血清miR-133a、sCD44v6、胃泌素-17在胃癌和癌前病变筛查中的应用及与Hp-IgG表达的关系

Application of serum miR-133a,sCD44v6,and gastrin-17 in gastric cancer and precancerous lesion screening and its relationship with Hp-IgG expression

目的 探究血清微小RNA-133a(miR-133a)、可溶性CD44变体6(sCD44v6)和胃泌素-17在胃癌和癌前病变筛查中的应用,并研究其与幽门螺杆菌-免疫球蛋白G(Hp-IgG)表达的关系。方法 回顾性选取2020年1月至2023年1月在重庆市开州区人民医院就诊的胃癌患者103例(胃癌组)、癌前病变患者112例(癌前病变组)及同期在本院进行体检的健康志愿者100名(对照组)作为本次研究对象。收集各组对象的血清miR-133a、sCD44v6、胃泌素-17水平,并探究其对胃癌及癌前病变筛查的诊断价值。比较癌前病变组及胃癌组患者Hp-IgG检测结果,并分析胃癌组及癌前病变组Hp-IgG阳性率与血清miR-133a、sCD44v6、胃泌素-17水平的相关性。结果 癌前病变组、胃癌组患者血清miR-133a相对表达水平低于对照组,sCD44v6、胃泌素-17水平高于对照组,且胃癌组血清miR-133a相对表达水平低于癌前病变组,sCD44v6、胃泌素-17水平高于癌前病变组,差异均有统计学意义(P<0.05)。血清miR-133a相对表达水平、sCD44v6、胃泌素-17水平诊断癌前病变的曲线下面积(AUC)值分别为0.621、0.932、0.945(P<0.05)。血清miR-133a相对表达水平、sCD44v6、胃泌素-17水平诊断胃癌的AUC值分别为0.864、0.876、0.845(P<0.05)。胃癌组患者的Hp-IgG阳性率为79.61%,高于癌前病变组(41.07%),差异有统计学意义(P<0.05)。癌前病变组患者的Hp-IgG阳性率与血清miR-133a相对表达水平无明显相关性(r=-0.065,P>0.05),与sCD44v6、胃泌素-17水平呈正相关(r=0.404、0.344,P<0.05)。胃癌组患者的Hp-IgG阳性率与血清miR-133a相对表达水平呈负相关(r=-0.693,P<0.05),与sCD44v6、胃泌素-17水平呈正相关(r=0.765、0.766,P<0.05)。结论 在胃癌和癌前病变中,血清miR-133a的相对表达水平较低,而sCD44v6和胃泌素-17的水平较高,且具有一定诊断价值,可用于胃癌和癌前病变的筛查。胃癌患者的Hp-IgG阳性率较高,并且与血清miR-133a呈负相关,与sCD44v6和胃泌素-17呈正相关。在癌前病变患者中,Hp-IgG阳性率与血清miR-133a相对表达水平无明显相关性,但与sCD44v6和胃泌素-17的水平呈正相关,应密切关注Hp-IgG在患者中的表达情况。

Objective To explore the application of serum microRNA-133a(miR-133a),soluble CD44 variant 6(sCD44v6) and gastrin-17 in gastric cancer and precancerous lesions screening,and to investigate its relationship with Helicobacter pylori-immunoglobulin G(Hp-IgG) expression.Methods One hundred and three gastric patients(gastric cancer group),112 precancerous patients(precancerous group) from January 2020 to January 2023,and 100 healthy volunteers(control group) who underwent physical examination in Kaizhou District People's Hospital of Chongqing were selected for this study.The um levels of miR-133a,s CD44v6 and gastrin-17 were collected and their value for gastric cancer and precancerous lesions was explored.The Hp-IgG detection results of patients with precancerous lesions and gastric cancer were compared,and the correlation between the Hp-IgG positivity rate and levels of serum miR-133a,CD44v6,and gastrin-17 in the gastric cancer and precancerous groups were analyzed.Results The levels of serum miR-133a relative expression in the precancerous and gastric cancer groups were lower than that in the control group,while the levels of sCD44v6 and gastrin-17 were higher than those in the control group,and the level of serum miR-133a relative expression in the gastric cancer group was lower than that in the precancerous group,and the levels of sCD44v6 and gastrin-17 were higher than those in the precancerous group,the differences were statistically significant(P<0.05).The area under the curve(AUC) values for the relative expression level of serum miR-133a,sCD44v6,and gastrin-17 levels in diagnosing precancerous lesions were 0.621,0.932,and 0.945,respectively(P<0.05).The AUC values of serum miR-133a relative expression level,sCD44v6,and gastrin-17 levels for diagnosing gastric cancer were 0.864,0.876,and 0.845,respectively(P<0.05).The Hp-IgG positivity rate in the gastric cancer group was 79.61%,which was higher than that in the precancerous group(41.07%),and the difference was statistically significant(P<0.05).There was no statistically significant correlation between Hp-IgG positivity rate and the level of serum miR-133a relative expression in precancerous group patients(r=-0.065,P>0.05),but was positively correlated with the levels of sCD44v6 and gastrin-17(r=0.404,0.344;P<0.05).There was negatively correlated between Hp-IgG positive rate and the level of serum miR-133a relative expression in gastric cancer patients(r=-0.693,P<0.05),and was positively correlated with the levels of sCD44v6 and gastrin-17(r=0.765,0.766;P<0.05).Conclusion In the screening of gastric cancer and precancerous,the relative levels of serum miR-133a are lower in patients with precancerous lesions and gastric cancer,while sCD44v6 and gastrin-17 are higher and have some diagnostic value and could serve as biomarkers for auxiliary diagnosis.The Hp-IgG positive rate in gastric cancer patients is relatively high,and it is negatively correlated with serum miR-133a,and positively correlated with sCD44v6 and gastrin-17.In patients with precancerous,the Hp-IgG positive rate is not significantly correlated with serum miR-133a,but is positively correlated with sCD44v6 and gastrin-17,so Hp-IgG expression in patients should be closely monitored.