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近年来由于人们生活方式及生活水平的改变,胃癌的发病逐渐趋于年轻化[1-2]。据2018年《全球癌症报告》显示,2018年全球新发癌症中胃癌以5.7%的占比位居第五位[3]。因此,提高早期胃癌病人的诊疗水平是当前医疗界亟待解决的难题[4]。血清亲环素B(cyclophilin B,CypB)属于亲环素家族中的一员,具有多种生物学活性,在细胞的信号转导、调节细胞的凋亡、促进蛋白质的折叠及介导亲环素A发挥其免疫抑制中发挥着重要的生物学作用[5-6]。近年来,随着人们对CypB研究的逐渐深入,发现其在多种肿瘤的发生发展中发挥着重要的作用,然而有关其与早期胃癌的关系至今尚不清楚[7]。本研究以蚌埠医学院第二附属医院收治的早期胃癌病人为研究对象,分析早期胃癌病人外周血CypB水平的改变,以期为早期胃癌的临床诊疗提供参考。
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2组对象在性别、年龄、BMI、吸烟史及糖尿病方面差异均无统计学意义(P>0.05)(见表 1)。
分组 n 男 女 年龄/岁 BMI/
(kg/m2)吸烟史 糖尿病 是 否 是 否 观察组 49 28 21 53.5±7.3 23.4±0.6 15 34 11 38 对照组 45 25 20 54.6±6.9 23.1±0.9 10 35 9 36 χ2 — 0.02 0.75△ 1.20△ 0.85 0.08 P — >0.05 >0.05 >0.05 >0.05 >0.05 △示t值 表 1 2组一般资料比较(n)
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观察组外周血CypB、CEA及CA-199水平均明显高于对照组(P<0.01)(见表 2)。
分组 n CypB/(ng/mL) CEA/(μg/L) CA-199/(ku/L) 观察组 49 5.8±1.4 9.1±2.8 36.4±5.3 对照组 45 1.9±0.6 2.6±0.4 21.3±4.2 t — 17.28 15.42 15.22 P — <0.01 <0.01 <0.01 表 2 2组研究对象外周血CypB、CEA及CA-199水平比较(x±s)
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观察组病人外周血CypB水平与CEA(r=0.364,P<0.05)及CA-199(r=0.361,P<0.05)均呈明显正相关关系。
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ROC曲线分析显示,以4.030 ng/mL为截点值,CypB诊断早期的敏感性为76.36%,特异性为75.51%,曲线下面积为0.766,诊断效能优于CEA及CA-199(见表 3)。
指标 诊断分界点 曲线下面积 敏感性/% 特异性/% CypB/(ng/mL) 4.030 0.766 76.36 75.51 CEA/(ug/L) 7.674 0.677 70.59 78.63 CA-199/(ku/L) 32.480 0.650 70.53 61.65 表 3 外周血CypB、CEA及CA-199水平对早期胃癌的诊断价值分析
早期胃癌病人血清CypB改变及其辅助诊断价值
Change of the serum level of cyclophilin B and its diagnostic value in patients with early gastric cancer
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摘要:
目的探讨血清亲环素B(CypB)在早期胃癌病人中的改变及辅助诊断价值,以期为早期胃癌的临床诊疗提供参考。 方法纳入49例早期胃癌病人为观察组。另纳入同期健康体检者45名作为对照组。采用酶联免疫吸附法检测2组外周血血清CypB、癌胚抗原(CEA)及糖类抗原-199(CA-199)水平,并分析各指标在早期胃癌病人中的诊断价值,以及早期胃癌病人外周血CypB水平与CEA及CA-199的相关性。 结果观察组病人外周血血清CypB、CEA及CA-199水平均明显高于对照组(P < 0.01);观察组病人外周血血清CypB水平与CEA及CA-199均呈明显正相关关系(P < 0.05);ROC曲线分析显示,以4.030 ng/mL为截点值,CypB诊断早期胃癌的敏感性为76.36%,特异性为75.51%,曲线下面积为0.766,诊断效能优于CEA及CA-199。 结论早期胃癌病人外周血血清CypB水平升高,对辅助诊断具有一定价值。 Abstract:ObjectiveTo investigate the changes of the serum level of cyclophilin B(CypB) and its auxiliary diagnosis value in patients with early gastric cancer, and provide reference in the clinical diagnosis and treatment of early gastric cancer. MethodsForty-nine patients with early gastric cancer and 45 health examiners were divided into the observation group and control group, respectively.The serum levels of CypB, carcinoembryonic antigen(CEA) and carbohydrate antigen-199(CA-199) in two groups were detected using enzyme linked immunosorbent assay.The early diagnostic value of each index in early gastric cancer patients was evaluated, and the correlation of serum level of CypB with CEA and CA-199 in patients with early gastric cancer was analyzed. ResultsThe difference of general data between two groups was not statistically significant(P>0.05).The serum levels of CypB, CEA and CA-199 in observation group were significantly higher than those in control group(P < 0.01).The serum level of CypB in observation group was significantly positively correlated with CEA and CA-199(P < 0.05).The ROC curve analysis showed that when 4.030 ng/mL was set as the cut-off point, the sensitivity and specificity of CypB in the diagnosis of early gastric cancer were 76.36% and 75.51%, respectively, the area under the curve was 0.766, and the diagnostic efficacy of CypB was better than that of CEA and CA-199. ConclusionsThe serum level of CypB in patients with early gastric cancer increases, which has certain value for auxiliary diagnosis. -
Key words:
- early gastric cancer /
- cyclophilin B /
- diagnostic value
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表 1 2组一般资料比较(n)
分组 n 男 女 年龄/岁 BMI/
(kg/m2)吸烟史 糖尿病 是 否 是 否 观察组 49 28 21 53.5±7.3 23.4±0.6 15 34 11 38 对照组 45 25 20 54.6±6.9 23.1±0.9 10 35 9 36 χ2 — 0.02 0.75△ 1.20△ 0.85 0.08 P — >0.05 >0.05 >0.05 >0.05 >0.05 △示t值 表 2 2组研究对象外周血CypB、CEA及CA-199水平比较(x±s)
分组 n CypB/(ng/mL) CEA/(μg/L) CA-199/(ku/L) 观察组 49 5.8±1.4 9.1±2.8 36.4±5.3 对照组 45 1.9±0.6 2.6±0.4 21.3±4.2 t — 17.28 15.42 15.22 P — <0.01 <0.01 <0.01 表 3 外周血CypB、CEA及CA-199水平对早期胃癌的诊断价值分析
指标 诊断分界点 曲线下面积 敏感性/% 特异性/% CypB/(ng/mL) 4.030 0.766 76.36 75.51 CEA/(ug/L) 7.674 0.677 70.59 78.63 CA-199/(ku/L) 32.480 0.650 70.53 61.65 -
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