国际肿瘤学杂志

国际肿瘤学杂志 ›› 2024, Vol. 51 ›› Issue (8): 498-503.doi: 10.3760/cma.j.cn371439-20240304-00083

• 论著 • 上一篇    下一篇

血清G-17、sB7-H3、DKK1检测对早期胃癌的诊断价值

刘文会1(), 殷平2, 戚洁2   

  1. 1中国人民解放军陆军第八十一集团军医院体检科，张家口 075000
    2中国人民解放军陆军第八十一集团军医院消化内科，张家口 075000
  • 收稿日期:2024-03-04 修回日期:2024-05-23 出版日期:2024-08-08 发布日期:2024-09-24
  • 通讯作者: 刘文会，Email：o41pre@163.com

Diagnostic value of detection of serum G-17，sB7-H3，and DKK1 for early gastric cancer

Liu Wenhui1(), Yin Ping2, Qi Jie2   

  1. 1Department of Medical Examination，Hospital of 81st Group Army of the Chinese People's Liberation Army，Zhangjiakou 075000，China
    2Department of Gastroenterology，Hospital of 81st Group Army of the Chinese People's Liberation Army，Zhangjiakou 075000，China
  • Received:2024-03-04 Revised:2024-05-23 Online:2024-08-08 Published:2024-09-24
  • Contact: Liu Wenhui，Email：o41pre@163.com

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摘要：

目的 探究血清促胃液素-17（G-17）、可溶性B7-H3（sB7-H3）、Dickkopf-1（DKK1）检测对早期胃癌（EGC）的诊断价值。方法 选取2021年4月至2023年4月中国人民解放军陆军第八十一集团军医院收治的95例EGC患者作为EGC组，95例胃炎患者作为胃炎组，95例健康体检者作为对照组。比较3组研究对象血清G-17、sB7-H3、DKK1水平及EGC组不同病理特征患者血清G-17、sB7-H3、DKK1水平。采用受试者操作特征（ROC）曲线分析血清G-17、sB7-H3、DKK1水平对EGC的诊断价值。采用多因素logistic回归分析EGC发生的危险因素。结果 对照组、胃炎组、EGC组幽门螺杆菌感染者比例分别为20.00%（19/95）、35.79%（34/95）、61.05%（58/95），差异有统计学意义（χ2=34.26，P<0.001），血清G-17水平分别为（6.98±0.55）、（8.39±0.95）、（9.46±1.38）pmol/L，差异有统计学意义（F=141.82，P<0.001），sB7-H3水平分别为（18.86±1.64）、（20.34±2.16）、（22.44±2.62）ng/ml，差异有统计学意义（F=64.86，P<0.001），DKK1水平分别为（12.87±1.96）、（14.75±2.09）、（6.93±2.24）ng/ml，差异具有统计学意义（F=88.95，P<0.001）。两两比较发现，对照组、胃炎组、EGC组幽门螺杆菌感染者比例依次升高，血清G-17、sB7-H3、DKK1水平均依次升高（均P<0.05）。不同血清G-17、sB7-H3、DKK1水平EGC患者的年龄、性别差异均无统计学意义(均P>0.05),肿瘤最大径(χ2=5.74,P=0.017;χ2=4.98,P=0.026;χ2=5.74,P=0.017）、肿瘤浸润（χ2=10.94，P=0.001;χ2=16.16,P<0.001;χ2=21.16,P<0.001）、淋巴结转移（χ2=6.75,P=0.009;χ2=10.68,P=0.001;χ2=4.74，P=0.029）、分化类型（χ2=7.00,P=0.008;χ2=4.26,P=0.039;χ2=27.18,P<0.001)差异均有统计学意义。ROC曲线分析发现，G-17、sB7-H3、DKK1诊断EGC的曲线下面积（AUC）分别为0.825、0.763、0.785，三者联合检测EGC的AUC为0.933，优于3项指标单独检测（Z=3.22，P=0.001；Z=4.94，P<0.001；Z=4.53，P<0.001）。多因素logistic回归分析显示，血清G-17（OR=3.82，95%CI为1.73~8.44，P<0.001）、sB7-H3（OR=3.96，95%CI为1.75~8.96，P<0.001）、DKK1（OR=3.85，95%CI为1.77~8.41，P<0.001）水平均为EGC发生的独立危险因素。结论 血清G-17、sB7-H3、DKK1对EGC有一定的辅助诊断价值，三项指标联合检测价值更高。

关键词: 胃肿瘤, 胃泌素类, 可溶性B7-H3, Dickkopf-1, 诊断

Abstract:

Objective To explore the diagnostic value of detection of serum gastrin-17 (G-17),soluble B7-H3 (sB7-H3),and Dickkopf-1 (DKK1) in early gastric cancer (EGC). Methods A total of 95 patients with EGC admitted to the Hospital of 81st Group Army of the Chinese People's Liberation Army from April 2021 to April 2023 were selected as the EGC group,95 gastritis patients as the gastritis group,and 95 healthy individuals as the control group. The serum levels of G-17,sB7-H3,and DKK1 were compared among the three groups of subjects,and serum G-17,sB7-H3 and DKK1 levels of patients with different pathological characteristics in EGC group were also compared. Receiver operator characteristic (ROC) curve was applied to analyze the diagnostic value of serum G-17,sB7-H3,and DKK1 levels for EGC. Multivariate logistic regression was applied to analyze the risk factors of EGC. Results The proportions of Helicobacter pylori infection in the control group,gastritis group,and EGC group were 20.00% (19/95),35.79% (34/95),and 61.05% (58/95),respectively,with a statistically significant difference (χ2=34.26,P<0.001). The serum G-17 levels were (6.98±0.55),(8.39±0.95),and (9.46±1.38) pmol/L,respectively,with a statistically significant difference (F=141.82,P<0.001). The levels of sB7-H3 were (18.86±1.64),(20.34±2.16),(22.44±2.62) ng/ml,respectively,with a statistically significant difference (F=64.86,P<0.001). The levels of DKK1 were (12.87±1.96),(14.75±2.09),(6.93±2.24) ng/ml,respectively,with a statistically significant difference (F=88.95,P<0.001). Pairwise comparison showed that the proportion of Helicobacter pylori infection in the control group,gastritis group and EGC group increased in turn,and the levels of serum G-17,sB7-H3 and DKK1 increased in turn (all P<0.05). There were no significant difference in age and gender between EGC patients with different serum G-17,sB7-H3 and DKK1 levels (all P>0.05),and there were statistically significant differences in tumor diameter (χ2=5.74,P=0.017; χ2=4.98,P=0.026; χ2=5.74,P=0.017),tumor invasion (χ2=10.94,P=0.001; χ2=16.16,P<0.001; χ2=21.16,P<0.001),lymph node metastasis (χ2=6.75,P=0.009; χ2=10.68,P=0.001; χ2=4.74,P=0.029) and differentiation type (χ2=7.00,P=0.008; χ2=4.26,P=0.039; χ2=27.18,P<0.001). ROC curve analysis showed that the area under the curve (AUC) of G-17,sB7-H3 and DKK1 in the diagnosis of EGC was 0.825,0.763 and 0.785,respectively. The AUC of the combined detection of the three indicators was 0.933,which was better than that of the three separate tests (Z=3.22, P=0.001; Z=4.94, P<0.001; Z=4.53, P<0.001). Multivariate logistic regression analysis showed that the levels of G-17(OR=3.82,95%CI: 1.73-8.44, P<0.001), sB7-H3(OR=3.96, 95%CI:1.75-8.96, P<0.001), DKK1(OR=3.85, 95%CI:1.77-8.41,P<0.001) were the independent risk factors of EGC. Conclusion Serum G-17,sB7-H3,and DKK1 have certain auxiliary diagnostic value of three indexes for EGC,and the combined detection value is higher.

Key words: Stomach neoplasms, Gastrins, Soluble B7-H3, Dickkopf-1, Diagnosis