血清三叶因子3在胃癌中表达的临床研究*



血清三叶因子3在胃癌中表达的临床研究*

张谢1#宋毓飞1张学松1黄志刚2&

宁波市医疗中心李惠利医院消化内科1(315040)上海市东方医院消化内科2

背景：在中国恶性肿瘤发病率和死亡率排序中，胃癌分居第二和第三位。探索方法简便、敏感性高的非侵入性指标以筛选出胃癌高危人群接受胃镜检查是胃癌普查的有效途径。目的：探讨三叶因子3(TFF3)作为胃癌筛查血清生物学标记物的临床价值。方法：收集宁波市医疗中心李惠利医院2013年7月—2014年1月49例胃癌患者和29名健康体检者的血清标本，采用ELISA法检测血清TFFs浓度，以ROC曲线及其曲线下面积(AUC)分析血清TFF1、TFF2、TFF3对胃癌的诊断性能，并进一步分析三者与胃癌临床病理特征的关系。结果：胃癌组TFF3血清浓度显著高于健康对照组[(43.57±19.49) ng/mL对(29.97±14.20) ng/mL,P<0.01]，两组间TFF1、TFF2血清浓度差异无统计学意义(P>0.05)。血清TFF1、TFF2、TFF3诊断胃癌的AUC分别为0.56、0.56和0.83，TFF3诊断性能最高；以33.0 ng/mL为TFF3 cut off值，相应敏感性和特异性分别为63.3%和82.8%，预测胃癌风险的OR值为8.27。TFF3血清浓度与胃癌TNM分期、分化程度和淋巴结转移显著相关(P<0.05)。结论：血清TFF3是一个有应用前景的非侵入性胃癌筛查生物学标记物。

关键词胃肿瘤；筛查；生物学标记；三叶因子3

Clinical Research of Serum Trefoil Factor 3 Expression in Gastric Cancer

ZHANGXie1,SONGYufei1,ZHANGXuesong1,HUANGZhigang2.1DepartmentofGastroenterology,NingboMedicalTreatmentCenterLihuiliHospital,Ningbo,ZhejiangProvince(315040);2DepartmentofGastroenterology,ShanghaiEastHospital,Shanghai

Correspondence to: HUANG Zhigang, Email: huangzg@foxmail.com

Background: Gastric cancer is the second most frequently diagnosed cancer and the third cause of cancer death in China. Selection of candidates in high risk of gastric cancer by a simple and non-invasive marker with high sensitivity and then undergoing endoscopy is an optimal approach for large scale gastric cancer screening. Aims: To evaluate the clinical value of using trefoil factor 3 (TFF3) as a serum biomarker for gastric cancer screening. Methods: Serum samples of 49 gastric cancer patients and 29 healthy subjects were collected for measurements of serum TFFs by ELISA from Jul. 2013 to Jan. 2014 at Ningbo Medical Treatment Center Lihuili Hospital. ROC curve and the area under curve (AUC) were used to verify the diagnostic performance of serum TFF1, TFF2 and TFF3 for gastric cancer. Correlations between TFFs and clinicopathological characteristics of gastric cancer were further analyzed. Results: Serum concentration of TFF3 in gastric cancer group was significantly higher than that in healthy controls [(43.57±19.49) ng/mLvs. (29.97±14.20) ng/mL,P<0.01], but no significant differences were found in serum concentrations of TFF1 and TFF2 between the two groups (P>0.05). AUC of serum TFF1, TFF2 and TFF3 for diagnosis of gastric cancer were 0.56, 0.56 and 0.83, respectively, which indicated that the performance of TFF3 was the best. Taken 33.0 ng/mL as the cut off value of TFF3, the sensitivity and specificity were 63.3% and 82.8%, respectively, and the odds ratio for predicting gastric cancer was 8.27. Significant correlations were existed between serum concentration of TFF3 and TNM stage, differentiation and lymph node metastasis of gastric cancer (P<0.05). Conclusions: Serum TFF3 is a promising non-invasive biomarker for gastric cancer screening.

Key wordsStomach Neoplasms;Screening;Biological Markers;Trefoil Factor 3

胃癌是最常见的恶性肿瘤之一，全球每年确诊例数约为100万例[1]。在大多数国家(包括中国)，胃癌患者确诊时多已处于进展期，预后相对较差。日本从20世纪60年代开始应用X线钡餐和内镜技术开展胃癌筛查，成功检出大量早期胃癌，使胃癌相关死亡率降低40%~60%[2-4]。然而，胃镜检查过程较痛苦，令很多患者望而却步，故不适合作为无症状人群的普查手段。探索方法简便、敏感性高的非侵入性指标以筛选出胃癌高危人群接受胃镜检查是适用于胃癌普查的有效途径。……