三叶因子1蛋白与血清胃蛋白酶原在胃溃疡中的表达及其意义  

Expression and significance of trefoil factor 1protein and serum pepsinogen in benign and malignant gastric ulcers

作　　者：杨俊[1] 厉朝喜[1] 戴一扬[1] 彭芳 翁秀妹 季木西[1] 

机构地区：[1]浙江医院消化科,杭州310013 [2]病理科 [3]检验科

出　　处：《中华医学杂志》2012年第22期1540-1543,共4页National Medical Journal of China

基　　金：浙江省医药卫生科学研究基金（2010KYA025）;浙江省老年医学重点学科群招标项目（2009ZB004）

摘　　要：目的探讨组织三叶因子1（TFF1）蛋白表达水平与血清胃蛋白酶原（PG）在鉴别良、恶性胃溃疡中的临床意义。方法筛选自2011年1-6月在浙江医院行胃镜及病理组织学检查的18例对照、25例胃溃疡和13例溃疡型胃癌患者的胃黏膜组织，采用免疫组织化学法测定胃黏膜中TFF1蛋白的表达；酶联免疫吸附法（ELISA）检测血清PGⅠ、Ⅱ含量并计算PGI与PGH的比值（PGR）。结果胃溃疡、溃疡旁组织、胃癌旁组织中TFF1表达明显均高于对照胃黏膜和胃癌组织（3．04％±0．20％、3．00％±0．20％、3．23％±0．26％比1．67％±O．18％和0．46％±0．18％，均P〈0．01）。TFF1升高增加患者罹患胃溃疡风险（OR：1．365，95％CI1．065-1．749，P=0．014）；TFF1表达下调则增高患者罹患胃癌风险（OR-3．067，95％CI1.391-6．757，P=0．005）。胃溃疡组患者血清PGⅠ、PGⅡ水平均明显高于对照及胃癌组[（150±27）、（28±9）比（121±22）、（17±7），（79±12）、（20±5）μg／L，均P〈0．01]；胃癌组血清PGⅠ、PGR均显著低于对照组（均P〈0．01），PGH水平则与对照组差异无统计学意义（P〉0．05）。受试者特征曲线分析：血清PGI及PGR对胃癌的诊断价值较高（曲线下面积分别为0．975和0．914）。结论TFF1蛋白在胃溃疡中高表达，而在胃癌中表达明显降低；血清PGⅠ、PGⅡ显著升高提示良性溃疡，而血清PGI、PGR明显降低是恶性溃疡的危险信号。检测TFF1蛋白表达和血清PG水平有利于良、恶性胃溃疡的鉴别诊断。Objective To explore the clinical significance of trefoil factor 1 （TFF1） protein expression and serum pepsinogen（PC,） concentration in benign and malignant gastric ulcers. Methods The TFF1 protein expression was evaluated by immunohistochemistry in biopsies of gastric mucosa from 18 normal controls, 25 patients with gastric ulcer and 13 patients with ulcerative gastric cancer at our hospital during January to June 2011. The serum concentrations of PGⅠand PG Ⅱ were detected by enzyme-linked immunosorbent assay （ELISA） and PG/PG Ⅱ （PGR） was subsequently calculated. Results The expression of TFF1 protein increased significantly in ulcerative and peripheral gastric mocusa and peripheral mocusa of gastric cancers versus that in normal controls and the ulcerocancer group （3.04% ± 0. 20% , 3.00% ±0. 20% , 3. 23% ±0. 26% vs 1.67% ±. 18%, 0.46% ±0. 18% , all P 〈0. 01 ）. The elevated expression of TFF1 increased the risk of gastric ulcer （ OR： 1. 365, 95% CI： 1. 065 - 1. 749, P = 0. 014 ） while the down-regulation of TFF1 significantly increased the risk of ulcerocancer （OR：3. 067, 95% CI： 1. 391 - 6. 757, P = 0. 005）. The serum levels of PG Ⅰand PG Ⅱ in gastric ulcer group were significantly higher than that in normal control and ulcerocancer group（ （ 150±27）, （28 ±9） vs （ 121 ±22）, （ 17 ±7）, （79± 12）, （20 ±5）μg/L,all P 〈0. 01 ）. The PG I level and PGR decreased significantly in the ulcerocancer group versus normal control （both P 〈 0. 01 ）. But there was no statistical difference in PG Ⅱ （P 〉 0. 05 ）. Receiver operating characteristic curve analysis revealed that PG I and PGR were valuable for the diagnosis of malignant gastric cancer with an area under curve of 0. 975 and 0. 914 respectively. Conclusions The expression of TFF1 protein increases in gastric ulcer but decreases in gastric ulcerocancer. The elevated serum levels of PG Ⅰ and PG Ⅱ indicate benign ulcer while a marked decline of serum PG I and PGRserves

关 键 词：胃蛋白酶原A 胃蛋白酶原C 胃溃疡 胃肿瘤 三叶因子1蛋白 

分 类 号：R735.2[医药卫生—肿瘤]