miR-375、CCL20与CEA联检对Hp感染相关胃癌前病变的诊断价值

doi:10.3760/cma.j.cn441417-20240828-06003

摘要/Abstract

摘要：

目的　探究血清微小RNA-375（microRNA-375，miR-375）、CC趋化因子配体20（C-C motif chemokine ligand 20，CCL20）与癌胚抗原（carcinoembryonic antigen，CEA）联检诊断幽门螺杆菌（Helicobacter pylori，Hp）感染相关胃癌前病变的临床价值。方法　选取2021年6月至2023年6月西安大兴医院收治的90例Hp感染的慢性萎缩性胃炎患者进行病例对照研究。所有患者均接受胃镜检查。根据有无胃癌前病变进行分组：26例发生病变的患者纳入研究组，其他64例未发生病变的患者纳入对照组。记录两组患者临床资料。检测所有患者血清miR-375、CCL20、CEA、胃蛋白酶原Ⅰ（pepsinogen Ⅰ，PGⅠ），计算PGⅠ/PGⅡ，并对影响胃癌前病变的相关因素进行分析。采用χ²检验、t检验进行统计分析。对影响患者发生胃癌前病变的因素进行多因素分析。采用受试者操作特征曲线（ROC）分析各指标的诊断效能。结果　两组性别、年龄、恶性肿瘤家族史、合并病史等比较，差异均无统计学意义（均P>0.05）。研究组PGⅠ水平、PGⅠ/PGⅡ、miR-375表达水平均低于对照组［（51.12±15.15）μg/L比（69.48±12.66）μg/L、12.05±2.34比15.11±2.51、0.77±0.09比0.88±0.06，t=-5.885、-5.342、-6.772，均P<0.001］；研究组CCL20、CEA水平均高于对照组［（32.88±5.11）ng/L比（17.22±5.02）ng/L、（10.22±2.12）U/ml比（6.13±1.56）U/ml，t=13.345、10.121，均P<0.001］；两组PGⅡ、胃泌素-17（gastrin-17，G-17）水平比较，差异均无统计学意义（均P>0.05）。经多因素分析，血清miR-375、CCL20、CEA均对患者胃癌前病变的发生具有影响。经ROC分析，血清miR-375、CCL20、CEA对患者胃癌前病变具有较高的诊断价值，其曲线下面积（AUC）分别为0.848、0.828、0.787；将上述指标纳入逻辑分析，并进行联合诊断，其AUC为0.894。结论　血清miR-375、CCL20和CEA联合诊断Hp感染的慢性萎缩性胃炎患者胃癌前病变具有较高的临床应用价值。

关键词:

微小RNA-375, CC趋化因子配体20, 癌胚抗原, 幽门螺杆菌, 胃癌前病变

Abstract:

Objective　To explore the clinical value of serum microRNA-375 (miR-375), C-C motif chemokine ligand 20 (CCL20), and carcinoembryonic antigen (CEA) in the diagnosis of Helicobacter pylori (Hp) -related gastric precancerous lesions. Methods　Ninety patients diagnosed with chronic atrophic gastritis and Hp infection treated at Xi'an Daxing Hospital between June 2021 and June 2023 were selected for the case control study. All the patients underwent endoscopy, and were grouped according to the presence or absence of gastric precancerous lesions: the 26 patients with lesions were assigned to a study group, and the remaining 64 patients without lesions a control group. The clinical data in both groups were recorded. The serum levels of miR-375, CCL20, CEA, and pepsinogen I (PG I) and the PG I/PG II ratio were measured. The factors affecting gastric precancerous lesions were analyzed. χ² and t tests were used for the statistical analysis. Multivariate analysis was used to analyzed the influencing factors. The diagnostic efficacy of each marker was evaluated using the receiver operating characteristic curve (ROC). Results　There were no statistical differences in gender, age, family history of malignancy, or comorbidities between the two groups (all P>0.05). The PGⅠ level, PGⅠ/PGⅡ, and miR-375 expression level in the study group were lower than those in the control group [(51.12±15.15) μg/L vs. (69.48±12.66) μg/L, 12.05±2.34 vs. 15.11±2.51, and 0.77±0.09 vs. 0.88±0.06; t=-5.885, -5.342, and -6.772; all P<0.001]; the levels of CCL20 and CEA in the study group were higher than those in the control group [(32.88±5.11) ng/L vs. (17.22±5.02) ng/L and (10.22±2.12) U/ml vs. (6.13±1.56) U/ml; t=13.345 and 10.121; both P<0.001]; there were no statistical differences in the levels of PGⅡ and gastrin-17 (G-17) between the two groups (both P>0.05). The multivariate analysis revealed that serum miR-375, CCL20, and CEA were the influential factors for the development of gastric precancerous lesions. The ROC analysis indicated that miR-375, CCL20, and CEA had high diagnostic value, with the areas under the curves (AUC) of 0.848, 0.828, and 0.787, respectively. Combining these markers using logistic analysis yielded an AUC of 0.894. Conclusion　The combination of serum miR-375, CCL20, and CEA in the diagnosis of Hp-related gastric precancerous lesions is clinically valuable.

Key words:

MicroRNA-375, CC chemokine ligand 20, Carcinoembryonic antigen, Helicobacter pylori, Gastric precancerous lesions

曾庆房朱盼盼施海.

miR-375、CCL20与CEA联检对Hp感染相关胃癌前病变的诊断价值 [J]. 国际医药卫生导报, 2025, 31(6): 890-895.

Zeng Qingfang, Zhu Panpan, Shi Hai.

Value of of miR-375, CCL20, and CEA in diagnosis of Hp-related gastric precancerous lesions [J]. International Medicine and Health Guidance News, 2025, 31(6): 890-895.

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