The Establishment Of Diagnostic Model Of Combined Detection Of SHLA-G, PGR And GPR And Its Evaluation For Diagnosis Of Gastric Cancer

Objective:To detect expression of pepsinogens (PG I and PG II), gastrin-17(G-17) and sHLA-G in the patients with gastric cancer or precancerous lesion, and to evaluate the efficiency of combined diagnosis index of PGR (PG I/II), GPR (G-17/PG I) and sHLA-G in these patients.Method:1.5ml plasma or serum samples were collected from every patient, then centrifuged with 3000 r/min for 10min. The collected serum and plasma must be determined immediately, stored at 4℃within one week,-20℃ or -80℃ for long-time detection (more than 1 week).2. The levels of PGs, G-17 were detected in 50 healthy volunteers,46 patients with atrophic gastritis,50 patients with gastric intraepithelial neoplasia,36 with early gastric cancer and 74 with advanced gastric cancer by chemiluminescent microparticle immunoassay3. The levels of sHLA-G were detected in 50 healthy volunteers,46 patients with atrophic gastritis,50 patients with gastric intraepithelial neoplasia,36 with early gastric cancer and 74 with advanced gastric cancer by ELISA analysis.4. The logistic regression and ROC curve were used to establish a new diagnostic panel for gastric cancer using the combined diagnosis biomarkers PGR, GPR and sHLA-G.Results:1. The significant reduced GPR was detected in patients with early and advanced gastric cancer, compared with healthy volunteers, patients with gastric intraepithelial neoplasia and atrophic gastritis (P<0.001, respectively).2. The levels of sHLA-G and PGR were significantly higher in patients with early and advanced gastric cancer than those in healthy volunteers, patients with gastric intraepithelial neoplassia and atrophic gastritis (P<0.001, respectively).3. The ROC-AUC of sHLA-G and GPR were 0.846 (95%CI,0.760-0.910) and 0.835 (95%CI,0.748-0.902) respectively, which were significantly higher than those of GPR (0.716,95%CI,0.617-0.802). The new diagnostic model of gastric cancer was logit(Y)=0.41+0.03 X sHLA-G-5.90 X PGR, and the ROC-AUC of diagnosis of gastric cancer of the new variable Y was 0.924(95%CI,0.853-0.967), which was higher than those of sHLA-G and PGR(P<0.05).4. Conclusion:1. The diagnostic value of sHLA-G, PGs and G17 were somehow uneven. Based on the information, the ratio of PGs (PGR), PGs and G17 (GPR) were evaluated and a more significant value of sHLA-G and PGR were found during this process2. The combined detection of sHLA-G and PGR was helpful for diagnosis of gastric cancer, and it was a useful supplement to traditional tumor markers. Thus, a new diagnostic model was established for a better diagnostic value of gastric cancer.