| Objective The study was to investigated the variation of serum pepsin and gastrin-17 concentrations in gastric cancer,and evaluate their clinical value in the auxiliary diagnosis of gastric cancer.Meanwhile,we analyzed the expression of serum miRNA-18 a in gastric cancer and its relationship with clinical pathological feature,and evaluated whether miRNA-18 a could be as a novel serum marker for the anxiliary diagnosis of gastric cancer.Methods(1)The level of serum PG?,PG ?,G-17,from 158 patients with gastric cancer,56 patients with chronic atrophic gastritis,53 patients with chronic superficial gastritis,85 healthy controls were determined by chemiluminescent method and calculated PG?/PG II(PGR).Data were analyzed by SPSS.Compared the expression of indexs in different grups,and receiver operating characteristic(ROC)curerves were ued for evaluate its auxiliary diagnostic value.(2)62 patients with gastric cancer,18 patients with chronic atrophic gastritis and 20 healthy controls were recruited.And real-time PCR was used to detemined the serum of miRNA-18 a.The results were analyzed by SPSS.The serum level of miRNA-18 a in different groups were compared and analyzed the correlation with clinicopathological features of gastric cancer,such as gender,age,tumor size,and its auxiliary diagnostic value for gastric cancer.Results(1)1)There was significant difference in the serum level of PGI?PGII and PGR,among gastric cancer patients,patients with chronic atrophic gastritis,patients with chronic superficial gastritis and healthy controls(F=23.929,p<0.01,F=10.785,p<0.01;F=28.076;p<0.01),while the serum G-17 level had no difference among four groups(F=1.428,p=0.235).The serum levels of PGI and PGR in gastric cancer patients were lower than other groups,but the difference in serum PGI level between gastric cancer group and chronic atrophic gastritis group has no statistically significant(p=0.135).2)The serum levels of PGI and PGR in gastric cancer were no obvious correlation with gender or age(p>0.05),but related to pathological stage or lesion location.The patients with advanced gastric cancer had lower of PG? and PGR than patients with early gastric cancer(p=0.014).The serum levels of PGI and PGR in gastric antral cancer were significant higher than gastric corpus cancer or multifocal gastric cancer(p<0.05).The expressions of G-17 were not correlation with gender,age or pathological stage(p>0.05),but related to lesion location.In chronic atrophic gastritis group or gastric cancer group,the G-17 serum level was lower in patients with gastric antral lesion compared with gastric antral lesion,but higher than patients with multifocal lesion(p<0.05).3)Acording to receiver operating characteristic(ROC)curves,the best cutoff point for the diagnosis of chronic atrophic gastritis was PG?: 83.5 ng/ml,PGR :8.2,and for gastric cancer were 69.6 ng/ml?2.9.(2)The expressions of serum miRNA-18 a in patients with gastric cancer were significantly higher than patients with chronic atrophic gastritis or healthy control(p<0.001),and there was no difference in serum serum miRNA-18 a level between chronic atrophic gastritis group and healthy control(p=0.726).The difference of serum miRNA-18 a level was not statistical significance in gender,age,tumor size,pathological stage(p>0.05),but related to lymph node metastasis and TNM stage(p<0.05).The area under receiver operating characteristic curve(AUC)of miRNA-18 a for diagnosis of gastric was 0.879(95% CI:0.816~0.943),the miRNA-18 a has a higher sensitivity in the diagnosis of gastric cancer,compared to pepsinogen(p<0.001).Conclusion Serum pepsinogen detection for chronic atrophic gastritis and gastric cancer has a good auxiliary diagnosis value.The detection of gastrin 17 was of little value in the diagnosis of gastric cancer,but the level of G-17 was related to the lesion of gastric cancer.The expression of serum miRNA-18 a in gastric cancer was increased.The expression level of serum miRNA-18 a was correlated with clinical stage and lymph node metastasis.miRNA-18 a has better auxiliary diagnosis for gastric cancer. |
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