外周血sHLA-G与PGR、GPR联合检测在胃癌诊断中的效能评估  

Evaluation of combined detection of sHLA-G,PGR and GPR in the diagnosis of gastric cancer

作　　者：丁娟[1] 郑桂喜[1] 杜鲁涛[1] 尹作花[1] 张建[1] 王传新[1] 

机构地区：[1]山东大学齐鲁医院检验科,山东济南250012

出　　处：《山东大学学报（医学版）》2015年第11期59-63,共5页Journal of Shandong University:Health Sciences

基　　金：国家自然科学基金(81271916)

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。方珐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％a，0．748～0．902），均高于GPR的AuC0．716（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％a，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。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, com- pared 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, O. 760-0. 910） and 0.835 （95% CI, 0. 748-0. 902） respective- ly, 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 the diagnosis of gastric cancer was 0. 924 （ 95 % CI, O. 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.

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

分 类 号：R735.2[医药卫生—肿瘤] R446.6[医药卫生—临床医学]