血清EGF联合VCAM-1对慢性萎缩性胃炎的诊断价值  

Diagnostic Value of Serum EGF Combined with VCAM-1 in Chronic Atrophic Gastritis

作　　者：王海燕 赵润根 朱壹澎 WANG Haiyan;ZHAO Rungen;ZHU Yipeng(Department of Gastroenterology,General Hospital of Pingmei Shenma Medical Group,Pingdingshan Henan 467000,China)

机构地区：[1]平煤神马医疗集团总医院消化内科,河南平顶山467000

出　　处：《河南医学高等专科学校学报》2023年第1期29-33,共5页Journal of Henan Medical College

摘　　要：目的探讨血清表皮生长因子(EGF)联合血管细胞黏附分子-1(VCAM-1)对慢性萎缩性胃炎的诊断价值。方法选取108例慢性萎缩性胃炎患者作为观察组,另选取120例同期体检的健康者作为对照组。根据疾病萎缩部位不同将观察组患者分为胃窦萎缩组(n=57)、全胃多灶萎缩组(n=27)、胃体萎缩组(n=24)。采用酶联免疫吸附法检测血清EGF、VCAM-1水平。采用受试者工作特征(ROC)曲线评估血清EGF、VCAM-1对慢性萎缩性胃炎的诊断价值,多因素logistic回归分析探讨影响慢性萎缩性胃炎发生的相关因素。结果2组患者嗜酒、家族胃病史、Hp感染、胆汁反流比较,差异有统计学意义(P<0.05)。对照组血清EGF水平高于观察组,VCAM-1水平低于观察组,差异有统计学意义(P<0.05)。与胃体萎缩组比较,全胃多灶萎缩组、胃窦萎缩组血清EGF水平依次升高,VCAM-1水平依次降低,差异有统计学意义(P<0.05)。血清EGF、VCAM-1诊断慢性萎缩性胃炎的曲线下面积(AUC)分别为0.765、0.827,截断值分别为279.97 ng·L^(-1)、100.04μg·L^(-1),特异度分别为54.43%、68.96%,敏感度分别为92.09%、92.09%,两者联合预测的AUC为0.909,特异度为86.25%,敏感度为85.47%。嗜酒≥3次/周、Hp感染、胆汁反流、EGF≤279.97 ng·L^(-1)、VCAM-1≥100.04μg·L^(-1)是慢性萎缩性胃炎的危险因素(P<0.05)。结论慢性萎缩性胃炎患者血清EGF水平降低、VCAM-1水平升高,二者能够作为预测慢性萎缩性胃炎发生的生物标志物,且联合预测效能更高。Objective To investigate the diagnostic value of serum epidermal growth factor(EGF)combined with vascular cell adhesion molecule-1(VCAM-1)in chronic atrophic gastritis.Methods 108 patients with chronic atrophic gastritis were selected as the observation group,and another 120 healthy persons were selected as the control group.The patients in the observation group were divided into gastric antrum atrophy group(n=57),whole stomach multifocal atrophy group(n=27),and gastric body atrophy group(n=24)according to the different atrophy sites of the disease.Serum EGF and VCAM-1 levels were detected by enzyme-linked immunosorbent assay.The diagnostic value of serum EGF and VCAM-1 in chronic atrophic gastritis was evaluated by the working characteristic(ROC)curve of subjects,and the related factors affecting the occurrence of chronic atrophic gastritis were explored by multivariate logistic regression analysis.Results There were significant differences in alcoholism,family history of stomach disease,Hp infection and bile reflux between the observation group and the control group(P<0.05).The level of serum EGF in the control group was higher than that in the observation group,and the level of VCAM-1 was lower than that in the observation group,with statistically significant differences(P<0.05).Compared with the gastric body atrophy group,the serum EGF level in the whole stomach multifocal atrophy group and the gastric antrum atrophy group increased in turn,and the VCAM-1 level decreased in turn,with statistically significant differences(P<0.05).The AUCs of serum EGF and VCAM-1 for the diagnosis of chronic atrophic gastritis were 0.765 and 0.827,with cut-off values of 279.97 ng·L^(-1)and 100.04 ng·L^(-1),respectively,and specificities of 54.43%and 68.96%,and sensitivities of 92.09%and 92.09%,respectively.The area under the curve(AUC)predicted by the combination of the above two was 0.909,with a specificity of 86.25%and a sensitivity of 85.47%.Alcohol consumption≥3 times/week,Hp infection,bile reflux,EGF≤279.97 ng·L^(-1

关 键 词：慢性萎缩性胃炎 表皮生长因子 血管细胞黏附分子-1 诊断价值 

分 类 号：R573.32[医药卫生—消化系统]