血清三叶因子3、胃泌素17、膜联蛋白A7联合检测对胃癌及癌前病变的临床诊断价值  

Clinical diagnostic value of combined detection of serum trefoil factor 3,gastrin 17 and annexin A7 in gastric cancer and precancerous lesions

作　　者：颜红芳[1] 周吕蒙 梁华[3] 罗俊[4] 杨兴萍[1] YAN Hongfang;ZHOU Lyumeng;LIANG Hua;LUO Jun;YANG Xingping(Department of Hospital Infection Control,General Hospital of Panzhihua Iron&Steel Group,Panzhihua,Sichuan 617023,China;Laboratory Department,General Hospital of Panzhihua Iron&Steel Group,Panzhihua,Sichuan 617023,China;Department of Traditional Chinese Medicine,General Hospital of Panzhihua Iron&Steel Group,Panzhihua,Sichuan 617023,China;Department of Respiratory Medicine,General Hospital of Panzhihua Iron&Steel Group,Panzhihua,Sichuan 617023,China)

机构地区：[1]攀钢集团总医院院感科,四川攀枝花617023 [2]攀钢集团总医院检验科,四川攀枝花617023 [3]攀钢集团总医院中医科,四川攀枝花617023 [4]攀钢集团总医院呼吸内科,四川攀枝花617023

出　　处：《安徽医药》2021年第10期2057-2060,共4页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探讨血清三叶因子3(TFF3)、胃泌素-17(G-17)联合膜联蛋白A7(ANXA7)对胃癌及癌前病变的临床诊断价值。方法2018年1月至2019年12月选取攀枝花市攀钢集团总医院收治的经病理组织学确诊为胃部病变病人168例,另选取60例健康体检者为对照组,采用酶联免疫吸附测定法(ELISA)测定各组血清TFF3、G-17、ANXA7水平,并应用受试者特异性曲线(ROC)分析血清TFF3、G-17、ANXA7在胃癌及癌前病变临床诊断中的应用价值。结果低级别上皮内瘤变(LGIN)组、高级别上皮内瘤变(HGIN)组及胃癌组血清TFF3、G-17、ANXA7水平[TFF3(38.25±4.10)μg/L比(52.92±5.26)比(78.36±6.89);G-17(14.85±3.26)mmol/L比(23.69±4.58)mmol/L比(35.96±5.85)mmol/L;ANXA7(22.36±3.96)μg/L比(38.96±4.89)μg/L比(52.36±6.25)μg/L]明显高于萎缩性胃炎、浅表胃炎组及对照组[TFF3:(14.58±3.22)μg/L比(14.85±2.73)比(14.15±2.10);G-17(8.69±1.36)mmol/L比(8.16±1.18)mmol/L比(8.12±1.02)mmol/L;ANXA7(10.78±1.78)μg/L比(10.26±1.26)μg/L比(10.12±1.26)μg/L](P<0.05)。不同TNM分期、分化程度及淋巴结转移胃癌组病人血清TFF3、G-17、ANXA7水平差异有统计学意义(P<0.05)。经ROC曲线分析可知,血清TFF3、G-17、ANXA7诊断胃癌及癌前病变的AUC(95%CI)分别为0.844(0.731-0.974)、0.717(0.558-0.921)、0.748(0.578-0.968)。联合应用的诊断价值更高,AUC(95%CI)为0.880(0.823-0.941),灵敏度和特异度分别为0.903、0.872。结论血清TFF3、G17、ANXA7水平与胃组织癌前期病变,胃癌分期、分化程度以及淋巴结转移密切相关,可作为胃癌病人预后的评价指标,联合应用可提高其诊断效能。Objective To explore the clinical diagnostic value of combined detection of serum trefoil factor 3(TFF3),gastrin 17(G-17)and annexin A7(ANXA7)in gastric cancer and precancerous lesions.Methods A hundred and sixty-eight cases of patients with gastric lesions diagnosed by gastroscopy in General Hospital of Panzhihua Iron&Steel Group from January 2018 to December 2019 were enrolled in the study.Another 60 healthy subjects were selected as the control group.The expression levels of serum TFF3,G-17,and ANXA7 of each group were determined by the enzyme-linked immunosorbent assay(ELISA).The value of serum TFF3,G-17,ANXA7 in the clinical diagnosis of gastric cancer was analyzed by receiver operating characteristic curve(ROC).Results The levels of TFF3,G-17 and ANXA7 in low-grade intraepithelial neoplasia(LGIN)group,high-grade intraepithelial neoplasia(HGIN)group and gastric cancer group[TFF3:(38.25±4.10),(52.92±5.26)and(78.36±6.89);G-17:(14.85±3.26)mmol/L,(23.69±4.58)mmol/L and(35.96±5.85)mmol/L;ANXA7:(22.36±3.96)μg/L,(38.96±4.89)μg/L and(52.36±6.25)μg/L]were significantly higher than gastritis group,superficial gastritis and the control group[TFF3:(14.58±3.22),(14.85±2.73)and(14.15±2.10);G-17:(8.69±1.36)mmol/L,(8.16±1.18)mmol/L and(8.12±1.02)mmol/L;ANXA7:(10.78±1.78)μg/L,(10.26±1.26)p g/L and(10.12±1.26)p g/L](P<0.05).There were significant differences in serum TFF3,G-17 and ANXA7 levels among patients with different TNM stage,degree of differentiation and lymph node metastasis(P<0.05).ROC curve analysis results showed that the AUC(95%CI)of serum TFF3,G-17 and ANXA7 in the diagnosis of gastric cancer and precancerous lesions were 0.844(0.731-0.974),0.717(0.558-0.921)and 0.748(0.578-0.968),respectively.Combined application was of higher diagnostic value,with an AUC(95%CI)of 0.880(0.823-0.941),sensitivity and specificity of 0.903 and 0.872,respectively.Conclusion The levels of serum TFF3,G-17 and ANXA7 are closely related to the progression of gastric precancerous lesions,TNM stage of gastric cancer,

关 键 词：胃肿瘤 癌症早期检测 三叶因子3 胃泌素-17 膜联蛋白A7 癌前状态 

分 类 号：R735.2[医药卫生—肿瘤]