长链非编码RNA脑源性神经营养因子-反义物和信号素3B-反义物1在胃癌病人中的表达及联合超声检查在胃癌诊断中的应用

Expression of long non-coding RNA brain-derived neurotrophic factor-antisense and semaphorin 3B-antisense 1 in gastric cancer patients and the application of them combined ultrasound in the diagnosis of gastric cancer

目的探究长链非编码RNA(lncRNA)脑源性神经营养因子-反义物(BDNF-AS)和信号素3B-反义物1(SEMA3B-AS1)在胃癌病人中的表达及联合超声检查在胃癌诊断中的应用价值。方法2021年1月~2023年2月收治的118例胃癌病人为胃癌组,同期113例胃部良性病变者为良性病变组。实时荧光定量PCR(qRT-PCR)检测血清BDNF-AS和SEMA3B-AS1表达水平,并以平均值分为BDNF-AS高表达组(55例)和BDNF-AS低表达组(63例)、SEMA3B-AS1高表达组(57例)和SEMA3B-AS1低表达组(61例);Kappa检验分析超声诊断与临床病理诊断的一致性;受试者工作特征曲线(ROC)分析血清BDNF-AS和SEMA3B-AS1联合超声对胃癌的诊断价值。结果与良性病变组比较,胃癌组血清BDNF-AS和SEMA3B-AS1水平均明显下降(t=10.205,t=9.590,P<0.05);BDNF-AS和SEMA3B-AS1在肿瘤直径≥3 cm、浸润深度较深、分化程度较低、发生淋巴结转移的胃癌病人中表达水平明显较低(P<0.05);Kappa检验结果显示,超声诊断与临床病理诊断的一致性较高(Kappa值=0.723,P<0.05);ROC结果显示,血清BDNF-AS、SEMA3B-AS1水平和超声诊断胃癌的AUC分别为0.848、0.835、0.861,三者联合诊断的AUC(0.949)显著大于血清BDNF-AS单独诊断的AUC(Z=4.713,P=0.000)、血清SEMA3B-AS1水平单独诊断的AUC(Z=4.112,P=0.0015)和超声诊断的AUC(Z=3.350,P=0.0008),联合诊断的敏感度、特异度优于三者单独诊断。结论血清BDNF-AS和SEMA3B-AS1联合超声检查在胃癌的诊断上具有较高的应用价值。

Objective To investigate the expression of long non-coding RNA(lncRNA)brain-derived neurotrophic factor-antisense(BDNF-AS)and semaphorin 3B-antisense 1(SEMA3B-AS1)in patients with gastric cancer and the application value of combined ultrasound in the diagnosis of gastric cancer.Methods From January 2021 to February 2023,118 gastric cancer patients admitted to our hospital were retrospectively selected as the gastric cancer group,another 113 cases with benign gastric lesions in our hospital were as the benign lesion group.Real-time fluorescence quantitative PCR(qRT-PCR)was applied to detect the expression levels of serum BDNF-AS and SEMA3B-AS1,and patients were divided into BDNF-AS high expression group(n=55)and BDNF-AS low expression group(n=63),SEMA3B-AS1 high expression group(n=57),and SEMA3B-AS1 low expression group(n=61)based on the average value;Kappa test was applied to analyze the consistency between ultrasound diagnosis and clinical pathological diagnosis;receiver operating characteristic curve(ROC)was applied to analyze the diagnostic value of serum BDNF-AS and SEMA3B-AS1 combined with ultrasound for gastric cancer.Results Compared with the benign lesion group,the serum levels of BDNF-AS and SEMA3B-AS1 in the gastric cancer group were obviously lower(t=10.205,t=9.590,P<0.05);the expression levels of BDNF-AS and SEMA3B-AS1 were obviously lower in gastric cancer patients with tumor diameter≥3 cm,deeper infiltration depth,lower differentiation,and lymph node metastasis(P<0.05);Kappa test results showed a high consistency between ultrasound diagnosis and clinical pathological diagnosis(Kappa value=0.723,P<0.05);ROC results showed that the AUC of serum levels of BDNF-AS,SEMA3B-AS1,and ultrasound in diagnosis of gastric cancer was 0.848,0.835,and 0.861,respectively,the AUC(0.949)diagnosed by the combination of the three was obviously higher than that diagnosed by serum BDNF-AS alone(Z=4.713,P=0.000),serum SEMA3B-AS1 level alone(Z=4.112,P=0.0015),and ultrasound diagnosis(Z=3.350,P=0.0008),the sensitivity and specificity of the combined diagnosis were superior to those diagnosed by the three alone.Conclusion The combination of serum BDNF-AS and SEMA3B-AS1 ultrasound has high practical value in the diagnosis of gastric cancer.