生活习惯及细胞色素P4501A1基因多态性对胃镜诊断慢性萎缩性胃炎的影响

Influence of lifestyle and cytochrome P4501A1 gene polymorphism on the diagnosis of chronic atrophic gastritis by gastroscopy

摘要:

目的 探讨生活习惯及细胞色素P4501A1（CYP1A1）基因多态性对胃镜诊断慢性萎缩性胃炎的影响因素。方法 选取2023年5月－2024年5月于该院行胃镜检查确诊的慢性萎缩性胃炎患者118例，纳入慢性萎缩性胃炎组，同期行胃镜检查确诊慢性非萎缩性胃炎的120例患者，纳入慢性非萎缩性胃炎组。比较两组患者临床资料、生活习惯、胃镜检查情况和CYP1A1基因多态性；采用多因素Logistic回归模型，分析影响胃镜诊断慢性萎缩性胃炎的因素；建立回归方程，并绘制受试者操作特征曲线（ROC curve），分析回归方程对胃镜诊断慢性萎缩性胃炎的预测价值。结果 多因素Logistic分析结果显示，幽门螺杆菌感染、胃炎家族史、快食、烫食、失眠和CYP1A1基因型G/G型是经胃镜诊断慢性萎缩性胃炎的影响因素（P < 0.05）。将上述因素纳入回归方程：Logit（P） = -8.252+幽门螺杆菌感染×0.741+胃炎家族史×0.636 + 快食×0.595+烫食×0.754+失眠×0.791 + CYP1A1基因型G/G型×0.752。按照回归方程绘制预测胃镜诊断慢性萎缩性胃炎的ROC curve，结果显示：当Logit（P） > 0.727时，敏感度为87.29%，特异度为86.67%，曲线下面积（AUC）为0.922。结论 幽门螺杆菌感染、胃炎家族史、快食、烫食、失眠和CYP1A1基因型G/G型是胃镜诊断慢性萎缩性胃炎的影响因素，据此建立的回归方程有效，可为临床筛选高危患者，制定预防和干预措施。

Abstract:

Objective To analyze the influencing factors of chronic atrophic gastritis diagnosed by gastroscopy based on living habits and cytochrome P4501A1 (CYP1A1) gene polymorphism.Methods A total of 118 patients with chronic atrophic gastritis diagnosed by gastroscopy in our hospital from May 2023 to May 2024 were included in the chronic atrophic gastritis group, and another 120 patients with chronic non-atrophic gastritis diagnosed by gastroscopy during the same period were included in the chronic non-atrophic gastritis group. Clinical data, lifestyle, gastroscopy and CYP1A1 gene polymorphism were compared between the two groups. The risk factors of chronic atrophic gastritis diagnosed by gastroscopy were analyzed by multivariate Logistic regression, and the regression equation was established. Receiver operating characteristic curve (ROC curve) was drawn to analyze the predictive value of the regression equation for the diagnosis of chronic atrophic gastritis by gastroscopy.Results Multivariate Logistic analysis showed that Helicobacter pylori infection, family history of gastritis, fast eating, hot eating, insomnia, CYP1A1 genotype G/G were the risk factors for the diagnosis of chronic atrophic gastritis by gastroscopy (P < 0.05). The above factors were included in the regression equation: Logit (P) = -8.252 + Helicobacter pylori infection × 0.741 + family history of gastritis × 0.636 + fast food × 0.595 + hot food ×0.754 + insomnia × 0.791 + CYP1A1 genotype G/G × 0.752. According to the regression equation, ROC curve was drawn to predict the occurrence of chronic atrophic gastritis diagnosed by gastroscopy. The results showed that when Logit (P) > 0.727, the sensitivity was 87.29%, the specificity was 86.67%, and the area under the curve (AUC) was 0.922.Conclusion The influencing factors of chronic atrophic gastritis diagnosed by gastroscopy include Helicobacter pylori infection, family history of gastritis, fast food, hot food, insomnia, CYP1A1 genotype G/G, the establishment of the regression equation is effective, which can lay a foundation for screening high-risk patients and formulating preventive interventions.