胃充盈超声造影联合血清DDIT4、LTBP2对早期胃癌的诊断价值OA
Diagnostic value of gastric filling contrast-enhanced ultrasound combined with serum DDIT4 and LTBP2 in early gastric cancer
目的 探讨胃充盈超声造影联合血清DNA损伤诱导转录因子4(DDIT4)、转化生长因子结合蛋白2(LTBP2)对早期胃癌的诊断价值.方法 选择2023年10月至2024年6月该院收治的120例胃癌高危患者为研究对象,所有入选者进行为期12个月的随访,在随访期内均进行多轮胃充盈超声造影和病理学检查,依据病理学检查结果分为胃癌和非胃癌患者;采用酶联免疫吸附试验检测血清DDIT4、LTBP2水平;绘制受试者工作特征(ROC)曲线分析血清 DDIT4、LTBP2对胃癌的诊断效能,获取最佳截断值;以病理学检查结果为金标准,通过诊断四格表分析胃充盈超声造影及血清DDIT4、LTBP2检测对胃癌的诊断效能.结果 病理学检查结果显示,120例胃癌高风险患者中胃癌64例、非胃癌56例.胃癌患者血清DDIT4、LTBP2水平明显高于非胃癌患者(P<0.05).肿瘤最大径≥2 cm 的胃癌患者血清DDIT4、LTBP2水平高于肿瘤最大径<2 cm 的患者(P<0.05);TNM 分期为Ⅰ期的胃癌患者血清 DDIT4、LTBP2水平高于 TNM 分期为0期的患者(P<0.05);分化程度为低分化的胃癌患者血清 DDIT4、LTBP2水平高于分化程度为中高分化的患者(P<0.05).血清DDIT4、LTBP2诊断胃癌的最佳截断值分别为9.787 ng/L、19.891 μg/L.胃充盈超声造影诊断胃癌的准确度为75.83%,血清 DDIT4诊断早期胃癌的准确度为79.17%,血清 LTBP2诊断早期胃癌的准确度为73.33%.胃充盈超声造影联合血清DDIT4、LTBP2检测诊断胃癌的灵敏度为90.63%、特异度为91.07%、准确度为90.83%、阴性预测值为89.47%、阳性预测值为92.06%,3项联合诊断胃癌的准确度高于任一指标单独诊断(P<0.05).结论 早期胃癌患者血清DDIT4、LTBP2水平升高,与部分临床病理特征有关;胃充盈超声造影联合血清DDIT4、LTBP2检测对早期胃癌的诊断价值较高,是具有广阔应用潜能的胃癌高危患者早期诊断方法.
Objective To explore the diagnostic value of gastric filling contrast-enhanced ultrasound com-bined with serum DNA damage-inducible transcript 4(DDIT4)and latent transforming growth factor beta binding protein 2(LTBP2)in early gastric cancer.Methods A total of 120 high-risk patients with gastric cancer admitted and treated in this hospital from October 2023 to June 2024 were selected as the research sub-jects.All selected subjects were followed up for 12 months and during the follow up period the multiple rounds of gastric filling contrast-enhanced ultrasound and pathological examinations were conducted.They were classified into the patients with gastric cancer and the patients with non-gastric cancer based on the diag-nosis.The serum DDIT4 and LTBP2 levels were detected by the enzyme-linked immunosorbent assay.The re-ceiver operating characteristic(ROC)curve was drawn to analyze the diagnostic efficiency of serum DDIT4 and LTBP2 for gastric cancer and the optimal cut-off values were obtained.The pathological examination re-sults were taken as the gold standard,and the diagnostic efficiency of gastric filling contrast-enhanced ultra-sound and serum DDIT4 and LTBP2 detection for gastric cancer was analyzed through the diagnostic fourfold table.Results The pathological examination results showed that among the 120 high-risk patients with gas-tric cancer,there were 64 cases of gastric cancer and 56 cases of non-gastric cancer.The serum DDIT4 and LT-BP2 levels in the patients with gastric cancer were significantly higher than those in the patients with non-gas-tric cancer(P<0.05).The serum DDIT4 and LTBP2 levels in gastric cancer patients with a maximum tumor diameter≥2 cm were higher than those with a maximum tumor diameter<2 cm(P<0.05),the serum DDIT4 and LTBP2 levels in gastric cancer patients with TNM stage Ⅰ were higher than those with stage 0(P<0.05),the serum DDIT4 and LTBP2 levels in gastric cancer patients with low differentiaton were higher than those with moderately to high differentiation(P<0.05).The optimal cut-off values of serum DDIT4 and LTBP2 for diagnosing gastric cancer were 9.787 ng/L and 19.891 μg/L,respectively.The accuracy degree of gastric filling contrast-enhanced ultrasound in diagnosing gastric cancer was 75.83%,which of serum DDIT4 in diagnosing early gastric cancer was 79.17%,and which of serum LTBP2 in diagnosing early gastric cancer was 73.33%.The sensitivity,specificity,accuracy,negative predictive value and positive predictive value of gastric filling contrast-enhanced ultrasound combined with serum DDIT4 and LTBP2 detection in diagnosing gastric cancer were 90.63%,91.07%,90.83%,89.47%and 92.06%,respectively.The accuracy of the 3-item combination diagnosis for gastric cancer was higher than that of any single indicator(P<0.05).Conclusion The serum DDIT4 and LTBP2 levels in the patients with early gastric cancer are increased and related to some clin-ical pathological features.The combination of gastric filling contrast-enhanced ultrasound with serum DDIT4 and LTBP2 detection has a high diagnostic value for early gastric cancer and is a promising early diagnostic method for gastric cancer in high-risk patients.
许万;罗伊真;刘治;胡婧;赵世恩
河西学院附属张掖人民医院:彩超室,甘肃 张掖 734000河西学院附属张掖人民医院:彩超室,甘肃 张掖 734000河西学院附属张掖人民医院:彩超室,甘肃 张掖 734000河西学院附属张掖人民医院:彩超室,甘肃 张掖 734000河西学院附属张掖人民医院:肿瘤科,甘肃 张掖 734000
医药卫生
胃癌胃充盈超声造影DNA损伤诱导转录因子4转化生长因子结合蛋白2诊断
gastric cancergastric filling contrast-enhanced ultrasoundDNA damage-inducible tran-script 4latent transforming growth factor-β binding protein 2diagnosis
《检验医学与临床》 2026 (10)
1334-1339,6
甘肃省高校教师创新基金项目(2025A-187).
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