血清TGF-β、CCL20、IFN-γ对胃癌前病变与胃癌的联合鉴别诊断价值及与病情进展的关系  

Value of serum TGF-β,CCL20,and IFN-γin combination for the differential diagnosis between precancerous lesions and gastric cancer and their relationship with disease progression

作　　者：邓亚男 谢媛媛[1] 李文君 倪猛[1] DENG Ya-nan;XIE Yuan-yuan;LI Wen-jun;NI Meng(Department of Gastroenterology 1,Department of Scientific Research,Nanyang 473000,Henan,CHINA;Nanyang Central Hospital,Nanyang 473000,Henan,CHINA)

机构地区：[1]南阳市中心医院消化内科一病区,河南南阳473000 [2]南阳市中心医院科研科,河南南阳473000

出　　处：《海南医学》2025年第3期311-316,共6页Hainan Medical Journal

基　　金：河南省南阳市2022年科技发展计划项目(编号:KJGG100)。

摘　　要：目的探讨血清转化生长因子-β(TGF-β)、CC趋化因子配体20(CCL20)、干扰素γ(IFN-γ)对胃癌前病变与胃癌的联合鉴别诊断价值及与病情进展的关系。方法选取2020年8月至2023年1月南阳市中心医院收治的103例胃癌患者作为癌变组,103例胃癌前病变患者作为癌前病变组,比较两组患者的血清TGF-β、CCL20、IFN-γ水平,采用受试者工作特征(ROC)曲线分析血清TGF-β、CCL20、IFN-γ对胃癌前病变与胃癌的诊断价值,采用相对危险度分析血清TGF-β、CCL20、IFN-γ与胃癌发生风险的关系,并比较癌变组不同病理特征患者的血清TGF-β、CCL20、IFN-γ水平,采用Spearman相关系数分析血清TGF-β、CCL20、IFN-γ与胃癌病理特征的相关性。结果癌变组患者的血清TGF-β、CCL20水平分别为(40.78±6.44)pg/mL、(44.53±9.18)pg/mL,明显高于癌前病变组的(31.19±4.81)pg/mL、(33.76±6.47)pg/mL,IFN-γ水平为(31.47±10.03)μg/L,明显低于癌前病变组的(50.68±16.22)μg/L,差异均有统计学意义(P<0.05);ROC曲线分析结果显示,血清TGF-β、CCL20、IFN-γ诊断胃癌前病变与胃癌的AUC为0.796、0.806、0.810,联合诊断的AUC为0.905,敏感度为84.47%,特异度为83.50%,明显优于各指标单独诊断(P<0.05);相对危险度分析结果显示,血清TGF-β、CCL20β高表达患者的胃癌发生风险分别是低表达患者的2.758倍、3.101倍,IFN-γ低表达患者胃癌发生风险是高表达患者的2.668倍,差异均有统计学意义(P<0.05);临床分期Ⅲ~Ⅳ期患者血清TGF-β、CCL20水平明显高于Ⅰ~Ⅱ期患者,IFN-γ水平明显低于Ⅰ~Ⅱ期患者,差异均有统计学意义(P<0.05);有淋巴结转移患者血清TGF-β、CCL20水平高于无淋巴结转移患者,IFN-γ水平明显低于无淋巴结转移患者,差异均有统计学意义(P<0.05);低分化患者血清TGF-β、CCL20水平明显高于中高分化患者,IFN-γ水平明显低于中高分化患者,差异均有统计学意义(P<0.05);Spearman相关性分析结果显示,血Objective To explore the value of serum transforming growth factor-β(TGF-β),CC chemokine li-gand 20(CCL20),and interferon-γ(IFN-γ)in combination for the differential diagnosis of precancerous lesions and gastric cancer,as well as their relationship with disease progression.Methods A total of 103 patients with gastric cancer from August 2020 to January 2023 in Nanyang Central Hospital were selected as the cancer group,and 103 patients with precancerous lesions of gastric cancer were selected as the precancerous lesion group.The levels of serum TGF-β,CCL20,and IFN-γof patients were compared between the two groups.Receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of serum TGF-β,CCL20,and IFN-γfor precancerous lesions and gastric cancer.Relative risk analysis was used to analyze the relationship between serum levels of TGF-β,CCL20,and IFN-γand the risk of gastric cancer.The levels of serum TGF-β,CCL20,and IFN-γwere compared among patients with different pathological characteristics in the cancer group.The correlation between serum TGF-β,CCL20,IFN-γand pathological characteristics of gastric cancer was analyzed using Spearman correlation coefficient.Results The levels of serum TGF-βand CCL20 in the cancer group were(40.78±6.44)pg/mL and(44.53±9.18)pg/mL,respectively,which were sig-nificantly higher than(31.19±4.81)pg/mL and(33.76±6.47)pg/mL in the precancerous lesion group,respectively;the level of IFN-γwas 31.47±10.03μg/L,which was significantly lower than 50.68±16.22μg/L in the precancerous lesion group;the differences were statistically significant(P<0.05).ROC curve analysis showed that the AUC of serum TGF-β,CCL20,and IFN-γfor the diagnosis of precancerous lesions and gastric cancer was 0.796,0.806,and 0.810,respectively.The AUC of TGF-β,CCL20,and IFN-γin combination for diagnosis was 0.905,with a sensitivity of 84.47%and a specificity of 83.50%,which was significantly better than each indicator alone(P<0.05).The relative risk analysis showed that the

关 键 词：胃癌 胃癌前病变 转化生长因子-Β CC趋化因子配体20 干扰素Γ 诊断价值 病理特征 

分 类 号：R735.2[医药卫生—肿瘤]