CST4、HP抗体分型及HER2在胃癌中的表达及其诊断价值  

CST4,HP antibody typing and expression of HER2 in gastric cancer and their clinical significance

作　　者：金水[1] 王瑞[2] 张丹丹 路亮[1] Jin Shui;Lu Liang;Wang Rui;Zhang Dandan(Dept of Gastroenterology,Chaohu Affiliated Hospital of Anhui Medical University,Chaohu 238000;Dept of Pathology,Chaohu Affiliated Hospital of Anhui Medical University,Chaohu 238000)

机构地区：[1]安徽医科大学附属巢湖医院消化内科,巢湖238000 [2]安徽医科大学附属巢湖医院病理科,巢湖238000

出　　处：《安徽医科大学学报》2024年第12期2229-2236,共8页Acta Universitatis Medicinalis Anhui

基　　金：安徽省高校自然科学研究重点项目(编号:2023AH050581);安徽医科大学校科研基金项目(编号:2022xkj208)。

摘　　要：目的探讨人半胱氨酸蛋白酶抑制剂S(CST4)、幽门螺杆菌(HP)抗体分型及人表皮生长因子受体2(HER2)在胃癌患者中的表达及其对于预测胃癌淋巴结转移和TNM分期的预测价值。方法选取2021年12月至2023年12月入住安徽医科大学附属巢湖医院接受手术的150例胃癌患者作为研究对象,术前行血清CST4及HP抗体分型检测,术后采用免疫组化检测胃癌组织中HER2表达水平。比较不同血清CST4、HP抗体分型及HER2表达的胃癌患者手术后临床病理资料并进行相关性分析。通过ROC曲线比较血清CST4、HP抗体分型及HER2表达单项及联合检测对于胃癌淋巴结转移及TNM分期的预测价值。结果CST4、HPI型及HER2阳性表达患者的肿瘤浸润深度更深,更易发生远处淋巴结转移,TNM分期更高(P<0.05),同时CST4阳性表达患者肿瘤更易发生脉管和神经侵犯(P<0.05),HPI型阳性表达患者肿瘤多发生于贲门、胃底部,且肿瘤直径较大、更易侵犯脉管(P<0.05),而HER2与肿瘤分化程度呈负相关,多发生高中分化肿瘤(P<0.05)。ROC曲线分析显示,患者血清CST4、HPI型及HER2表达单项及联合检测预测胃癌淋巴结转移的AUC分别为0.780、0.676、0.611和0.872(P<0.05),诊断胃癌TNM分期的AUC分别为0.762、0.635、0.613和0.801(P<0.05),联合检测的诊断效能均高于各单项检测。结论血清CST4、HPI型及HER2表达与肿瘤浸润深度、淋巴结转移、TNM分期密切相关,血清CST4、HPI型和HER2表达可作为胃癌患者有无淋巴结转移及TNM分期的重要预测指标,为临床诊断提供新的思路。Objective To investigate the expression of human cysteine protease inhibitor S(CST4),Helicobacter pylori(HP)antibody typing and human epidermal growth factor receptor 2(HER2)in patients with gastric cancer and its predictive value for lymph node metastasis and TNM staging of gastric cancer.Methods A total of 150 gastric cancer patients admitted to Chaohu Hospital Affiliated to Anhui Medical University for surgery from December 2021 to December 2023 were selected as the study objects.Serum CST4 and HP antibody typing were performed before surgery,and HER2 expression levels in gastric cancer tissues were detected by immunohistochemistry after surgery.The clinicopathological data of gastric cancer patients with different serum CST4,HP antibody types and HER2 expression were compared and the correlation was analyzed.ROC curve was used to compare the predictive value of single and combined detection of serum CST4,HP antibody typing and HER2 expression in lymph node metastasis and TNM staging of gastric cancer.Results Patients with CST4,HPI and HER2-positive expression had deeper tumor invasion and were more likely to develop distant lymph node metastasis,and TNM stages were more likely to occur inⅢandⅣstages(P<0.05).Meanwhile,patients with CST4 positive expression were more likely to have vascular and nerve invasion(P<0.05).In patients with HPI positive expression,tumors were more likely to occur in the cardia and the bottom of the stomach,and the tumor diameter was larger and vascular invasion was more likely(P<0.05),while HER2 was negatively correlated with the degree of tumor differentiation,and the tumors were more likely to occur in high and secondary differentiation(P<0.05).ROC curve analysis showed that the AUC of single and combined detection of serum CST4,HPI and HER2 expression to predict lymph node metastasis of gastric cancer were 0.780,0.676,0.611 and 0.872,respectively(P<0.05).The AUC for TNM stage diagnosis of gastric cancer were 0.762,0.635,0.613 and 0.801(P<0.05),respectively.The diagnostic effici

关 键 词：人半胱氨酸蛋白酶抑制剂S 幽门螺杆菌抗体分型 人表皮生长因子受体2 胃癌 病理分期 胃癌淋巴结转移 

分 类 号：R446.11[医药卫生—诊断学]