胃镜活检组织Ki67和E-Cad水平预测胃癌淋巴结转移的临床 价值  

Clinical value of Ki67 and E-Cad detection of gastroscopic biopsy tissue in predicting gastric cancer lymph node metastasis

作　　者：刘敏 王菡 饶卉明 谢华平 LIU Min;WANG Han;RAO Hui-ming;XIE Hua-ping(Department of Gastroenterology,the People's Hospital of Sanya,Hainan Sanya 572000,China;Department of Pathology,the People's Hospital of Sanya,Hainan Sanya 572000,China;Department of Gastroenterology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Hubei Wuhan 430030,China)

机构地区：[1]三亚市人民医院消化内科,海南三亚572000 [2]三亚市人民医院病理科,海南三亚572000 [3]华中科技大学同济医学院附属同济医院消化内科,湖北武汉430030

出　　处：《内科急危重症杂志》2023年第3期208-212,共5页Journal of Critical Care In Internal Medicine

基　　金：海南省卫生健康行业科研项目(No:21A200430)。

摘　　要：目的:探讨胃镜活检组织中Ki67和E-Cad对胃癌诊断及淋巴结转移的评估价值。方法:采用免疫组织化学检测在60例浅表性胃炎、60例萎缩性胃炎及180例胃癌内镜活检组织中Ki67和E-Cad的表达,并按胃癌的临床病理特征分类统计。采用单因素方差分析、卡方检验、Z检验分析显著性,Spearman系数分析相关性,受试者工作特征(ROC)曲线分析临床价值。结果:在胃癌组织和胃炎组织中Ki67和E-Cad阳性表达率存在明显差异(P均<0.01),其中Ki67表达在浅表性胃炎、萎缩性胃炎和胃癌活检组织中逐次上升(18.3%vs 31.7%vs 77.2%),而E-Cad呈现逐次下降(98.3%vs 84.6%vs 37.8%);在有无淋巴结转移的2组胃癌患者之间Ki67和E-Cad表达率存在明显差异(P均<0.01);Ki67联合E-Cad检测预测淋巴结转移的预测值与实际值呈现强相关性(r=0.707);Ki67和E-Cad联合预测在准确度、灵敏度、特异性、阳性及阴性预测值、假阳性及假阴性率等方面皆优于单独预测(P均<0.05),且两者联合预测的ROC曲线下面积明显高于单独Ki67或E-Cad预测(P均<0.01)。结论:Ki67和E-Cad胃癌诊断联合检测对判定和评估胃癌淋巴结转移可能具有参考价值。Objective:To investigate the value of Ki67 and E-Cad detection of gastroscopic biopsy tissue for the diagnosis of gastric cancer and lymph node metastasis.Methods:The expression of Ki67 and E-Cad in endoscopic biopsies of 60 cases of chronic superficial gastritis,60 cases of chronic atrophic gastritis and 180 cases of gastric cancer was detected by immunohistochemistry,and classified statistically according to the clinicopathological characteristics of gastric cancer.One-way ANOVA,chi-square test and Z-test were used to analyze significance.The Spearman coefficient was used to analyze correlation,and the receiver operating characteristic(ROC)curve was used to analyze clinical value.Results:There were significant differences in Ki67 and E-Cad positive expression rates between gastric cancer tissues and gastritis tissues(P<0.01),of which Ki67 increased successively in chronic superficial gastritis,chronic atrophic gastritis and gastric cancer cases(18.3%vs.31.7%vs.77.2%),while E-Cad showed a gradual decrease in contrast(98.3%vs.84.6%vs.37.8%).There were significant differences in the expression rates of Ki67 and E-Cad between the two groups of gastric cancer patients with or without lymph node metastasis(both P<0.01).The predicted value of lymph node metastasis by Ki67 combined with E-Cad detection showed a strong correlation with the actual value(r=0.707).The combined prediction of Ki67 and E-Cad outperformed the prediction alone in terms of accuracy,sensitivity,specificity,positive and negative predictive values,false positive and false negative rates(all P<0.05),and the area under the ROC curve predicted by the two was significantly higher than that of Ki67 or E-Cad alone(both P<0.01).Conclusion:In the diagnosis of gastric cancer,the combined detection of Ki67 and E-Cad may have reference value for the determination and evaluation of gastric cancer lymph node metastasis.

关 键 词：胃癌 KI67 E-CAD 萎缩性胃炎 浅表性胃炎 淋巴结转移 

分 类 号：R735.2[医药卫生—肿瘤]