幽门螺杆菌联合miR-26a、miR-663对老年胃癌癌前病变的诊断价值研究  

The diagnostic value of Helicobacter pylori combined with miR-26a and miR-663 for precancerous lesions of gastric cancer in elderly patients

作　　者：唐忠明[1] 姚林华[1] 陆会飞 朱晟易[1] TANG Zhongming;YAO Linhua;LU Huifei;ZHU Shengyi(Department of Gastroenterology,Huzhou First People's Hospital,Huzhou,Zhejiang 313000,China;不详)

机构地区：[1]湖州市第一人民医院消化内科,浙江313000

出　　处：《中国微生态学杂志》2024年第4期437-441,447,共6页Chinese Journal of Microecology

基　　金：湖州市科技计划项目(2021GY22)。

摘　　要：目的 探讨幽门螺杆菌联合微小RNA-26a(miR-26a)、微小RNA-663(miR-663)对老年胃癌癌前病变的诊断价值,为该病的诊断提供参考。方法 选择2022年9月至2023年8月湖州市第一人民医院收治的经胃镜及病理学检查确诊的136例胃部良性病变、癌前病变或早期胃癌的老年患者作为研究对象。采用实时荧光定量聚合酶链式反应检测其血清miR-26a、miR-663的表达,并采用13C尿素呼气试验检测患者幽门螺杆菌阳性情况,分析miR-26a、mi R-663和幽门螺杆菌及联合检测对胃良性病变、癌前病变及早期胃癌的诊断价值,同时绘制ROC曲线,评估其诊断准确性。结果 胃良性病变、癌前病变、早期胃癌患者性别、年龄、体质量指数、吸烟史、饮酒史差异均无统计学意义(均P>0.05)。胃癌前病变和早期胃癌患者胃癌家族史高于胃良性病变患者(均P<0.05),但癌前病变和早期胃癌患者胃癌家族史差异无统计学意义(P>0.05)。胃癌前病变和早期胃癌患者血清miR-26a、miR-663表达量均低于胃良性病变患者(均P<0.05)。早期胃癌患者血清mi R-26a、miR-663表达量均低于癌前病变患者,幽门螺杆菌阳性率高于胃良性病变患者(均P<0.05)。癌前病变和早期胃癌患者幽门螺杆菌阳性率差异无统计学意义(P>0.05)。联合检测的灵敏度显著高于单一miR-26a检测(χ^(2)=4.680,P=0.031)、单一miR-663检测(χ^(2)=8.223,P=0.004)、单一幽门螺杆菌检测(χ^(2)=6.363, P=0.012)。血清miR-26a截断值为2.63, ROC曲线下面积为0.79(95%CI:0.774~0.856),敏感度和特异度分别为75.43%和79.85%。血清miR-663截断值为4.35, ROC曲线下面积为0.83(95%CI:0.796~0.875),敏感度和特异度分别为81.37%和78.56%。幽门螺杆菌ROC曲线下面积为0.72(95%CI:0.648~0.769),敏感度和特异度分别为68.93%和78.45%。三者联合诊断的ROC曲线下面积为0.89(95%CI:0.815~0.873),敏感度和特异度分别为89.72%和74.43%。结论 幽门螺杆菌联合miR-26a�Objective To explore and analyze the diagnostic value of Helicobacter pylori combined with microRNA-26a (miR-26a) and microRNA-663 (miR-663) for precancerous lesions of gastric cancer in elderly patients, providing a reference for the diagnosis. Methods A total of 136 elderly patients with benign gastric lesions, precancerous lesions, or early gastric cancer diagnosed through gastroscopy and pathological examination admitted to our hospital from September 2022 to August 2023 were selected as the subjects. Real time fluorescence quantitative polymerase chain reaction was used to detect the expression of miR-26a and miR-663 in their sera, and 13C urea breath test was used to detect the positivity of Helicobacter pylori. The diagnostic value of miR-26a, miR-663, Helicobacter pylori, and their combined detection for different degrees of gastric benign lesions, precancerous lesions, and early gastric cancer was analyzed, and ROC curves were drawn to evaluate their diagnostic accuracy. Results There were no statistically significant differences in gender, age, body mass index, smoking history, and drinking history among patients with benign gastric lesions, precancerous lesions, and early gastric cancer (all P>0.05). The family history of gastric cancer in patients with precancerous lesions and early gastric cancer was higher than that in patients with benign lesions (P<0.05), and there was no statistically significant difference in family history of gastric cancer between precancerous lesions and early gastric cancer patients (P>0.05). The expression levels of miR-26a and miR-663 in sera of patients with gastric precancerous lesions and early gastric cancer were lower than those of patients with gastric benign lesions. The expression levels of miR-26a and miR-663 in sera of patients with early gastric cancer were lower than those of patients with precancerous lesions, and the positive rate of Helicobacter pylori was higher than that of patients with gastric benign diseases (all P<0.05). There was no statistically sign

关 键 词：幽门螺杆菌 微小RNA-26a 微小RNA-663 胃癌癌前病变 诊断价值 

分 类 号：R573[医药卫生—消化系统]