外周血sHLA-G与PGR、GPR联合检测在胃癌诊断中的效能评估

doi:10.6040/j.issn.1671-7554.0.2015.837

摘要/Abstract

摘要： 目的检测血浆可溶性HLA-G(sHLA-G)及胃蛋白酶原PGI、PGII胃泌素-17(G-17)在胃癌及相关胃病患者外周血中的表达水平,评估sHLA-G与PGR(PGI/PGII)、GPR(G-17/PGI)联合检测在胃癌诊断中的效能.方法采用化学发光微粒子免疫分析技术检测50例健康对照组、46例萎缩性胃炎组、50例胃上皮内瘤变组、36例早期胃癌组及74例进展期胃癌组PGI、PGII的表达,同时采用酶联免疫吸附试验(ELISA)法检测G-17、sHLA-G的表达水平,通过Logistic回归将各标志物引入方程,构建胃癌诊断模型,利用ROC曲线评估其在胃癌诊断中的效能.结果与健康对照组、萎缩性胃炎组和胃上皮内瘤变组比较,早期胃癌和进展期胃癌组的PGR较低(P<0.05),而GPR与sHLA-G较高(P<0.05);sHLA-G与PGR诊断胃癌的ROC曲线下面积(AUC)分别为0.846(95%CI,0.760~0.910)和0.835(95%CI,0.748~0.902),均高于GPR的AUC 0.716(95%CI,0.617~0.802, P<0.05);构建联合检测胃癌诊断模型的方程为logit(Y)=0.41+0.03×sHLA-G-5.90×PGR,得到新变量Y诊断胃癌的AUC为0.924(95%CI,0.873~0.967),高于sHLA-G和PGR(P<0.05).结论 sHLA-G和PGR联合检测对胃癌具有较高的诊断价值,可作为传统肿瘤标志物的有益补充.

关键词: 胃泌素类, 可溶性人类白细胞抗原G, Logistic 回归, 胃肿瘤, 血清胃蛋白酶原类, 受试者工作曲线

Abstract: Objective To detect the expressions of pepsinogens (PGI and PGII), gastrin-17 (G-17) and sHLA-G in patients with gastric cancer or precancerous lesion, and to evaluate the efficiency of combined diagnostic index of PGR (PGI/II), GPR (G-17/PGI) and sHLA-G in these patients. Methods The levels of PGs were detected in 50 healthy volunteers, 46 patients with atrophic gastritis, 50 patients with gastric intraepithelial neoplasia, 36 patients with early gastric cancer and 74 patients with advanced gastric cancer by chemiluminescent microparticle immunoassay, and the levels of G-17 and sHLA-G were detected by ELISA. Logistic regression and ROC curve were used to establish a new diagnostic panel for gastric cancer using the combined diagnosis biomarkers PGR, GPR and sHLA-G. Results Reduced PGR and increased GPR and sHLA-G were detected in patients with early and advanced gastric cancer, compared with healthy volunteers, patients with gastric intraepithelial neoplasia and atrophic gastritis (all P<0.001). The ROC-AUC of sHLA-G and PGR were 0.846 (95%CI, 0.760-0.910) and 0.835 (95%CI, 0.748-0.902) respectively, which were significantly higher than those of GPR (0.716, 95%CI, 0.617-0.802). The new diagnostic model of gastric cancer was logit (Y)=0.41+0.03×sHLA-G-5.90×PGR, and the ROC-AUC of the new variable Y in thediagnosis of gastric cancer was 0.924 (95%CI, 0.853-0.967), which was higher than that of sHLA-G and PGR (P<0.05). Conclusion The combined detection of sHLA-G and PGR is helpful in the diagnosis of gastric cancer, which can serve as a useful supplement to traditional tumor markers.

Key words: Logistic regression, Stomach neoplasms, Soluble human leukocyte antigen G, Pepsinogens, Gastrins, ROC curve

中图分类号:

R735.2

丁娟, 郑桂喜, 杜鲁涛, 尹作花, 张建, 王传新. 外周血sHLA-G与PGR、GPR联合检测在胃癌诊断中的效能评估[J]. 山东大学学报（医学版）, 2015, 53(11): 59-63.

DING Juan, ZHENG Guixi, DU Lutao, YIN Zuohua, ZHANG Jian, WANG Chuanxin. Evaluation of combined detection of sHLA-G, PGR and GPR in the diagnosis of gastric cancer[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2015, 53(11): 59-63.

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