胃癌患者血清FABP1水平及其与幽门螺杆菌感染的关系

Level of serum FABP1 and its relationship with Helicobacter pylori infection in patients with gastriccancer

目的探讨胃癌患者血清中脂肪酸结合蛋白1(FABP1)的水平及其与幽门螺杆菌(Hp)感染的关系。方法选取2021年8月至2022年8月青海大学附属医院收治的40例胃癌患者(胃癌组)作为研究对象,将同期的40例体检者作为对照组,40例慢性萎缩性胃炎患者作为CAG组。采用13C尿素呼气试验检测Hp感染情况,采用酶联免疫吸附试验检测血清FABP1的水平。分析3组研究对象Hp感染情况、血清FABP1的水平及两者间的关系,分析血清FABP1水平与胃癌患者临床病理特征的关系,采用受试者工作特征(ROC)曲线评估血清FABP1、CA19-9、CA72-4以及3项指标联合检测的诊断效能。结果对照组、CAG组、胃癌组Hp感染率分别为32.50%(13/40)、55.00%(22/40)、60.00%(24/40),差异有统计学意义(χ^(2)=6.87,P=0.032)。其中,对照组与胃癌组相比,差异有统计学意义(P<0.05);CAG组分别与对照组、胃癌组相比,差异均无统计学意义(均P>0.05)。对照组、CAG组、胃癌组血清FABP1水平分别为[63.47(37.53,71.59)]ng/ml、[65.26(51.15,79.67)]ng/ml、[72.84(53.44,82.25)]ng/ml,差异有统计学意义(H=6.62,P=0.037)。其中,对照组与胃癌组相比,差异有统计学意义(H=19.93,P=0.031);CAG组分别与对照组、胃癌组相比,差异均无统计学意义(H=1.50,P=0.133;H=1.09,P=0.277)。全部研究对象中Hp阳性者(n=59)与Hp阴性者(n=61)血清FABP1水平分别为[77.05(68.90,83.54)]ng/ml、[47.80(37.76,63.32)]ng/ml,差异有统计学意义(Z=7.45,P<0.001);对照组Hp阳性和Hp阴性者血清FABP1水平分别为[77.34(68.84,86.31)]ng/ml、[39.79(36.83,63.75)]ng/ml,差异有统计学意义(Z=4.46,P<0.001);CAG组Hp阳性和Hp阴性者血清FABP1水平分别为[76.51(65.30,80.97)]ng/ml、[49.34(39.92,59.41)]ng/ml,差异有统计学意义(Z=4.32,P<0.001);胃癌组Hp阳性和Hp阴性者血清FABP1水平分别为[77.15(72.62,84.13)]ng/ml、[50.57(44.54,68.97)]ng/ml,差异有统计学意义(Z=4.32,P<0.001)。FABP1水平与胃癌患者吸烟(t=2.54,P=0.015)、肿瘤直径(t=2.23,P=0.035)、淋巴结转移(t=3.22,P=0.003)均有关,与性别(t=0.98,P=0.333)、年龄(t=1.60,P=0.117)、饮酒(Z=0.10,P=0.925)、肿瘤部位(F=1.06,P=0.356)、分化程度(t=0.61,P=0.545)、浸润深度(t=1.41,P=0.166)、远处转移(Z=1.96,P=0.050)以及TNM分期(Z=0.66,P=0.508)均无关。ROC曲线分析显示,血清FABP1诊断胃癌的曲线下面积(AUC)为0.62,95%CI为0.51~0.72,敏感性为57.50%,特异性为68.70%;血清CA19-9诊断胃癌的AUC为0.89,95%CI为0.83~0.95,敏感性为77.50%,特异性为86.30%;血清CA72-4诊断胃癌的AUC为0.88,95%CI为0.81~0.94,敏感性为70.00%,特异性为93.70%;3项指标联合检测诊断胃癌的AUC为0.91,95%CI为0.82~0.97,敏感性为67.50%,特异性为95.00%。结论胃癌患者Hp感染率高于健康体检者,胃癌患者血清FABP1水平较健康体检者高,Hp阳性者的FABP1水平高于Hp阴性者,Hp感染与FABP1水平在胃癌发生发展中可能存在共同致癌机制。

Objective To investigate the serum level of fatty acid binding protein 1(FABP1)and its relationship with Helicobacter pylori(Hp)infection in patients with gastric cancer.Methods Forty gastric cancer patients(gastric cancer group)who were hospitalized in Affiliated Hospital of Qinghai University from August 2021 to August 2022 were selected as the research subjects,and 40 physical examination subjects during the same period were selected as the normal control group and 40 chronic atrophic gastritis patients were selected as the CAG group.The Hp infection were detected by 13C breath test,and the levels of serum FABP1 were detected by enzyme-linked immunosorbent assay.The Hp infection status,serum FABP1 levels,and the relationship between the two in the three groups of study subjects were analyzed.And the relationships between the level of serum FABP1 and the clinicopathological features of gastric cancer patients were analyzed.The diagnostic value of serum FABP1,CA19-9,CA72-4 and combined test of 3 indexes were evaluated by receiver operating characteristic(ROC)curve.Results The Hp infection rates in the control group,CAG group,and gastric cancer group were 32.50%(13/40),55.00%(22/40),and 60.00%(24/40),respectively,with a statistically significant difference(χ^(2)=6.87,P=0.032).Among them,the Hp infection rate in the control group was compared with that in the gastric cancer group,with a statistically significant difference(P<0.05),and there were no statistically significant differences between the CAG group and the control group,the gastric cancer group(both P>0.05).The levels of serum FABP1 in the control group,CAG group,and gastric cancer group were[63.47(37.53,71.59)]ng/ml,[65.26(51.15,79.67)]ng/ml,and[72.84(53.44,82.25)]ng/ml,respectively,with a statistically significant difference(H=6.62,P=0.037).Among them,there was a statistically significant difference between the control group and the gastric cancer group(H=19.93,P=0.031),while there were no statistically significant differences between the CAG group and the control group,the gastric cancer group(H=1.50,P=0.133;H=1.09,P=0.277).Among all study subjects,the levels of serum FABP1 in the Hp positive group(n=59)and Hp negative group(n=61)were[77.05(68.90,83.54)]ng/ml and[47.80(37.76,63.32)]ng/ml,respectively,with a statistically significant difference(Z=7.45,P<0.001).In the control group,the levels of FABP1 in the serum of Hp positive and Hp negative persons were[77.34(68.84,86.31)]ng/ml and[39.79(36.83,63.75)]ng/ml,respectively,with a statistically significant difference(Z=4.46,P<0.001).In the CAG group,the levels of FABP1 in the serum of Hp positive and Hp negative patients were[76.51(65.30,80.97)]ng/ml and[49.34(39.92,59.41)]ng/ml,respectively,with a statistically significant difference(Z=4.32,P<0.001).In the gastric cancer group,the levels of FABP1 in the serum of Hp positive and Hp negative patients were[77.15(72.62,84.13)]ng/ml and[50.57(44.54,68.97)]ng/ml,respectively,with a statistically significant difference(Z=4.32,P<0.001).There were significant correlations between the serum level of FABP1 and smoking(t=2.54,P=0.015),tumor diameter(t=2.23,P=0.035),and lymph node metastasis(t=3.22,P=0.003)in gastric cancer patients.And there were no significant correlations between FABP1 and gender(t=0.98,P=0.333),age(t=1.60,P=0.117),alcohol consumption(Z=0.10,P=0.925),tumor site(F=1.06,P=0.356),degree of differentiation(t=0.61,P=0.545),the depth of infiltration(t=1.41,P=0.166),distant metastasis(Z=1.96,P=0.050)and TNM staging(Z=0.66,P=0.508).ROC curve analysis showed that the area under the curve(AUC)of serum FABP1 for gastric cancer diagnosis was 0.62,95%CI:0.51-0.72,the sensitivity and specificity were 57.50%and 68.70%,respectively;the AUC of CA19-9 for gastric cancer diagnosis was 0.89,95%CI:0.83-0.95,the sensitivity and specificity were 77.50%,86.30%,respectively;the AUC of CA72-4 for gastric cancer diagnosis was 0.88,95%CI:0.81-0.94,the sensitivity and specificity were 70.00%,93.70%,respectively;the AUC of combined test of 3 indexes for gastric cancer diagnosis was 0.91,95%CI:0.82-0.97,the sensitivity and specificity were 67.50%and 95.00%,respectively.Conclusion The Hp infection rate of gastric cancer patients is higher than that of the health examiners,the serum FABP1 level of gastric cancer patients is higher than that of the healthy health examiners,the serum FABP1 level of Hp positive persons is higher than that of Hp negative persons,and Hp infection and FABP1 level may have a common carcinogenic mechanism in the occurrence and development of gastric cancer.