Objective To investigate the expressions and clinical significance of progranulin (PGRN) and epithelia cadherin (E-cadherin) in benign and malignant gastric ulcer tissues.

Methods A total of 190 patients with gastric ulcer were selected as study objects, 85 patients with benign gastric ulcer were included in benign gastric ulcer group and 105 patients with malignant gastric ulcer in ulcerative gastric cancer group. The expressions of PGRN and E-cadherin in benign gastric ulcer and ulcerative gastric cancer tissues were detected by immunohistochemistry, the relationships of positive expressions of PGRN and E-cadherin protein with the clinicopathological features of ulcerative gastric cancer patients were analyzed. Spearman correlation analysis was used to analyze the correlation between expression of PGRN and E-cadherin protein, and Pearson correlation analysis was used to analyze the correlation between expression of PGRN and E-cadherin mRNA. Receiver operating characteristic (ROC) curve was constructed to analyze the diagnostic value of PGRN and E-cadherin mRNA in ulcerative gastric cancer. Logistic regression analysis was used to analyze the factors influencing the occurrence of ulcerative gastric cancer; and Kaplan-Meier survival curve was used to analyze the relationship of the expressions of PGRN and E-cadherin with the survival prognosis of patients with ulcerative gastric cancer.

Results Compared with the benign gastric ulcer group, the positive expression rate of PGRN protein and PGRN mRNA expression level in the ulcerative gastric cancer group were significantly higher, and the positive expression rate and expression level of E-cadherin mRNA was significantly lower (P < 0.001). There was a negative correlation between the positive expression of PGRN and E-Cadherin protein in benign gastric ulcer and ulcerative gastric cancer tissues(r=-0.529, -0.426, P < 0.001). The expression level of PGRN mRNA was negatively correlated with that of E-cadherin mRNA in benign gastric ulcer and ulcerative gastric cancer tissues(r=-0.441, -0.306, P < 0.001). The positive expression rates of PGRN and E-cadherin protein in ulcerative gastric cancer tissue were correlated with lymph node metastasis, degree of invasion, degree of differentiation and TNM stage (P < 0.05). The area under the curve (AUC) of PGRN mRNA combined with E-cadherin mRNA in the diagnosis of ulcerative gastric cancer was significantly greater than that of PGRN or E-cadherin mRNA alone (Z=3.471, P < 0.001; Z=0.039, P=0.019). Logistic regression analysis showed that TNM stage, lymph node metastasis, degree of differentiation, degree of invasion, PGRN protein expression and E-cadherin protein expression were independent influencing factors of ulcerative gastric cancer (P < 0.05). Positive expression of PGRN protein and negative expression of E-cadherin protein were correlated with poor 3-year survival prognosis of patients with ulcerative gastric cancer (P < 0.05).

Conclusion The expression of PGRN in ulcerative gastric cancer tissue is higher than that in benign gastric ulcer tissue, and the expression of E-cadherin is lower than that in benign gastric ulcer tissue. Both PGRN and E-Cadherin have good diagnostic value for ulcerative gastric cancer, and are closely related to the clinical characteristics and prognosis of patients.