Application and prognostic value of combined diagnosis of vascular endothelial growth factor,PD-1 and gastrin in early gastric cancer
Objective To explore the application and prognostic value of the combined diagnosis of vascular endothelial growth factor(VEGF),programmed death receptor 1(PD-1),and gastrin in early gastric cancer(EGC).Methods One hundred and twenty patients with early gastric cancer admitted to Cangzhou Central Hospital from March 2020 to August 2022 were recruited(EGC group).At the same time,50 cases of benign gastric diseases(BGDs group)and 50 cases of healthy individuals confirmed by physical examination(control group)included.Before treatment or on the day of physical examination,PD-1 expression in peripheral blood,and VEGF and three items of gastric function(gastrin 17[G-17],Pepsin Ⅰ[PG Ⅰ],PG Ⅱ[PG Ⅱ])were detected to evaluate the diagnostic value of the combination indicators for EGC.Patients of EGC group underwent endoscopic submucosal dissection(ESD),followed up for 12 months with recurrence as the endpoint event.Recurrent patients were included in the recurrence group,while non recurrent patients were included in the non recurrence group.The data of the two groups were compared,with a focus on analyzing the relationship between VEGF,PD-1,and gastrin and prognosis.Results The levels of VEGF,PD-1,and G-17 in three groups were compared:EGC group＞BGD group＞control group.The levels of PG-Ⅰ in three groups were compared:EGC＜BGD group＜control group(P＜0.05).The level of PG-Ⅱ in the control group was lower than that of the other two groups(P＜0.05),but there was no significant difference between EGC group and BGD group(P＞0.05).The areas under curve(AUC)of serum VEGF,PD-1,G-17,and PG-Ⅰ for single diagnosis of gastric cancer was greater than 0.70,indicating certain diagnostic value.The AUC of PG-Ⅱ for diagnosis of gastric cancer was less than 0.7,indicating poor diagnostic value.The AUC of combined diagnosis was 0.968,indicating the highest diagnostic value.EGC patients were followed up for 12 months after ESD surgery,and 15(12.50％)cases recurred.At admission,the levels of serum VEGF,PD-1,G-17,and PG-Ⅰ in the recurrence group were higher than those of the non recurrence group,while the levels of PG-Ⅱ were lower.At all postoperative points,the levels of VEGF,PD-1,G-17,and PG-Ⅰ gradually decreased compared to before surgery,while PG-Ⅱ gradually increased(P＜0.05).Logistic regression analysis showed that abnormal expression of serum VEGF,PD-1,G-17,PG-Ⅰ,and PG-Ⅱ at admission was associated with postoperative recurrence in EGC patients,with VEGF,PD-1,G-17,and PG-Ⅱas risk factors and PG-Ⅰ as protective factors(P＜0.05).Conclusion Serum VEGF,PD-1,and gastrin are all abnormally expressed in EGC patients,which can be used in the diagnosis of EGC.The abnormal expression may also be a influencing factor for postoperative recurrence.
gastric cancervascular endothelial growth factorprogrammed death 1gastrin three itemsrecurrence
万方数据
维普
