Relationship between GLDC and TRAF-4 expression in lesion tissues and recurrence after endoscopic submucosal dis-section in patients with precancerous gastric cancer
Objective To investigate the relationship between the expression of glycine decarboxylase(GLDC)and tumor necrosis factor receptor related factor 4(TRAF-4)in lesion tissues of patients with gastric pre-lesions(GPL)and the recurrence after endoscopic submucosal dissection(ESD).Methods A total of 124 GPL patients admitted to the Gastroen-terology Department of Tongchuan People's Hospital from January 2019 to June 2022 were selected.The pre-cancerous tis-sues and adjacent tissues of gastric cancer were removed and GLDC and TRAF-4 expression were detected by real time flu-orescent quantitative polymerase chain reaction(RT PCR).The postoperative recurrence of ESD was analyzed at 1 year fol-low up.Multivariate Logistic regression analysis was conducted to analyze the factors affecting ESD recurrence in GPL pa-tients,and the value of GLDC and TRAF-4 in predicting ESD recurrence in GPL patients was analyzed by receiver operating characteristic(ROC)curve.Results The expressions of GLDC and TRAF-4 in GPL tissues were higher than those in adja-cent GPL tissues(t/P=15.032/＜0.001,22256/＜0.001),and those in relapsed GPL tissues were higher than those in non-re-lapsed GPL tissues(t/P=6.368/＜0.001,13.834/＜0.001).Incomplete resection,atypical hyperplasia,high expression of GLDC and high expression of TRAF-4 were risk factors for postoperative recurrence in GPL patients[OR(95％CI)=4.174(1.668-10.445),2.593(1227-5.483),1.668(1.114-2.499),1.544(1.092-2.186)].The area under the curve of GLDC,TRAF-4 and combined prediction of ESD recurrence in GPL patients was 0.830,0.810 and 0.933,respectively.The area under the curve of GLDC,TRAF-4 and combined prediction of GPL patients was higher than that of single prediction(Z=1.953,2.599,P＜0.05).Conclusion The high expression of GLDC and TRAF-4 in GPL tissue is associated with postoperative recurrence of ESD,and the combination of GLDC and TRAF-4 can predict the risk of postoperative recurrence of ESD.
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