CDX2、HNF4α、CAP2蛋白联合检测诊断幽门螺杆菌感染相关高危胃癌效果  

Value of combined detection of CDX2, HNF4α and CAP2 in diagnosis of patients with Helicobacter pylori infection related high-risk gastric cancer

作　　者：杨琴[1] 周嘉伟 张岩[1] 于本章[1] YANG Qin;ZHOU Jia-wei;ZHANG Yan;YU Ben-zhang(Clinical Laboratory,Shengli Oilfield Central Hospital,Dongying,Shandong257000,China)

机构地区：[1]胜利油田中心医院检验科,山东东营257000

出　　处：《中华医院感染学杂志》2020年第16期2405-2410,共6页Chinese Journal of Nosocomiology

基　　金：沈阳医学院科技基金资助项目(20162037)。

摘　　要：目的探讨组织尾侧型同源转录因子2(Caudal type homeobox transcription factor 2,CDX2)、肝细胞核因子4α(Hepatocyte nuclear factor 4 alpha,HNF4α)、腺苷酸环化酶相关蛋白2(Adenylate cyclase related protein 2,CAP2)联合检测对幽门螺杆菌(Hp)感染相关高危胃癌患者的诊断价值。方法收集2017年2月-2019年1月胜利油田中心医院收治的47例萎缩性胃炎及59例胃癌患者胃黏膜组织标本;免疫组化染色测定组织CDX2、HNF4α、CAP2蛋白表达情况,快速银染法检测Hp感染情况,分析三者在Hp感染相关胃部炎症恶性转化过程中的作用,受试者工作曲线(Receiver operator characteristic curve,ROC)分析三者联合检测对Hp感染相关胃癌的诊断价值。结果胃癌患者组织标本CDX2阳性率低于萎缩性胃癌患者(P<0.05),HNF4α、CAP2阳性率高于萎缩性胃炎患者(P<0.05);胃癌患者Hp感染率为79.66%,高于萎缩性胃炎Hp感染率42.55%(P<0.05),Hp阳性胃癌、萎缩性胃炎组织标本CDX2、HNF4α、CAP2阳性率皆高于Hp阴性病例组织标本(P<0.05);胃癌患者组织CDX2、HNF4α、CAP2表达与Hp感染率呈正相关(P<0.05);HNF4α阳性染色评分>3分预测Hp相关高危胃癌价值最高,曲线下面积(Area under the curve,AUC)为0.870,敏感度、特异性分别为91.49%、75.00%;其次为CAP2,AUC为0.860,敏感度、特异性为89.36%、75.00%;三者联合预测Hp相关高危胃癌综合效能最高,AUC为0.891,敏感度、特异性分别为89.36%、91.67%。结论组织CDX2、HNF4α、CAP2异常表达与Hp感染有关,参与胃炎向胃癌恶性转化过程;联合检测组织CDX2、HNF4α、CAP2对Hp感染相关高危胃癌有较高的预测价值。OBJECTIVE To explore the diagnostic value of tissue caudal type homeobox transcription factor 2(CDX2) and hepatocyte nuclear factor 4 alpha(HNF4α) combined with adenylate cyclase-related protein 2(CAP2) in patients with Helicobacter pylori(Hp) infection related high-risk gastric cancer(GC). METHODS The gastric mucosal tissue specimens were collected from 47 patients with atrophic gastritis and 59 patients with GC who were admitted to Shengli Oilfield Central Hospital from Feb. 2017 to Jan. 2019. Immunohistochemical staining was applied to detect the expression of CDX2, HNF4α and CAP2 in tissue. The rapid silver staining was applied to detect Hp infection. The correlation between the three indexes and the malignant transformation process of Hp infection-related stomach inflammation were analyzed. The receiver operating characteristic(ROC) curve was applied to analyze predicting value of the indexes in Hp infection related GC. RESULTS The positive rate of CDX2 in GC patients was significantly lower than that in AG patients(P<0.05), whereas positive rates of HNF4α and CAP2 were significantly higher than that in AG patients(P<0.05). The Hp infection rate in GC patients was significantly higher than that in AG patients(79.66% vs 42.55%)(P<0.05). The positive rates of CDH2, HNF4α and CAP2 in cases with Hp positive GC and AG were significantly higher than that with negative Hp(P<0.05). The expression of tissue CDX2, HNF4α and CAP2 in GC patients was positively correlated with Hp infection rate(P<0.05). The predicting value of HNF4α positive staining score higher than 3 points in Hp-related high-risk GC was the highest. Its area under the curve(AUC), sensitivity and specificity were 0.870, 91.49% and 75.00%, respectively, which was followed by CAP2(AUC:0.860, sensitivity:89.36%, specificity: 75.00%). The comprehensive effectiveness of the combination of the three indexes for the prediction of Hp-related high-risk GC was the highest, with the AUC, sensitivity and specificity of 0.891, 89.36% and 91.67%, respectively

关 键 词：胃癌 幽门螺杆菌感染 尾侧型同源转录因子2 肝细胞核因子4Α 腺苷酸环化酶相关蛋白2 

分 类 号：R735.2[医药卫生—肿瘤]