血清MG7-Ag水平检测与新型胃癌评分系统在胃癌高危人群风险评估中的价值

The value of serum MG7-Ag level detection and novel gastric cancer scoring system in risk assessment of high-risk population for gastric cancer

目的:研究血清MG7-Ag与新型胃癌评分系统在胃癌高危人群风险评估中的临床价值。方法:纳入2021年1月至2022年12月在本院接受胃镜检查及活检的163例胃癌癌前病变患者和42例胃癌患者作为研究对象。收集一般资料,包括年龄、性别、血清幽门螺杆菌抗体(呼气试验C13/C14)、胃蛋白酶原I/胃蛋白酶原II比值(PGR)、胃泌素17(G17)、内镜检查及病理诊断结果:根据新型胃癌筛查评分系统将入组患者分为低危组、中危组、高危组,采用酶联免疫吸附法进行MG7-Ag检测,分析影响胃癌诊断的影响因素,评价MG7-Ag和新型胃癌评分系统在胃癌高危人群风险评估中的价值。结果:胃癌癌前病变和胃癌组患者一般资料差异无统计学意义,具有可比性。所有205例患者中,新型胃癌评分系统分为高危34例、中危63例和低危108例,其中胃癌检出率分别为24(73.53%)例、13(20.63%)例、5(4.63%)例。以MG7-Ag表达的中位数分为高表达组和低表达组,其中高表达组41例、低表达组164例,其中胃癌检出率分别为33(80.49%)例、9(5.49%)例。单因素和多因素分析显示,新型胃癌评分系统和MG7-Ag检测均为影响胃癌诊断的影响因素之一。通过ROC曲线分析新型胃癌评分系统和MG7-Ag检测在癌前病变和胃癌中的诊断价值,结果显示,新型胃癌评分系统的曲线下面积(AUC)为0.71(95%CI:0.65~0.74),MG7-Ag检测的AUC为0.78(95%CI:0.75~0.80),两者联合诊断的AUC为0.86(95%CI:0.81~0.90),两者联合诊断的价值明显优于单独诊断。结论:血清MG7-Ag与新型胃癌评分系统联合诊断在筛选胃癌高危人群中的价值明显优于单独检测,对未来胃癌癌前病变和胃癌的诊断具有很高的临床指导价值。

Objective:To investigate the clinical value of serum MG7-Ag and a novel gastric cancer scoring system in risk assessment of high-risk populations for gastric cancer.Methods:163 patients with precancerous lesions of gastric cancer and 42 patients with gastric cancer who underwent gastroscopy and biopsy in our hospital from January 2021 to December 2022 were included as the study subjects.General data were collected,including age,gender,serum Helicobacter pylori antibody(breath test C13/C14),Pepsin I/Pepsin II ratio(PGR),Gastrin 17(G17),endoscopic examination and pathological diagnosis results.According to the new gastric cancer screening scoring system,enrolled patients are divided into low-risk group,medium risk group,and high-risk group.Using enzyme-linked immunosorbent assay for MG7-Ag detection,analyze the influencing factors on the diagnosis of gastric cancer.To evaluate the value of MG7-Ag and the new gastric cancer scoring system in risk assessment of high-risk populations for gastric cancer.Results:There is no statistically significant difference in general data between patients with precancerous lesions of gastric cancer and those in the gastric cancer group,which is comparable.Among all 205 patients,the new gastric cancer scoring system was divided into 34 high-risk cases,63 medium risk cases,and 108 low risk cases.The detection rates of gastric cancer were 24(73.53%),13(20.63%),and 5(4.63%),respectively.The median expression of MG7-Ag was divided into high expression group and low expression group,with 41 cases in the high expression group and 164 cases in the low expression group.The detection rates of gastric cancer were 33(80.49%)and 9(5.49%),respectively.Single factor and multivariate analysis showed that the new gastric cancer scoring system and MG7-Ag detection are both influencing factors for the diagnosis of gastric cancer.Receiver operating characteristic was used to analyze the diagnostic value of the new gastric cancer scoring system and MG7-Ag detection in precancerous lesions and gastric cancer.The results showed that the area under the curve(AUC)of the new gastric cancer scoring system was 0.71(95%CI:0.65~0.74),the AUC detected by MG7-Ag was 0.78(95%CI:0.75~0.80),and the AUC diagnosed by the combination of the two was 0.86(95%CI:0.81~0.90).The value of the combined diagnosis of the two was significantly better than that of individual diagnosis.Conclusion:The combined diagnosis of serum MG7-Ag and the new gastric cancer scoring system has significantly better value in screening high-risk populations for gastric cancer compared to individual detection.It has high clinical guiding value for the diagnosis of precancerous lesions and gastric cancer in the future.