P53、PCNA、CA724、胃泌素17 及幽门螺杆菌抗体联合检测在萎缩性胃炎与早期胃癌鉴别中的应用价值

目的探讨P53、增殖细胞核抗原(PCNA)、糖类抗原724(CA724)、胃泌素17(G-17)及幽门螺杆菌(HP-IgG)抗体联合检测在萎缩性胃炎与早期胃癌鉴别中的应用价值。方法选取2017年11月至2018年11月在湖南省人民医院(湖南师范大学第一附属医院)消化科行胃镜检查的186例患者作为研究对象,根据病理诊断结果分为正常对照组(50例),萎缩性胃炎组(76例),胃癌组(60例)。采用免疫组化检测P53、PCNA的表达情况;采用电化学发光免疫分析法检测血清CA724水平;采用酶联免疫法检测血清G-17水平;采用胶体金法定性检测HP-IgG抗体表达。分析各指标对萎缩性胃炎与早期胃癌鉴别的价值。结果胃癌组患者P53、PCNA阳性率高于萎缩性胃炎组和对照组(均P0.05)。胃癌组、萎缩性胃炎组患者HP-IgG阳性率明显高于对照组(均P0.05),同时胃癌组HP-IgG阳性率高于萎缩性胃炎组(均P0.05)。胃癌组患者血清CA724水平明显高于对照组和萎缩性胃炎组(P0.05)。胃癌组患者血清G-17水平高于萎缩性胃炎组和对照组(均P0.05),同时萎缩性胃炎组血清G-17水平明显低于对照组(P0.05)。HP-IgG抗体阳性患者P53、PCNA阳性率以及血清CA724、G-17水平均高于HP-IgG抗体阴性患者(均P0.05)。CA724预测胃癌的AUC为0.815,截断值为33.57 U/mL,灵敏度为70.00%,特异性为83.33%。G-17预测胃癌的AUC为0.847,截断值为15.36 U/mL,灵敏度为80.00%,特异性为85.71%。各指标联合检测胃癌的灵敏度、特异性、阳性预测值、阴性预测值及准确度均高于单指标检测。结论胃癌患者P53、PCNA、HP-IgG抗体阳性率较高,血清CA724、G-17水平升高,而萎缩性胃炎患者血清G-17水平降低,可作为萎缩性胃炎与早期胃癌的鉴别指标。各指标联合检测可提高对胃癌的诊断价值。     

胃癌患者手术前后血清的激光拉曼光谱研究

为了探讨胃癌患者血清光谱在手术前后的变化及临床应用价值,用光谱法分别检测了30例胃癌细胞培养液、20例健康人血清和41例胃癌患者手术前、后血清的激光拉曼光谱。结果表明细胞培养液的拉曼光谱与空白对照有明显不同,且峰值与培养时间增成正相关;胃癌患者血清的拉曼光谱与健康人有显著差异;手术后胃癌患者血清的拉曼光谱峰值比术前明显降低。研究表明拉曼光谱可以作为胃癌细胞体外研究的检测手段,并有潜力成为胃癌筛查、预后监测及疗效判断的新方法。     

血清胃蛋白酶原联合G-17对萎缩性胃炎及胃癌早期诊断价值

目的:探索检测血清胃蛋白酶原Ⅰ(PGⅠ)、胃蛋白酶原Ⅱ(PGⅡ)、胃泌素-17(G-17)在萎缩性胃炎及胃癌中的诊断价值。方法:收集医院2015年2月至12月门诊及住院的慢性非萎缩性胃炎44例(非萎缩性胃炎组),慢性萎缩性胃炎47例(萎缩性胃炎组),早期胃癌42例(胃癌组)。采用酶联免疫吸附试验(ELISA)测定各组血清PGⅠ、PGⅡ、G-17的水平,同时计算PGⅠ/PGⅡ的比值(PGR),比较各组指标间的差异,同时绘制各指标筛查萎缩性胃炎及胃癌的受试者工作曲线(ROC)曲线,分别评价其诊断价值。结果:胃癌组及萎缩性胃炎组的血清PGⅠ、PGR水平较非萎缩性胃炎组明显下降,且胃癌组下降更明显,差异均具有统计学意义(P0.05),萎缩性胃炎组血清PGⅡ显著低于非萎缩性胃炎组,差异均具有统计学意义(P0.05);胃癌组的血清G-17水平较非萎缩性胃炎组及萎缩性胃炎组均升高,差异有统计学意义(P0.05)。血清PGⅠ筛查萎缩性胃炎的最佳界值为PGⅠ90 ng/m L,其灵敏度和特异度分别为71.5%和51.0%,血清PGR筛查萎缩性胃炎的最佳界值为PGR8,其灵敏度和特异度分别为71.9%和54.0%,血清G-17筛查萎缩性胃炎的最佳界值为G-175 pmol/L,其灵敏度和特异度分别为66.1%和64.0%。血清PGⅠ筛查胃癌的最佳界值为PGⅠ73 ng/m L,其灵敏度和特异度分别为86.0%和74.9%;血清PGR筛查胃癌的最佳界值为PGR3,其灵敏度和特异度分别为90.2%和62.5%;血清G-17筛查胃癌的最佳界值为G-174 pmol/L,其灵敏度和特异度分别为62.5%和61.3%。结论:胃癌及萎缩性胃炎患者血清PGⅠ、PGR水平下降明显,且胃癌患者的血清G-17异常升高,血清PG联合GS-17测定可用于萎缩性胃炎及胃癌的早期筛查。     

老年人萎缩性胃炎和胃癌与胃液pH及微生态环境改变的关系探讨

本实验研究了老年人萎缩性胃炎和胃癌患者的胃液ｐＨ值及胃内部分菌群数量与正常人胃液ｐＨ值及菌群数量的比较,从１５例萎缩性胃炎患者和１５例胃癌患者的胃液中发现ｐＨ值增高,随之肠杆菌、肠球菌、拟杆菌数量也明显高于正常人,而一些胃内的生理菌少于正常人,由此证明胃内微环境的改变与胃癌的发病率有关系     

RUNX3与CHFR基因甲基化提示胃癌癌前病变的研究

本研究通过比较胃癌与萎缩性胃炎的RUNX3及CHFR基因表达情况探讨其中的相关性。选取2014年1月至2016年7月前来浙江舟山群岛新区旅游与健康职业学院进行胃镜检查的137例慢性萎缩性胃炎患者作为研究对象,分为胃炎轻度组、胃炎中度组与胃炎重度组,并选取同期胃癌患者42例作为胃癌组。取胃炎患者的胃体与胃窦处的黏膜,胃癌患者的癌灶组织、癌旁组织与远端正常处组织进行DNA的提取,并进行比较。经比较后,胃炎重度组患者的RUNX3与CHFR基因甲基化阳性率分别为29.63%、37.04%,与胃癌组患者的正常组织处比较,有显著的统计学差异,与胃癌组癌灶组织处比较无差异;而胃炎重度组患者的蛋白表达有缺失情况发生,经Elisa检测后,蛋白表达量与胃癌组癌灶组织处比较无差异。严重萎缩性胃炎患者的RUNX3与CHFR基因甲基化可抑制抑癌基因的表达,而异常升高的阳性率会影响患者的病程进展,可认为RUNX3与CHFR基因甲基化对癌前病变进程具有临床诊断意义。     

拉曼光谱检测胃癌变信号的研究

利用激光拉曼光谱对胃癌患者血清及非胃癌患者血清进行对比检测,并结合对体外培养胃癌细胞分泌物的检测,对胃癌特征拉曼峰作初步探讨。得出一种有重要临床应用价值的癌症辅助快速诊断方法。     

拉曼光谱在胃癌诊断中的应用与研究进展

拉曼光谱是一种分子振动光谱技术,具有分子水平的肿瘤检测和诊断能力.胃癌是常见恶性肿瘤,经常到晚期才得到诊断,死亡率较高,而早期胃癌预后较好,因此胃癌早期检测和诊断显得尤为重要.文章介绍了拉曼光谱用于胃癌早期检测和诊断的应用,并综述其研究进展,结果认为拉曼光谱探针与内镜整合,将实现胃癌活体检测和诊断,极具临床应用价值.     

PGⅠ、PGⅡ在胃癌组织中的表达及意义

目的:研究胃蛋白酶原Ⅰ(PGⅠ)、胃蛋白酶原Ⅱ(PGⅡ)在胃癌组织中的表达及意义。方法:将我院2011年5月至2013年10月收治的上消化道疾病患者243例纳入研究,根据胃镜及病理组织学结果,按照胃癌、慢性萎缩性胃炎、慢性非萎缩性胃炎、不典型增生以及胃溃疡分为5组,对照组为57名来我院检查的健康的人群。应用酶联免疫法测定各组血清PGⅠ、PGⅡ的含量并计算胃蛋白酶原比值(PGR),比较胃癌患者手术前后血清PGⅠ、PGⅡ的含量以及PGR,并通过ROC曲线下面积评价血清PGⅠ、PGⅡ以及PGR诊断胃癌的效能。结果:与对照组比较,胃溃疡组PG Ⅰ、PG ⅠⅠ均明显升高,PGR降低(P0.05),慢性萎缩性胃炎组、不典型增生组及胃癌组PGⅠ、PGR均明显降低(P0.05);与慢性萎缩性胃炎组比较,不典型增生组和胃癌组PGR显著降低(P0.05)。手术治疗后,胃癌患者血清PGⅠ、PGⅡ含量较手术前明显下降(P0.05)。血清PGⅠ、PGⅡ以及PGR含量诊断胃癌的ROC曲线下面积依次为0.779、0.920以及0.991。结论:胃癌患者血清PGⅠ、PGR均明显降低,二者可用于初步筛查胃癌。     

树突状细胞对胃癌前病变的免疫保护分析

摘要 目的：探究树突状细胞(Dendritic cells,DC)对胃癌的免疫保护作用。方法：选择2016年1月至2018年1月于我院接受治疗的145例胃癌、39例慢性萎缩性胃炎、21例不典型增生、27例肠上皮化生以及20例正常对照组患者为研究对象,分别采集其胃粘膜标本进行染色,记录和比较其胃粘膜中S100⁺、CD4⁺和CD8⁺细胞的数量、平均面积以及平均吸光度,并将胃癌患者分为中分化腺癌(49例)、低分化腺癌(53例)和未分化癌(43例)进行对比。结果：(1)胃癌组、慢性萎缩性胃炎组、不典型增生、肠上皮化生组的胃粘膜S100⁺阳性细胞计数明显高于正常对照组（P<0.05）,胃癌组平均吸光度低于对照组,其他3组平均吸光度显著高于对照组,(P<0.05);胃癌组平均面积与正常对照组相比无差异(P>0.05),其他三组平均面积显著高于对照组（P<0.05）;(2)慢性萎缩性胃炎组、肠上皮化生组、不典型增生组患者CD4⁺细胞数均低于对照组(P<0.05);胃癌组、慢性萎缩性胃炎组、肠上皮化生组患者平均面积均低于对照组(P<0.05);胃癌组、慢性萎缩性胃炎组、不典型增生、肠上皮化生组平均吸光度均低于对照组(P<0.05);(3)慢性萎缩性胃炎组、肠上皮化生组、不典型增生组患者CD8⁺细胞数明显高于对照组(P<0.05),胃癌组稍低于对照组(P>0.05);胃癌组患者平均面积低于对照组(P<0.05);胃癌组患者平均吸光值低于对照组,慢性萎缩性胃炎组、肠上皮化生组患者高于对照组(P均<0.05);(4)随着胃癌分化程度的降低,胃癌患者DC细胞数有降低趋势。结论：胃癌前病变患者胃粘膜中DC数量会显著增多,免疫功能加强,DC细胞数量会随胃癌分化程度的降低而减少,分析其原因与DC细胞能够抑制癌前病变有关。     

PGI、PGⅡ在胃癌组织中的表达及意义

目的：研究胃蛋白酶原I(PGI)、胃蛋白酶原Ⅱ(PGⅡ)在胃癌组织中的表达及意义。方法：将我院2011 年5 月至2013年10月 收治的上消化道疾病患者243 例纳入研究,根据胃镜及病理组织学结果,按照胃癌、慢性萎缩性胃炎、慢性非萎缩性胃炎、不典型 增生以及胃溃疡分为5 组,对照组为57 名来我院检查的健康的人群。应用酶联免疫法测定各组血清PGI、PGⅡ的含量并计算胃 蛋白酶原比值(PGR),比较胃癌患者手术前后血清PGI、PGⅡ的含量以及PGR,并通过ROC曲线下面积评价血清PGI、PGⅡ以及 PGR 诊断胃癌的效能。结果：与对照组比较,胃溃疡组PG I、PG II均明显升高,PGR 降低(P<0.05),慢性萎缩性胃炎组、不典型增生 组及胃癌组PGI、PGR均明显降低(P<0.05);与慢性萎缩性胃炎组比较,不典型增生组和胃癌组PGR 显著降低(P<0.05)。手术治疗 后,胃癌患者血清PGⅠ、PGⅡ含量较手术前明显下降(P＜0.05)。血清PGⅠ、PGⅡ以及PGR含量诊断胃癌的ROC 曲线下面积依 次为0.779、0.920 以及0.991。结论：胃癌患者血清PGI、PGR均明显降低,二者可用于初步筛查胃癌。     

Atrophic gastritis, Helicobacter pylori, and colorectal cancer risk: a case-control study

BACKGROUND: Helicobacter pylori is a major risk factor for atrophic gastritis and gastric cancer. Various extragastric manifestations of H. pylori infection have also recently been suggested. However, the correlation between H. pylori and colorectal cancer (CRC) is controversial. The aim of this study was to examine the correlation between H. pylori, serum gastrin level, and atrophic gastritis with CRC. MATERIALS AND METHODS: Subjects were patients with CRC; controls were participants of a health check-up program that was conducted between October 1998 and March 2002 at four hospitals in Nagano Prefecture. For 121 newly diagnosed CRC cases, two controls matched by age (within 3 years), gender, and residence were randomly selected from the program participants. We conducted questionnaires and obtained blood samples from the cases and their controls. Consequently, the CRC cancer pairs consisted of 113 cases and 226 controls. RESULTS: Neither H. pylori infection nor gastrin level nor atrophic gastritis showed any association with a risk for CRC. However, serologically determined atrophic gastritis demonstrated significant elevation in odds ratios (ORs) for rectal cancer (OR = 3.15, 95% confidence interval; 1.19-8.35). CONCLUSIONS: Gastric conditions such as chronic H. pylori infection and atrophic gastritis are unlikely to increase the risk for CRC, although atrophic gastritis may increase the risk of rectal cancer.     

Qualitative and quantitative characteristics of estrogen receptors in patients with atrophic gastritis and stomach cancer

The article deals with the comparative estimation conducted both in the normal and atrophic gastric mucosa, its cancer tumoral tissues. All the results obtained have been studied in dependence on the atrophic gastritis variants. The process various stages as well as on the patients sex. The findings obtained evidence about more high frequency of identification and more high estrogens receptors level in the patients suffering from the cancer if compare with suffering from atrophic gastritis one.     

Effect of body-mass index on the risk of gastric cancer: A population-based cohort study in A Japanese population

BackgroundBody fatness and weight gain are considered probable causes of gastric cancer, specifically in the cardia region. However, limited evidence is available in Asia, where the burden of gastric cancer is high. The objective of this study was to determine an association between body-mass index (BMI) and gastric cancer risk using a large population prospective cohort.Methods92,056 subjects enrolled in the Japan Public Health Center-based prospective Study who reported their height and weight were followed up until the end of 2013. A Cox proportional hazards model was used to estimate the risk for gastric cancer and its subsite based on baseline BMI. A subgroup analysis was conducted taking account of Helicobacter pylori (H. pylori) infection and atrophic gastritis status.Results2,860 gastric cancer cases (2,047 men, 813 women), 307 proximal gastric cancer cases (244 men, 63 women), and 1967 distal gastric cancer cases (1,405 men, 562 women) were found during the follow-up period. Among men, baseline BMI ≥ 27 kg/m² increased the risk of overall gastric cancer (hazards ratio (HR) 1.23, 95% confidence interval (CI) 1.00–1.53). For both sexes, U-shaped increase in the risk was observed for proximal gastric cancer. Subgroup analysis showed a statistically significant association between the risk of proximal gastric cancer and BMI ≥ 27 kg/m² among those who were atrophic gastritis positive, H. pylori antibody positive, and those who tested positive to either or both atrophic gastritis and H. pylori antibody.ConclusionOur result suggests that gastric cancer risk increases for men with BMI ≥ 27 kg/m².     

MTHFR Polymorphisms Involved in Vitamin B12 Deficiency Associated with Atrophic Gastritis

Genetic polymorphisms affecting methylentetrahydrofolate reductase (MTHFR) activity may influence hematological and neurological dysfunction in cobalamin-deficient patients. We studied the prevalence of C677T and A1298C polymorphisms by analyzing genomic DNA in 30 cobalamin-deficient patients. No significant difference was found in 677 and 1298 genotype distribution with respect to hematological parameters, B₁₂ and folate levels, and neurological symptoms. The two MTHFR polymorphisms were not protective against anemia or neurological dysfunction in patients with cobalamin deficiency; however, we found evidence of a significant increase in atrophic gastritis in the 677TT group (P = 0.009) but not for the 1298CC genotype. Based on observations that inadequate cobalamin intake and reduced MTHFR activity might be significant risk factors for gastric cancer, and the increased risk of gastric cancer shown in patients affected by atrophic gastritis, we speculate that concomitant atrophic gastritis and impaired MTHFR function could have a role in the development of gastric cancer.     

Plasma obestatin levels in men with chronic atrophic gastritis

Obestatin is a recently discovered active peptide isolated from the stomach. The purpose of the present study was to investigate the modification of plasma obestatin levels in men with chronic atrophic gastritis. Men older than 65 years undergoing upper gastrointestinal endoscopy were included. All patients with chronic atrophic gastritis underwent multiple biopsies. Fasting plasma obestatin and ghrelin levels were examined in 50 men with chronic atrophic gastritis and 50 healthy men. Plasma obestatin levels were significantly lower in patients with chronic atrophic gastritis than in healthy subjects. Plasma ghrelin levels and ghrelin to obestatin ratio was decreased in men with chronic atrophic gastritis. There was a significant relationship between atrophy and decreased obestatin. A negative correlation was found between circulating obestatin levels and body mass index (BMI) in healthy subjects, but not in patients with chronic atrophic gastritis. The data indicated that chronic atrophic gastritis influenced plasma obestatin levels as well as ghrelin to obestatin ratio in elderly men.