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山东大学学报(医学版) ›› 2011, Vol. 49 ›› Issue (6): 125-129.

• 论文 • 上一篇    下一篇

血浆可溶性sHLA-G检测对胃癌早期诊断的意义

杜鲁涛1，王传新1，肖晓燕2，郑妮1，张欣1，张旭华3，王丽丽1，王顺1，董召刚1   

  1. 山东大学 1.齐鲁医院检验科,  济南 250012； 2.齐鲁医院肾内科,  济南 250012；3.第二医院检验科,  济南 250033
  • 收稿日期:2010-12-15 出版日期:2011-06-10 发布日期:2011-06-10
  • 通讯作者: 王传新(1963- )，男，教授，博士研究生导师，主要从事肿瘤免疫和分子生物学的研究。 E-mail：cxwang@sdu.edu.cn
  • 作者简介:杜鲁涛(1984- )，男，硕士研究生，主要从事肿瘤免疫和分子生物学的研究。 E-mail：dulutao1984@163.com
  • 基金资助:

    国家自然科学基金资助项目(30672010)；山东省自然科学基金重点项目资助项目(ZR2010HZ004)。

The significance of detection of plasm sHLA-G for early diagnosis of gastric cancer

DU Lu-tao1, WANG Chuan-xin1, XIAO xiao-yan2, ZHENG Ni1, ZHANG Xin1, ZHANG Xu-hua3, WANG Li-li1, WANG Shun1,  DONG Zhao-gang1   

  1. 1. Department of Clinical Laboratory, Qilu Hospital, Shandong University, Jinan 250012, China;
    2. Department of Nephrology, Qilu Hospital, Shandong University, Jinan 250012, China;
    3. Department of Clinical Laboratory, the Second Hospital of Shandong University, Jinan 250033, China
  • Received:2010-12-15 Online:2011-06-10 Published:2011-06-10

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摘要：

目的     检测可溶性人类白细胞抗原G ( sHLA-G)在胃癌及癌前病变患者血浆中的表达水平，并探讨其临床诊断意义。方法     采用ELISA法检测82例胃癌患者(胃癌组)、39例胃上皮内瘤变患者(胃上皮内瘤变组)、36例萎缩性胃炎患者(萎缩性胃炎组)、52例浅表性胃炎患者(浅表性胃炎组)及67名健康对照者(健康对照组)血浆中sHLA-G水平，同时检测血浆癌胚抗原(CEA)水平，分析二者对胃癌早期诊断的意义及sHLA-G与胃癌临床病理参数间的关系。结果     胃癌组血浆sHLA-G水平明显高于胃上皮内瘤变组、萎缩性胃炎组、浅表性胃炎组及健康对照组(P均<0.001)；胃上皮内瘤变组血浆sHLA-G水平明显高于健康对照组(P<0.05)。胃癌组血浆CEA水平明显高于其他各组(P均<0.01)。sHLAG作为诊断指标的ROC曲线AUC为0.814，其诊断价值高于CEA (0.692，P=0.01)。sHLA-G和CEA联合检测的ROC曲线AUC为0.846，明显高于sHLA-G或CEA(P＜0.05；P<0.001)。ROC曲线确定sHLA-G诊断临界值为101.37U/mL，其敏感度为73.2%，特异度为82.5%，阳性预测值为63.8%，阴性预测值为87.9%，准确性为79.7%。胃癌患者血浆sHLA-G水平与患者年龄及肿瘤大小密切相关(P均<0.05)，而与患者性别、分化类型、浸润程度、淋巴结转移及临床分期无关(P均>0.05)。结论     血浆sHLA-G可能参与了胃癌的发生和发展，检测其表达水平有助于早期发现胃癌及癌前病变，血浆sHLA-G有可能成为临床胃癌早期诊断的一个潜在性指标。

关键词: 可溶性人类白细胞抗原G；胃肿瘤；癌胚抗原

Abstract:

Objective    To detect expression of sHLA-G in the patients with gastric cancer or precancerous lesions, and to explore its diagnostic significance.  Methods    sHLA-G was detected by ELISA in 82 cases with gastric cancer, 39 cases with gastric intraepithelial neoplassia, 36 cases with atrophic gastritis, 52 cases with superficial gastritis and 67 cases of healthy controls, while the levels of carcino-embryonic antigen (CEA) was also simultaneously detected. The diagnostic value of sHLAG and its correlations with clinicopathological features were analyzed.  Results     The level of sHLA-G was significantly higher in gastric cancer  than those in gastric intraepithelial neoplassia, atrophic gastritis, superficial gastritis and the control group(P<0.001, respectively). The level of sHLA-G was significantly higher in gastricintraepithelial neoplassia than that in the control group(P<0.05). The levels of CEA in gastric cancer was significantly higher than that in the healthy control, superficial gastritis, atrophic gastritis, and gastric intraepithelial neoplassia(P<0.01, respectively). ROC curve analysis showed that AUC for sHLA-G was 0.814, which was significantly higher when compared with the AUC of CEA(0.692, P=0.01). The combined AUC of sHLA-G and CEA was 0.846, which was significantly higher when compared with the AUC of sHLA-G or CEA(P＜0.05; P<0.001). The cutoff value of sHLA-G for diagnosis was 101.37U/mL, while the diagnostic sensitivity, specificity, positive predictive value, negative predictive value and accuracy rate were 73.2%, 82.5%, 63.8%, 87.9% and 79.7%, respectively. The level of sHLA-G in gastric cancer was significantly correlated with age and tumor size (P<0.05, respectively), and  no significant correlations between the level of sHLA-G and other clinicopathological factors were identified(P>0.05, respectively).  Conclusions     HLA-G plays an important role in the pathogenesis and progression of gastric cancer, and detection of sHLA-G is helpful for the early diagnosis of gastric cancer and its precancerous lesions. Therefore, sHLA-G might serve clinically as a potential biomarker for the early diagnosis of gastric cancer.

Key words: Soluble human leukocyte antigen G; Stomach neoplasms; Carcino-embryonic antigen

中图分类号: 

  • R735.2
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