血清溴结构域蛋白4联合胃泌素17在幽门螺杆菌阳性早期胃癌诊断中的应用价值

Application value of serum bromodomain-containing protein 4 combined with gastrin-17 in diagnosis of Helicobacter pylori-positive early gastric cancer

  • 摘要:
    目的 探究血清溴结构域蛋白4(BRD4)联合胃泌素17(G-17)对幽门螺杆菌(Hp)阳性早期胃癌的诊断价值。
    方法 选取本院2021年9月-2023年9月收治的88例Hp阳性早期胃癌患者作为早期胃癌组, 选取同时期92例Hp阳性癌前病变患者作为癌前病变组, 另外选取同期本院收治的80例Hp阳性胃炎患者作为胃炎组。采用酶联免疫吸附试验(ELISA)检测血清BRD4、G-17水平, 多因素Logistic回归分析筛选Hp阳性早期胃癌的影响因素, 受试者工作特征(ROC)曲线分析血清BRD4、G-17对Hp阳性早期胃癌患者的诊断价值。
    结果 与胃炎组比较, 癌前病变组及早期胃癌组BRD4、G-17水平均升高, 差异有统计学意义(P < 0.05);与癌前病变组比较, 早期胃癌组BRD4、G-17水平升高, 差异有统计学意义(P < 0.05)。早期胃癌组有胃癌家族史、喜烫食、喜凉食、喜重盐患者占比及胃蛋白酶原Ⅱ(PG Ⅱ)、BRD4、G-17水平高于非胃癌组, 胃蛋白酶原Ⅰ(PGⅠ)水平低于非胃癌组, 差异有统计学意义(P < 0.05)。Logistic回归分析结果显示, 喜烫食、喜重盐、PGⅡ、BRD4、G-17、PGⅠ均为Hp阳性早期胃癌发生的影响因素(P < 0.05)。血清BRD4、G-17及二者联合诊断Hp阳性早期胃癌的曲线下面积(AUC)分别为0.793、0.830、0.912, 二者联合诊断的效能优于单独诊断(P < 0.05)。
    结论 Hp阳性早期胃癌患者血清BRD4、G-17水平升高, 且二者对Hp阳性早期胃癌具有一定诊断价值, 可作为Hp阳性早期胃癌诊断的血清标志物。

     

    Abstract:
    Objective To investigate the diagnostic value of serum bromodomain-containing protein 4 (BRD4) combined with gastrin-17 (G-17) in Helicobacter pylori (Hp)-positive early gastric cancer.
    Methods A total of 88 patients with Hp-positive early gastric cancer admitted to our hospital from September 2021 to September 2023 were selected as early gastric cancer group. Meanwhile, 92 patients with Hp-positive precancerous lesions and 80 patients with Hp-positive gastritis admitted during the same period were selected as precancerous lesion group and gastritis group, respectively. Enzyme-linked immunosorbent assay (ELISA) was used to detect the serum levels of BRD4 and G-17. Multivariate logistic regression analysis was performed to screen the influencing factors of Hp-positive early gastric cancer. Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic value of serum BRD4 and G-17 in Hp-positive early gastric cancer.
    Results Compared with the gastritis group, the levels of BRD4 and G-17 in the precancerous lesion group and early gastric cancer group were significantly increased (P < 0.05). Furthermore, compared with the precancerous lesion group, the levels of BRD4 and G-17 in the early gastric cancer group were also significantly elevated (P < 0.05). The proportion of patients with a family history of gastric cancer, those who preferred hot food, cold food, or high-salt food, as well as the levels of PGⅡ, BRD4, and G-17 were significantly higher in the early gastric cancer group than in the non-gastric cancer group, while the level of pepsinogen (PG)Ⅰ was significantly lower (P < 0.05). Logistic regression analysis revealed that preference for hot food, high-salt food, PGⅡ, BRD4, G-17, and PGⅠ were all influencing factors for Hp-positive early gastric cancer (P < 0.05). The area under the curve (AUC) values for serum BRD4, G-17, and their combination in diagnosing Hp-positive early gastric cancer were 0.793, 0.830, and 0.912, respectively. The diagnostic efficacy of the combined detection was superior to that of single detection (P < 0.05).
    Conclusion The serum levels of BRD4 and G-17 are elevated in patients with Hp-positive early gastric cancer, and both exhibit certain diagnostic value for Hp-positive early gastric cancer, suggesting their potential as serum biomarkers for the diagnosis of Hp-positive early gastric cancer.

     

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