伴Hp感染胃癌前病变血清PGⅠ/PGⅡ、sHLA-G、CCL20水平及与胃癌转化的关系  

Changes of serum PGⅠ/PGⅡ,sHLA-G and CCL20 in gastric precancerous lesions patients complicated with Hp infection and association with gastric cancer transformation

作　　者：靳玉红[1] 宋世义 范颖英[1] 齐红[1] 张利利[1] 常廷民[1] JIN Yu-hong;SONG Shi-yi;FAN Ying-ying;QI Hong;ZHANG Li-li;CHANG Ting-min(The First Affiliated Hospital of Xinriang Medical University,Xinriang,Henan 453000,China)

机构地区：[1]新乡医学院第一附属医院消化内镜科,河南新乡453000

出　　处：《中华医院感染学杂志》2024年第14期2168-2172,共5页Chinese Journal of Nosocomiology

基　　金：河南省医学科技攻关计划基金资助项目(LHGJ20220632)。

摘　　要：目的探究伴幽门螺杆菌(Hp)感染胃癌前病变患者血清胃蛋白酶原Ⅰ/胃蛋白酶原Ⅱ(PGⅠ/PGⅡ)、可溶性人白细胞抗原G(sHLA-G)、CC趋化因子配体20(CCL20)水平及与胃癌转化的关系.方法选取2022年8月-2023年8月新乡医学院第一附属医院118例接受胃镜检查的Hp感染患者,根据胃镜病理诊断结合相关血清学水平分为癌前状态组65例、癌前病变组37例和胃癌组16例,检测并比较三组患者血清PGⅠ/PGⅡ、sHLA-G、CCL20水平差异,分析各检查指标之间的关系及与胃癌转化的关系.结果胃癌组血清PGⅠ/PGⅡ低于癌前病变组、癌前状态组,血清sHLA-G、CCL20水平高于癌前病变组、癌前状态组;癌前病变组血清PGⅠ/PGⅡ低于癌前状态组,血清sHLA-G、CCL20水平高于癌前状态组(P<0.05);Hp感染患者血清PGⅠ/PGⅡ水平与sHLA-G、CCL20水平呈负相关(P<0.05),血清sHLA-G水平与CCL20水平呈正相关(P<0.05);血清PGⅠ/PGⅡ、sHLA-G、CCL20在胃癌筛查中的受试者工作特征(ROC)曲线下面积(AUC)分别为0.730、0.835、0.869,三指标联合筛查胃癌的曲线下面积为0.927,敏感度93.75%,特异度75.49%.结论PGⅠ/PGⅡ、sHLA-G、CCL20参与伴Hp感染胃癌前病变向胃癌转化过程,可检测患者血清PGⅠ/PGⅡ、sHLA-G、CCL20用于胃癌诊断.OBJECTIVE To explore the changes of serum pepsinogenⅠ/pepsinogenⅡ(PGⅠ/PGⅡ),soluble hu-man leukocyte antigen G(sHLA-G)and CC chemokine ligand 20(CCL20)in the gastric precancerous lesions pa-tients complicated with Helicobacter pylori(Hp)infection and analyze the association with gastric cancer trans-formation.METHODS Totally 118 patients with Hp infection who received gastroscopy in the First Affiliated Hos-pital of Xinxiang Medical University from Aug 2022 to Aug 2023 were enrolled in the study and were divided into the precancerous state group with 65 cases,the precancerous lesion group with 37 cases and the gastric cancer group with 16 cases according to the gastroscopic pathological diagnosis combined with serological indexes.The levels of serum PGⅠ/PGⅡ,sHLA-G and CCL20 were detected and compared among the three groups of patients,the relationship among the in-dexes and the association with gastric cancer transformation were analyzed.RESULTS The serum PGⅠ/PGⅡlevel of the gastric cancer group was lower than that of the precancerous lesion group and the precancerous state group,while the levels of serum sHLA-G and CCL20 of the gastric cancer group were higher than those of the precancer-ous lesion group and the precancerous state group;the serum PGⅠ/PGⅡlevel of the precancerous lesion group was lower than that of the precancerous state group,and the levels of serum sHLA-G and CCL20 of the precan-cerous lesion group were higher than those of the precancerous state group(P<0.05).The serum PGⅠ/PGⅡlev-el of the patients with Hp infection was negatively correlated with the serum sHLA-G and CCL20 levels(P<0.05),and the serum sHLA-G level was positively correlated with the CCL20 level(P<0.05).The areas under receiver operating characteristic(ROC)curves(AUCs)of the serum PGⅠ/PGⅡ,sHLA-G and CCL20 were re-spectively 0.730,0.835 and 0.869 in screening of gastric cancer,and the AUC of the joint detection of the three in-dexes was 0.927,with the sensitivity 93.75%,the specificity 75.49%.CONCLUSION

关 键 词：幽门螺杆菌感染 胃癌 癌前病变 胃蛋白酶原Ⅰ/胃蛋白酶原Ⅱ 可溶性人白细胞抗原G CC趋化因子配体20 

分 类 号：R735.2[医药卫生—肿瘤]