首页|早期胃癌预测模型对胃癌高危人群疾病进展的预测价值

早期胃癌预测模型对胃癌高危人群疾病进展的预测价值

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目的:分析基于幽门螺杆菌(helicobacter pylori,Hp)状态与外周血胃蛋白酶原I(pepsinogen Ⅰ,PGⅠ)、PGⅡ、胃泌素-17(gastrin-17,G-17)水平组成的预测模型对于胃癌高危人群疾病进展的预测价值.方法:回顾性选取 2023年 1月至 2024年 1月于天津大学津南医院完善PGⅠ、PGⅡ、G-17、C14尿素呼气试验和胃镜取组织病理活检的 126例胃癌高危人群临床资料,根据胃镜取组织病理活检结果将胃癌高危人群分为对照组、癌前病变组、早期胃癌组,比较各组患者PGⅠ、PGⅡ、G-17、C14尿素呼气试验等指标的诊断效能,并构建预测模型.结果:早期胃癌组Hp阳性率为 82.35%、PGⅡ为 22.73 ng/mL均高于癌前病变组、对照组,PGⅠ为 51.36 ng/mL低于癌前病变组、对照组,癌前病变组G-17为 5.17 pmoL/L低于对照组、早期胃癌组(P<0.05).PGⅠ、PGⅡ、G-17与Hp联合时,其受试者工作特征(receiver operating curve,ROC)曲线下面积(area under curve,AUC)可达到0.899,敏感度为 94.12%,特异度为 95.65%,对胃癌的诊断效能最为理想.根据预测模型,癌前病变分值界限为 10分,早期癌症的临界值为 19分.结论:对胃癌高危人群实施C14尿素呼气试验与PGⅠ、PGⅡ、G-17联合检测,有助于分析胃癌高危人群疾病进展情况.
Predictive value of early gastric cancer model for disease progression in high-risk pop-ulations
Objective:To assess the value of a model based on helicobacter pylori(Hp)status and peripheral blood levels of pepsinogen Ⅰ(PGⅠ),PGⅡ,and gastrin-17(G-17)for predicting disease progression in high-risk populations for gastric cancer.Methods:Retrospective se-lection of clinical data from 126 high-risk individuals for gastric cancer who underwent PGⅠ,PGⅡ,G-17,and C14 urea breath tests and gastro-scopy tissue biopsy at Tianjin University Jinnan Hospital from January 2023 to January 2024,Based on pathological biopsy results using gast-ric cancer tissues obtained by gastroscopy,the high-risk population for gastric cancer was assigned into normal control,precancerous lesion,and early gastric cancer groups.The diagnostic efficacies of PGⅠ,PGⅡ,G-17,C14 urea breath,and other indicators in each patient group were determined,and a predictive model was constructed.Results:The HP-positivity rate(82.35%)and PGⅡ level(22.73 ng/mL)in the early gastric cancer group were higher than those in the precancerous lesion and control groups.The PGI level(51.36 ng/mL)was lower in early gastric cancer than in precancerous lesions and control tissues.The G-17 level(5.17 pmol/L)was lower in the precancerous lesion group than in the control and early gastric cancer groups(P<0.05).Combined use of PGⅠ、PGⅡ、G-17and Hp,the area under curve(AUC)can reach 0.899,a sensitivity of 94.12%,and a specificity of 95.65%,making these factors ideal diagnostic tools for gastric cancer.According to the prediction model,the threshold for precancerous lesions was 10 points,and the critical value for early cancer was 19 points.Conclu-sions:Implementation of the C14 urea breath test combined with PGⅠ,PGⅡ,and G-17 detection in high-risk populations for gastric cancer can help monitor disease progression in high-risk populations for gastric cancer.

prediction modelhigh-risk population for gastric cancerdisease progressiondiagnostic efficacy

孙树申、宋蕊、李雪、吕洪敏

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天津大学津南医院(天津市津南医院)消化内科(300052)

天津市第三中心医院肝内科

预测模型 胃癌高危人群 疾病进展 诊断效能

天津市教委科研项目

2022YGYB17

2024

中国肿瘤临床
中国抗癌协会

中国肿瘤临床

CSTPCD北大核心
影响因子:1.32
ISSN:1000-8179
年,卷(期):2024.51(5)
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