放大内镜结合VEGF、CD34及CD105等血管生成分子检测在早期食管癌诊断中的价值  

The value of magnifying staining endoscopy combined with detection of angiogenic molecules such as VEGF,CD34,and CD105 in the diagnosis of early esophageal cancer

作　　者：邱敏霞 陈文妹 孔灿灿[1] 毛苇[1] Qiu Minxia;Chen Wenmei;Kong Cancan;Mao Wei(Endoscopic Diagnosis and Treatment Center of Hainan Provincial People's Hospital,Hainan Province,Haikou 570311,China)

机构地区：[1]海南省人民医院内镜诊疗中心,海口570311

出　　处：《疑难病杂志》2023年第7期686-690,共5页Chinese Journal of Difficult and Complicated Cases

基　　金：海南省卫生健康行业科研项目(22A200004)。

摘　　要：目的探索放大内镜结合血管内皮生长因子(VEGF)、CD34及CD105等血管生成分子检测在早期食管癌诊断中的价值。方法选取2022年1月—2022年12月海南省人民医院内镜诊疗中心检出可疑早期食管癌或癌前病变患者152例,进行放大内镜下日本食管学会(JES)分型,并检测患者血清VEGF、CD34及CD105水平。利用R软件构建列线图模型,并利用受试者工作特征曲线(ROC)评估列线图和各血清学指标的诊断效能。结果152例可疑早期食管癌或癌前病变患者中放大内镜JES分型为A型80例(早癌11例)、B1型51例(早癌36例)、B2型14例(早癌10例)、B3型7例(早癌6例),利用放大内镜JES分型诊断食管早癌的敏感度为0.730,特异度为0.663;血清VEGF、CD34及CD105水平在炎性反应、轻度不典型增生、重度不典型增生、食管早癌患者中依次逐渐升高(F/P=1536.000/<0.001、1133.000/<0.001、3156.000/<0.001),其诊断食管早癌的曲线下面积(AUC)分别为0.821、0.772和0.687;放大内镜JES分型联合血清标志物列线图诊断模型的AUC为0.922。结论放大内镜JES分型联合VEGF、CD34及CD105等血清标志物可用于食管早癌诊断,其诊断准确度显著高于单一指标。Objective To explore the value of magnifying staining endoscopy combined with Vascular endothelial growth factor(VEGF),CD34,CD105 and other angiogenesis molecules in the diagnosis of early esophageal cancer.Method One hundred and fifty-two patients with suspected early esophageal cancer or precancerous lesions detected at the Endoscopic Diagnosis and Treatment Center of Hainan Provincial People's Hospital from January 2022 to December 2022 were selected for classification by the Japanese Esophageal Society(JES)under magnifying endoscopy,and their serum levels of VEGF,CD34,and CD105 were measured.Build a column chart model using R software,and evaluate the diagnostic efficacy of the column chart and various serological indicators using the receiver operating characteristic curve(ROC).Results Among 152 suspected early esophageal cancer or precancerous lesions patients,80 cases were classified as type A(11 cases of early cancer),51 cases as type B1(36 cases of early cancer),14 cases as type B2(10 cases of early cancer),and 7 cases as type B3(6 cases of early cancer).The sensitivity and specificity of JES classification using magnifying endoscopy for diagnosing early esophageal cancer were 0.730 and 0.663,respectively;Serum VEGF,CD34,and CD105 gradually increased in patients with inflammatory response,mild atypical hyperplasia,severe atypical hyperplasia,and early esophageal cancer(F/P=1536.000/<0.001,1133.000/<0.001,3156.000/<0.001),and their area under the curve(AUC)for diagnosing early esophageal cancer were 0.821,0.772,and 0.687,respectively;The AUC of the diagnostic model for JES typing combined with serum biomarker nomograms under magnifying endoscopy is 0.922.Conclusion The combination of magnifying endoscopy JES typing and serum markers such as VEGF,CD34,and CD105 can be used for the diagnosis of early esophageal cancer,and its diagnostic accuracy is significantly higher than a single indicator.

关 键 词：食管癌 早期 放大内镜 血管内皮生长因子 糖类抗原34 糖类抗原105 

分 类 号：R735.1[医药卫生—肿瘤]