放大内镜联合MUC2、MUC5AC、MUC6和CD10在早期胃癌诊断中的价值

The value of magnifying endoscopy combined with MUC2, MUC5AC, MUC6 and CD10 in diagnosis of early gastric cancer

摘要:

目的 探讨放大内镜联合黏蛋白2（MUC2）、黏蛋白5AC（MUC5AC）、黏蛋白6（MUC6）和CD10在早期胃癌诊断中的价值。方法 选取2018年5月－2021年5月在郴州市第一人民医院拟行内镜黏膜下剥离术（ESD）治疗的127例早期胃癌患者，收集癌组织及癌旁组织（ESD标本距肿瘤边缘 ≥ 1 cm）。全部患者均行放大内镜检查，采用免疫组化法测定MUC2、MUC5AC、MUC6和CD10的表达。分析放大内镜诊断早期胃癌的准确率。比较胃癌组织与癌旁组织MUC2、MUC5AC、MUC6和CD10的表达情况；分析放大内镜联合MUC2、MUC5AC、MUC6和CD10在早期胃癌中的诊断灵敏度和特异度。结果 127例早期胃癌患者，经放大内镜准确诊断108例，准确率为85.03%（108/127）。癌组织MUC2阳性表达率（61.42%）高于癌旁组织（11.81%）（P < 0.05），癌组织MUC5AC阳性表达率（54.33%）高于癌旁组织（14.17%）（P < 0.05），癌组织MUC6阳性表达率（48.03%）高于癌旁组织（7.87%）（P < 0.05），癌组织CD10阳性表达率（73.23%）高于癌旁组织（15.75%）（P < 0.05）。放大内镜联合MUC2、MUC5AC、MUC6和CD10诊断早期胃癌，其灵敏度和特异度明显高于放大内镜、MUC2、MUC5AC、MUC6和CD10单独诊断（P < 0.05）。结论 放大内镜联合MUC2、MUC5AC、MUC6和CD10在早期胃癌中诊断价值良好，且联合诊断可提高灵敏度和特异度。

Abstract:

Objective To explore the diagnostic value of magnifying endoscopy combined with Mucin 2 (MUC2), Mucin 5AC (MUC5AC), Mucin 6 (MUC6) and CD10 in early gastric cancer.Methods Tissues and adjacent tissues ( ≥ 1 cm from tumor margin) of 127 patients with early gastric cancer who were scheduled for endoscopic submucosal dissection (ESD) treatment from May 2018 to May 2021 were selected. Early gastric cancer patients underwent magnifying endoscopy; immunohistochemical method was used to determine the protein expression of MUC2, MUC5AC, MUC6 and CD10. Analyze the accuracy of magnifying endoscopy in the diagnosis of early gastric cancer. Compare the expression of MUC2, MUC5AC, MUC6 and CD10 in gastric cancer tissues and adjacent tissues; analyze the sensitivity and specificity of magnifying endoscopy combined with MUC2, MUC5AC, MUC6 and CD10 in the diagnosis of early gastric cancer.Results Among 127 patients with early gastric cancer, 108 cases were diagnosed accurately by magnifying endoscopy, with an accuracy rate of 85.03% (108/127). The positive expression of MUC2 in cancer tissues (61.42%) was higher than that in adjacent tissues (11.81%) (P < 0.05). The positive expression of MUC5AC in cancer tissues (54.33%) was higher than that in adjacent tissues (14.17%) (P < 0.05). The positive expression of MUC6 in cancer tissues (48.03%) was higher than that in adjacent tissues (7.87%) (P < 0.05). The positive expression of CD10 in cancer tissues (73.23%) was higher than that in adjacent tissues (15.75%) (P < 0.05). The sensitivity and specificity of magnifying endoscopy combined with MUC2, MUC5AC, MUC6 and CD10 in the diagnosis of early gastric cancer were significantly higher than those of magnifying endoscopy, MUC2, MUC5AC, MUC6 and CD10 alone (P < 0.05).Conclusion Magnifying endoscopy combined with MUC2, MUC5AC, MUC6 and CD10 has a good diagnostic value in early gastric cancer, and the combined diagnosis can improve the sensitivity and specificity.