血清脂肪酸合酶、上皮钙黏素、再生蛋白4水平在早期胃癌中的诊断价值及与淋巴结转移的关系  

Diagnostic value of serum fatty acid synthase,E-cadherin and REG4 levels in patients with early gastric cancer and their relationship with lymph node metastasis

作　　者：陈艳红[1] 谢云霞[1] 刘涛[2] CHEN Yanhong;XIE Yunxia;LIU Tao(Department of Operation,the First Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan 450052,China;Department of Gastrointestinal Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan 450052,China)

机构地区：[1]郑州大学第一附属医院手术部,河南郑州450052 [2]郑州大学第一附属医院胃肠外科,河南郑州450052

出　　处：《安徽医药》2022年第2期321-325,共5页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探讨血清脂肪酸合酶(FAS)、上皮钙黏素(E-cadherin)、再生蛋白4(REG4)水平在早期胃癌中的诊断价值及与淋巴结转移的关系。方法选取郑州大学第一附属医院2014年1月至2016年8月收治的胃癌病人88例作为观察组,其中淋巴结转移病人35例,无淋巴结转移病人53例,另选取同期胃良性疾病病人80例作为对照组。检测对比两组、有无淋巴结转移病人血清FAS、E-cadherin、REG4水平,分析各血清诊断价值及胃癌淋巴结转移的影响因素。随访3年,比较不同血清FAS、E-cadherin、REG4表达水平病人生存状况。结果观察组血清FAS[(62.38±20.79)ng/mL比(41.90±13.92)ng/mL]、REG4水平[(5.93±1.97)ng/mL比(3.06±1.00)ng/mL]高于对照组,E-cadherin水平低于对照组[(3.57±1.01)μg/mL比(8.36±2.78)μg/mL](P<0.001)。对于早期胃癌的诊断价值而言,E-cadherin AUC(0.793)>REG4(0.747)>FAS(0.735),三指标联合应用的价值更高,其灵敏度和特异度分别为93.18%(82/88)、93.75%(75/80)。有淋巴结转移病人血清FAS、REG4水平高于无淋巴结转移病人,E-cadherin水平低于无淋巴结转移病人(P<0.001)。低分化、肿瘤最大径≥5 cm、黏膜下癌、血清FAS≥62.38 ng/mL、E-cadherin≤3.57μg/mL、REG4≥5.93 ng/mL是胃癌淋巴结转移的重要影响因素(P<0.05)。随访3年,FAS、E-cadherin、REG4高表达组、低表达组生存曲线对比,差异有统计学意义(P<0.05)。结论血清FAS、E-cadherin、REG4水平可考虑作为诊断胃癌的潜在有效肿瘤标志物,其水平异常表达是胃癌淋巴结转移的独立危险因素。Objective To investigate the diagnostic value of serum fatty acid synthase(FAS),E-cadherin(E-cadherin),and regenerating islet-derived 4(REG4)levels in patients with early gastric cancer(EGC)and their relationship with lymph node metastasis.Methods Eighty-eight patients with EGC who were treated in the First Affiliated Hospital of Zhengzhou University from January 2014 to August 2016 were selected as the observation group,including 35 patients with lymph node metastasis,53 patients without lymph node metastasis,and 80 patients with early gastric cancer during the same period were selected as the control group.Serum levels of FAS,E-cadherin,and REG4 in patients with and without lymph node metastasis were compared in the two groups,the diagnostic value of each serum and the influencing factors of EGC lymph node metastasis were analyzed.Follow-up for 3 years,the survival status of patients with different serum FAS,E-cadherin,and REG4 levels were compared.Results Serum levels of FAS[(62.38±20.79)ng/mL vs.(41.90±13.92)ng/mL]and REG4[(5.93±1.97)ng/mL vs.(3.06±1.00)ng/mL]in the observation group were higher than those in the con⁃trol group,and E-cadherin levels were lower than those in the control group[(3.57±1.01)μg/mL vs.(8.36±2.78)μg/mL](P<0.001).For the diagnostic value of early gastric cancer:E-cadherin AUC(0.793)>REG4(0.747)>FAS(0.735),the combined application of the three indicators had higher value,and its sensitivity and specificity were 93.18%(82/88)and 93.75%(75/80),respectively.Serum FAS and REG4 levels of patients with lymph node metastasis were higher than those without lymph node metastasis,and E-cadherin levels were lower than those without lymph node metastasis(P<0.001).Poorly differentiated,tumor diameter≥5 cm,submucosal cancer,serum FAS≥62.38 ng/mL,E-cadherin≤3.57μg/mL,REG4≥5.93 ng/mL were important influencing factors of lymph node metastasis in EGC(P<0.05).After 3 years of follow-up,the survival curves of FAS,E-cadherin,and REG4 high expression groups and low expression groups were

关 键 词：胃肿瘤 早期诊断 脂肪酸合酶 上皮钙黏素 再生蛋白4 淋巴结转移 

分 类 号：R735.2[医药卫生—肿瘤]