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目的检测可溶性人类白细胞抗原G(sHLA-G)在胃癌及癌前病变患者血浆中的表达水平,并探讨其临床诊断意义。方法采用ELISA法检测82例胃癌患者(胃癌组)、39例胃上皮内瘤变患者(胃上皮内瘤变组)、36例萎缩性胃炎患者(萎缩性胃炎组)、52例浅表性胃炎患者(浅表性胃炎组)及67名健康对照者(健康对照组)血浆中sHLA-G水平,同时检测血浆癌胚抗原(CEA)水平,分析二者对胃癌早期诊断的意义及sHLA-G与胃癌临床病理参数间的关系。结果 胃癌组血浆sHLA-G水平明显高于胃上皮内瘤变组、萎缩性胃炎组、浅表性胃炎组及健康对照组(P均<0.001);胃上皮内瘤变组血浆sHLA-G水平明显高于健康对照组(P<0.05)。胃癌组血浆CEA水平明显高于其他各组(P均<0.01)。sHLA-G作为诊断指标的ROC曲线AUC为0.814,其诊断价值高于CEA(0.692,P=0.01)。sHLA-G和CEA联合检测的ROC曲线AUC为0.846,明显高于sHLA-G或CEA(P<0.05;P<0.001)。ROC曲线确定sHLA-G诊断临界值为101.37 U/mL,其敏感度为73.2%,特异度为82.5%,阳性预测值为63.8%,阴性预测值为87.9%,准确性为79.7%。胃癌患者血浆sHLA-G水平与患者年龄及肿瘤大小密切相关(P均<0.05),而与患者性别、分化类型、浸润程度、淋巴结转移及临床分期无关(P均>0.05)。结论 血浆sHLA-G可能参与了胃癌的发生和发展,检测其表达水平有助于早期发现胃癌及癌前病变,血浆sHLA-G有可能成为临床胃癌早期诊断的一个潜在性指标。
Objective To detect the expression of soluble human leukocyte antigen G (sHLA-G) in the plasma of patients with gastric cancer and precancerous lesions and to explore its clinical significance. Methods 82 cases of gastric cancer (gastric cancer group), 39 cases of intraepithelial neoplasia (intraepithelial neoplasia group), 36 cases of atrophic gastritis (atrophic gastritis group), 52 cases of superficial gastritis (Superficial gastritis group) and 67 healthy control subjects (healthy control group), meanwhile, the levels of plasma carcinoembryonic antigen (CEA) were measured. The significance of both of them in the early diagnosis of gastric cancer and the expression of sHLA-G And clinicopathological parameters of gastric cancer. Results The level of plasma sHLA-G in gastric cancer group was significantly higher than that in gastric intraepithelial neoplasia group, atrophic gastritis group, superficial gastritis group and healthy control group (all P <0.001) Significantly higher than the healthy control group (P <0.05). Plasma CEA levels in gastric cancer group were significantly higher than those in other groups (all P <0.01). The AUC of ROC curve of sHLA-G was 0.814, which was higher than CEA (0.692, P = 0.01). The ROC curve AUC of sHLA-G and CEA was 0.846, which was significantly higher than that of sHLA-G or CEA (P <0.05; P <0.001). The critical value of sHLA-G diagnosis was 101.37 U / mL by ROC curve. The sensitivity and specificity were 73.2% and 82.5% respectively. The positive predictive value was 63.8%, the negative predictive value was 87.9% and the accuracy was 79.7%. The level of plasma sHLA-G in patients with gastric cancer was closely related to the age of patients and tumor size (all P <0.05), but not to gender, type of differentiation, degree of invasion, lymph node metastasis and clinical stage (all P> 0.05). Conclusions Plasma sHLA-G may be involved in the development and progression of gastric cancer. Detecting the expression of sHLA-G may be helpful for the early detection of gastric cancer and precancerous lesions. Plasma sHLA-G may be a potential indicator for the early diagnosis of clinical gastric cancer.