电子胃镜联合实验室指标检测在胃癌诊断中的价值及其与临床病理特征的关系

Clinical value of electronic esophagogastroduodenoscope combined with laboratory index detection in the diagnosis of gastric cancer and its relationship with clinicopathological features

摘要:

目的 探究电子胃镜联合实验室指标［血清糖类抗原724（CA724）、糖类抗原19-9（CA19-9）、微RNA-183（miRNA-183）和微RNA-144（miRNA-144）］检测在胃癌诊断中的价值及其与临床病理特征的关系。方法 选取2022年12月－2023年12月经病理检查确诊的122例胃癌患者作为A组（2022年12月－2023年12月该院收治），纳入该院同期收治的130例胃部良性肿瘤患者作为B组。所有患者在病理检查确诊前均先行电子胃镜检查，比较两组患者电子胃镜检查阳性率、血清CA724、CA19-9、miRNA-183和miRNA-144水平，并分析其对胃癌的诊断价值，比较不同病理特征胃癌患者电子胃镜检查阳性率及血清指标水平。结果 A组电子胃镜检查阳性率、血清CA724、CA19-9和miRNA-183水平高于B组，血清miRNA-144水平低于B组，差异均有统计学意义（P < 0.05）。与单独诊断相比，五者联合诊断胃癌的曲线下面积（AUC）更高，差异有统计学意义（P < 0.05）。不同分化程度、淋巴结转移情况和TNM分期患者电子胃镜检查阳性率、血清CA724、CA19-9、miRNA-183和miRNA-144水平比较，差异均有统计学意义（P < 0.05）。结论 电子胃镜检查在诊断胃癌及评估其病理特征方面，具有较好的应用效果，相关实验室指标（血清CA724、CA19-9、miRNA-183和miRNA-144）与胃癌的发生及病理特征密切相关，五者联合检测，可提高对胃癌的诊断效能。

Abstract:

Objective To explore the value of electronic esophagogastroduodenoscope combined with laboratory indicators [serum carbohydrate antigen 724 (CA724), carbohydrate antigen 19-9 (CA19-9), microRNA-183 (miRNA-183) and microRNA-144 (miRNA-144)] in the diagnosis of gastric cancer and its relationship with clinicopathological features.Methods 122 patients with gastric cancer diagnosed by pathological examination from December 2022 to December 2023 were selected as the group A, and 130 patients with gastric benign tumor in the same period were selected as the group B. All the patients underwent electronic esophagogastroduodenoscope before being diagnosed by pathological examination. The positive rates of electronic esophagogastroduodenoscope, the levels of serum CA724, CA19-9, miRNA-183 and miRNA-144 in the two groups of patients were compared, and their diagnostic value for gastric cancer was analyzed. The positive rates of electronic esophagogastroduodenoscope and the levels of serum indicators in patients with gastric cancer with different pathological characteristics were compared.Results The positive rate of electronic esophagogastroduodenoscope, the levels of serum CA724, CA19-9 and miRNA-183 in group A were higher than those in group B, while the level of serum miRNA-144 was lower than that in group B. The differences were all statistically significant (P < 0.05). Compared with individual diagnosis, the area under the curve (AUC) of the combined diagnosis of gastric cancer by the five was higher, and the difference was statistically significant (P < 0.05). There were statistically significant differences in the positive rates of electronic esophagogastroduodenoscope and the levels of serum CA724, CA19-9, miRNA-183 and miRNA-144 among patients with different degrees of differentiation, lymph node metastasis and TNM stage (P < 0.05).Conclusion Electronic esophagogastroduodenoscope has a good application effect in the diagnosis of gastric cancer and the evaluation of its pathological characteristics. Related laboratory indexes (serum CA724, CA19-9, miRNA-183 and miRNA-144) are closely related to the occurrence and pathological characteristics of gastric cancer. The combination of the five can improve the diagnostic efficiency of gastric cancer.