胃息肉切除术前GAS、MTL、PGs及Ghrelin水平特征对术后胃息肉复发的预测价值  

Predictive value of GAS,MTL,PGs and Ghrelin levels before resection of gastric polyps on postoperative recurrence of gastric polyps

作　　者：杨玲和 张梦霞 乔琨 高峰[1] Yang Linghe;Zhang Mengxia;Qiao Kun;Gao Feng(Department of Gastroenterology,People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830000,China)

机构地区：[1]新疆维吾尔自治区人民医院消化内科/新疆消化系统疾病临床医学研究中心,乌鲁木齐830000

出　　处：《疑难病杂志》2024年第8期929-933,共5页Chinese Journal of Difficult and Complicated Cases

摘　　要：目的探讨胃息肉切除术前胃泌素(GAS)、胃动素(MTL)、胃蛋白酶原(PGs)及胃饥饿素(Ghrelin)水平对术后胃息肉复发的预测价值。方法选择2019年5月—2021年12月新疆维吾尔自治区人民医院消化内科诊治胃息肉切除术后患者128例作为研究对象,患者均在术后持续随访2年,根据胃息肉是否复发划分为未复发组(n=86)和复发组(n=42)。检测并比较2组患者手术治疗前GAS、MTL、PGs及Ghrelin等胃肠激素水平;通过Spearman相关性分析、单因素及多因素Logistic回归分析筛选出胃息肉患者术后复发的独立危险因素,并通过受试者工作特征(ROC)曲线评估各危险因素独立及联合预测胃息肉复发的价值。结果复发组患者内镜下手术时间、存在多个胃息肉比例、最大胃息肉直径>2 cm比例均显著高于未复发组(Z/χ^(2)/P=3.453/0.001、5.965/0.015、7.342/0.007);术前血清GAS、MTL、PGⅠ、PGⅡ及Ghrelin均显著高于未复发组患者(t/P=7.736/<0.001、5.984/<0.001、6.326/<0.001、6.420/<0.001、6.326/<0.001);Spearman相关性分析表明,胃息肉切除术治疗患者内镜下手术时间、存在多个胃息肉、最大胃息肉直径>2 cm、血清GAS、MTL、PGⅠ、PGⅡ及Ghrelin均与术后胃息肉复发呈正相关(r/P=0.306/<0.001、0.216/0.014、0.239/0.006、0.563/<0.001、0.453/<0.001、0.486/<0.001、0.484/<0.001、0.458/<0.001);多因素Logistic回归分析发现,血清GAS、MTL、PGⅠ、PGⅡ及Ghrelin升高均是胃息肉术后患者疾病复发的重要独立危险因素[OR(95%CI)=1.394(1.086~1.789)、1.098(1.031~1.169)、1.081(1.026~1.139)、1.793(1.264~2.542)、1.059(1.007~1.114)];血清GAS、MTL、PGⅠ、PGⅡ、Ghrelin及五项联合预测胃息肉切除术后患者疾病复发的AUC分别为0.846、0.778、0.799、0.798、0.781及0.984,五项联合预测的价值大于各指标独立预测的价值(Z/P=3.014/<0.001、3.666/<0.001、3.354/<0.001、3.355/<0.001、3.462/<0.001)。结论胃息肉术后患者血清GAS、MTL、PGs及GObjective To explore the predictive value of preoperative gastrin(GAS),motilin(MTL),pepsinogen(PGs)and Ghrelin levels in postoperative recurrence of gastric polyps.Methods One hundred and twenty-eight patients who underwent gastric polypectomy at People's Hospital of Xinjiang Uygur Autonomous Region between May 2019 and December 2021 were included in this study.All patients were followed up for a duration of 2 years.Based on the recurrence of gastric polyps,they were categorized into two groups:non-recurrent group(n=86)and recurrent group(n=42).The general clinical information,as well as surgical and pathological data,were collected and compared between the two groups.Additionally,the levels of gastrointestinal hormones such as GAS,MTL,PGs,and Ghrelin were measured and compared prior to the operation.Spearman correlation analysis,univariate,and multivariate Logistic regression analysis were conducted to identify the risk factors for postoperative recurrence of gastric polyps.Furthermore,the independent and combined predictive value for gastric polyp recurrence was evaluated using a receiver operating characteristic(ROC)curve.Results The recurrent group showed significantly longer duration for endoscopic operations,a higher prevalence of multiple gastric polyps,and a higher proportion of patients with a maximum gastric polyp diameter>2cm compared to the non-recurrent group(Z/χ^(2)/P=3.453/0.001,5.965/0.015,7.342/0.007).Additionally,the average preoperative serum levels of GAS,MTL,PGⅠ,PGⅡ,and Ghrelin were significantly higher in the recurrent group compared to the non-recurrent group(t/P=7.736/<0.001,5.984/<0.001,6.326/<0.001,6.420//<0.001,6.326/<0.001).Spearman correlation analysis showed that endoscopic operation time,multiple gastric polyps,maximum diameter of gastric polyps>2 cm,serum GAS,MTL,PGⅠ,PGⅡand Ghrelin were positively correlated with postoperative recurrence of gastric polyps(r/P=0.306/<0.001,0.216/0.014,0.239/0.006,0.563/<0.001,0.453/<0.001,0.486/<0.001,0.484/<0.001,0.458/<0.001).Multivariate

关 键 词：胃息肉 胃肠激素 术后复发 预测价值 

分 类 号：R573[医药卫生—消化系统]