胃癌患者血清可溶性人白细胞抗原-G、生长分化因子15水平变化及临床意义

Changes and clinical significance of serum soluble human leukocyte antigen-G and growth differentiation factor 15 in gastric cancer

[目的]探讨血清可溶性人白细胞抗原-G(s-HLA-G)、生长分化因子15(GDF-15)水平变化及临床意义,为临床诊治提供理论依据。[方法]选取我院2015年1月～2017年12月诊治88例胃癌患者作为胃癌组,按照TNM分期标准分为Ⅰ～Ⅱ期组36例和Ⅲ～Ⅳ期组52例;另选取同期65例胃病患者作为胃病组和60例健康体检人群作为对照组,观察研究对象及不同临床分期胃癌患者血清s-HLA-G、GDF-15、癌胚抗原(CEA)、糖类抗原(CA)125和甲胎蛋白(AFP)水平,并通过受试者工作特征曲线(ROC)和曲线下面积(AUC)评价s-HLA-G和GDF-15在胃癌患者中的临床诊断价值。[结果]胃癌组血清s-HLA-G、GDF-15、CEA、CA125和AFP水平显著高于胃病组和对照组(P<0.05);胃病组血清s-HLA-G、GDF-15、CEA、CA125和AFP水平高于对照组,但差异无统计学意义(P>0.05)。胃癌Ⅲ期和Ⅳ期患者血清s-HLA-G、GDF-15、CEA、CA125和AFP水平显著高于Ⅰ期和Ⅱ期(P<0.05)。s-HLA-G、GDF-15诊断胃癌曲线下面积、灵敏度和特异度优于CEA、CA125和AFP。[结论]s-HLA-G、GDF-15与胃癌的发生发展有关,可作为胃癌诊断的辅助标志物。

[Objective]To investigate the changes and clinical significance of serum soluble human leukocyte antigen-G(sHLA-G)and growth differentiation factor-15(GDF-15)in gastric cancer.[Methods]From January 2015 to December 2017,88 patients with gastric cancer were selected as gastric cancer group who were divided into stageⅠ~Ⅱgroup(36 cases)and stageⅢ~Ⅳgroup(52 cases)according to TNM staging criteria.In addition,65 patients with gastric disease were selected as gastric disease group and 60 healthy people as control group.The sHLA-G,GDF-15,carcinoembryonic antigen(CEA),carbohydrate antigen(CA)125 and alpha-fetoprotein(AFP)levels were measured,and the clinical diagnostic value of sHLA-G and GDF-15 in gastric cancer patients was evaluated by ROC and AUC.[Results]The levels of serum sHLA-G,GDF-15,CEA,CA125 and AFP in gastric cancer group were significantly higher than those of in gastric disease group and control group(P<0.05).The serum sHLA-G,GDF-15,CEA,CA125 and AFP levels in gastric disease group were higher than those of in control group,but there was no significant difference(P>0.05).The serum levels of sHLA-G,GDF-15,CEA,CA125 and AFP in stageⅢandⅣgastric cancer patients were significantly higher than those of in stageⅠandⅡgastric cancer patients(P<0.05).The AUC,sensitivity and specificity of sHLA-G and GDF-15 in diagnosing gastric cancer were better than those of CEA,CA125 and AFP.[Conclusion]sHLA-G and GDF-15 are related to the occurrence and development of gastric cancer,which could be used as an marker for the diagnosis of gastric cancer.