胃充盈超声检查联合血清学指标在胃癌术前TNM分期中的应用价值  

Application value of gastric filling ultrasound combined with serological indicators in preoperative TNM staging of gastric cancer

作　　者：谢允虎 陈建峰[1] 吴海明[1] 程秋莹 朱彩霞[2] XIE Yunhu;CHEN Jianfeng;WU Haiming;CHENG Qiuying;ZHU Caixia(Department of Gastrointestinal Hernia Surgery,Yiwu Central Hospital,Zhejiang 322000,China)

机构地区：[1]浙江省义乌市中心医院胃肠疝外科,322000 [2]新疆维吾尔自治区人民医院胰腺外科

出　　处：《临床超声医学杂志》2021年第9期664-668,共5页Journal of Clinical Ultrasound in Medicine

摘　　要：目的探讨胃充盈超声检查(FUS)联合血清学指标基质金属蛋白酶-7(MMP-7)、基质金属蛋白酶-9(MMP-9)在术前筛查不同分期胃癌中的应用价值。方法82例胃癌患者均行血清MMP-7、MMP-9及FUS检查,分析不同分化程度、不同浸润深度及不同肿瘤淋巴结转移情况胃癌患者的MMP-7、MMP-9表达。以病理活检和《国际抗癌联盟及美国肿瘤联合会胃癌TNM分期系统(第8版)》为标准,绘制受试者工作特征(ROC)曲线分析FUS、MMP-7、MMP-9及其联合应用对TNM分期的诊断效能。结果不同TNM分期患者MMP-7、MMP-9比较差异均有统计学意义(均P<0.05),且各分期间两两比较差异均有统计学意义(均P<0.05)。低分化胃癌患者MMP-7、MMP-9阳性率高于中、高分化患者,淋巴结转移患者MMP-7、MMP-9阳性率高于无转移患者,浸润深度处于肌层/浆膜层患者MMP-7、MMP-9阳性率高于处于黏膜/黏膜下层患者,差异均有统计学意义(均P<0.05)。ROC曲线分析显示,FUS、MMP-7、MMP-9联合应用诊断TNM分期的曲线下面积分别为0.993、0.993、0.948,均高于三者单独应用,差异均有统计学意义(均P<0.05);联合应用的诊断敏感性、特异性、准确率亦高于三者单独应用(均P<0.05)。结论FUS联合MMP-7、MMP-9可提高对术前胃癌分期的准确性,具有较好的临床应用价值。Objective To investigate the application value of gastric filling ultrasound(FUS)combined with serological indicators matrix metalloproteinase-7(MMP-7)and matrix metalloproteinase-9(MMP-9)in preoperative screening of different stages of gastric cancer.Methods Serum MMP-7,MMP-9 and FUS tests were performed in 82 patients with gastric cancer,the expressions of MMP-7 and MMP-9 in different degrees of the differentiation,the different depth of tumor invasion,and the expression in lymph node metastasis in patients with gastric cancers were analyzed.ROC curve was drawn to analyze the diagnostic efficacy of FUS,MMP-7,MMP-9 and their combined application on TNM staging according to pathology and“International Anti-Cancer Alliance and American Cancer Federation TNM Staging System(8th Edition)”.Results There were statistically significant differences in the expressions of MMP-7 and MMP-9 in patients with different TNM stages,and there were statistically significant differences in two at each stage(all P<0.05).The positive rates of MMP-7 and MMP-9 in poorly differentiated gastric cancer patients were higher than those in moderately and highly differentiated gastric cancer patients(all P<0.05),the positive rates of MMP-7 and MMP-9 in patients with lymph node metastasis were higher than those in patients without lymph node metastasis(all P<0.05),the positive rates of MMP-7 and MMP-9 in patients with muscle/serous infiltration depth were higher than those in patients with mucosal/submucosal infiltration depth(all P<0.05).ROC curve analysis showed that the area under the curve of FUS,MMP-7,MMP-9 combined application in the diagnosis of TNM staging were 0.993,0.993,0.948,respectively,which were higher than those of the three applications alone,and the differences were statistically significant(all P<0.05).The sensitivity,specificity and accuracy of the combined application were higher than those of the three alone(all P<0.05).Conclusion FUS combined with MMP-7 and MMP-9 can improve the accuracy of preoperative gastric cancer

关 键 词：胃充盈超声检查 基质金属蛋白酶-7 基质金属蛋白酶-9 胃癌 分期 

分 类 号：R445.1[医药卫生—影像医学与核医学] R735[医药卫生—诊断学]