The diagnostic value of Helicobacter pylori combined with miR-26a and miR-663 for precancerous lesions of gastric cancer in elderly patients
Objective To explore and analyze the diagnostic value of Helicobacter pylori combined with microRNA-26a(miR-26a)and microRNA-663(miR-663)for precancerous lesions of gastric cancer in elderly patients,providing a refer-ence for the diagnosis.Methods A total of 136 elderly patients with benign gastric lesions,precancerous lesions,or early gastric cancer diagnosed through gastroscopy and pathological examination admitted to our hospital from September 2022 to August 2023 were selected as the subjects.Real time fluorescence quantitative polymerase chain reaction was used to detect the expression of miR-26a and miR-663 in their sera,and 13C urea breath test was used to detect the positivity of Helicobacter pylori.The diagnostic value of miR-26a,miR-663,Helicobacter pylori,and their combined detection for dif-ferent degrees of gastric benign lesions,precancerous lesions,and early gastric cancer was analyzed,and ROC curves were drawn to evaluate their diagnostic accuracy.Results There were no statistically significant differences in gender,age,body mass index,smoking history,and drinking history among patients with benign gastric lesions,precancerous lesions,and early gastric cancer(all P＞0.05).The family history of gastric cancer in patients with precancerous lesions and early gastric cancer was higher than that in patients with benign lesions(P＜0.05),and there was no statistically significant dif-ference in family history of gastric cancer between precancerous lesions and early gastric cancer patients(P＞0.05).The expression levels of miR-26a and miR-663 in sera of patients with gastric precancerous lesions and early gastric cancer were lower than those of patients with gastric benign lesions.The expression levels of miR-26a and miR-663 in sera of pa-tients with early gastric cancer were lower than those of patients with precancerous lesions,and the positive rate of Helico-bacter pylori was higher than that of patients with gastric benign diseases(all P＜0.05).There was no statistically signific-ant difference in the positive rate of Helicobacter pylori between patients with precancerous lesions and early gastric can-cer(P＞0.05).The sensitivity of the combined detection of the three was significantly higher than that of single miR-26a detection(x2=4.680,P=0.031),single miR-663 detection(x2=8.223,P=0.004),and single Helicobacter pylori detection(x2=6.363,P=0.012).The cutoff value of serum miR-26a was 2.63,and the area under the ROC curve was 0.79(95％CI:0.774-0.856);the sensitivity and specificity were 75.43％and 79.85％,respectively.The cutoff value of serum miR-663 was 4.35,and the area under the ROC curve was 0.83(95％CI:0.796-0.875);the sensitivity and specificity were 81.37％and 78.56％,respectively;the area under the ROC curve of Helicobacter pylori was 0.72(95％CI:0.648-0.769),with sensitivity and specificity of 68.93％and 78.45％,respectively.The area under the ROC curve for the combined diagnosis of the three was 0.89(95％CI:0.815-0.873),with sensitivity and specificity of 89.72％and 74.43％,respectively.Conclu-sion The combination of Helicobacter pylori with miR-26a and miR-663 has high diagnostic value for precancerous le-sions of gastric cancer in elderly patients.Combined diagnosis can improve diagnostic sensitivity and provide guidance for early diagnosis of gastric cancer in the elderlies.
Helicobacter pyloriMicroRNA-26aMicroRNA-663Gastric precancerous lesionsDiagnostic value
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