、70.0%。胃癌组织内的TK1阳性表达率明显高于良性胃病变组织(P<0.05);胃癌组织内TK1阳性表达水平与胃癌组织学及肿瘤直径有关(P<0.05);TK1阳性表达者的5 a无瘤生存期低于阴性组,两组5 a生存曲线差异有统计学意义(P<0.05)。结论TK1与胃癌发生及发展密切相关,在诊断胃癌及评估患者预后均有一定的临床意义。

Objective To investigate the significance of thymidine kinase 1(TK1) in clinical diagnosis and prognosis prediction of gastric cancer. Methods The serum TK1 level was detected for 60 cases with gastric cancer(Gastric Cancer Group), 20 cases with gastric ulcer(Gastric Ulcer Group), 20 cases with atrophic gastritis(Atrophic Gastritis Group), and 20 cases with gastric polyps(Gastric Polyps Group), and the efficiency of the serum TK1 in the diagnosis of gastric cancer was analyzed. The positive expression of TK1 in gastric cancer tissues and benign gastric lesions was detected, and the relationship between the clinical characteristics of patients with gastric cancer and the positive expression of TK1 in gastric cancer tissues was analyzed;The 5 a survival curve was drawn, and the survival of patients with positive and negative expression of TK1 in gastric cancer tissues was analyzed. Results Serum TK1 level was the highest in Gastric Cancer Group( P <0.01). The efficiency in the diagnosis of gastric cancer was the highest when the serum TK1 greater than 95.59 μg/L,with an area under the curve(AUC) of 0.750, 95% CI of 0.658-0.842, the sensitivity of 83.3%, and the specificity of 70.0%,respectively. The positive expression rate of TK1 in gastric cancer tissues was significantly higher than that in benign gastric lesions( P <0.05). The positive expression of TK1 in gastric cancer tissues was correlated with histology of gastric cancer and tumor diameter( P <0.05). The 5 a tumor-free survival of the group with positive TK1 expression was lower than that of the group with negative expression, and there was statistical difference in 5 a survival curve between the two groups( P <0.05). Conclusion TK1 is closely related to the occurrence and development of gastric cancer and has certain clinical significance in the diagnosis and prognosis prediction of gastric cancer.