Application Of Serum Gastric Functions Combined With ¹⁴C-UBT In The Screening Of First-degree Relatives Of Gastric Cancer

Objective1.To compare the differences of serum PGI,PGI,PGR and G-17 levels in FDRs of gastric cancer patients with no family history of cancer;2.To investigate the predictive value of serum PGI,PGI,PGR,G-17 and ¹⁴C-UBT alone and in combination with FDRs in patients with gastric cancer;3.To analyze the differences of risk of PLGC and GC among different types of FDRs in patients with gastric cancer.Method1.Collect patients with gastric cancer?GC?diagnosed by gastroscopy and pathology from the inpatient department and outpatient department of Yan'an University Affiliated Hospital from January 2017 to December 2018,and retrospectively investigate 163 cases of their first-degree relatives?FDRs?as observation groups,including parents,siblings,and children;At the same time,a number of healthy people were randomly selected as the control group?HC?.2.Collect all the research subjects:?1?General information:sex,age,height,weight,body mass index,smoking history,drinking history,salted fried diet and other living habits;?2?Auxiliary examination:serum gastric function,including serum pepsin Progesterone?PG?,PGR,serum gastrin-17?G-17?,¹⁴C-urea breath test(¹⁴C-UBT),electronic gastroscopy,histopathology and serum carcinoembryonic antigen?CEA?,carbohydrate antigen 199?CA199?.The FDRs group should also collect a family history section of the tumor.In this section,we divide their relatives into fathers,mothers,and siblings.Gastroscopy+pathological examination was used as the gold standard.3.SPSS 20.0 statistical analysis software package was used for statistical processing of all data;measurement data that conformed to the normal distribution were expressed as mean�standard deviation?`x�s?,and the two groups were compared using t test;the skewed distribution was expressed as the median trend using the median,Percentiles P25and P75 indicate the discrete trend,and the measurement data and ordered rank data of the skewed distribution use the Mann-Whiney rank sum test of two independent samples;the count data are expressed by[?n,%?],and the comparison between the two groups x²test or Fisher's exact test;draw the receiver operating characteristic curves?ROC?to determine the Good diagnostic cutoff value,the area under the curve?AUC?is used to evaluate the diagnostic efficacy of the index;use Binary Logistic regression to estimate gastric cancer odds?OR?ratios and 95%confidence?95%CI?intervals associated with family history of cancer.P<0.05 indicates that the difference is statistically significant.Result1.A total of 313 investigators who met the inclusion and exclusion criteria were included in this study.The FDRs group:n=163,79 males?48.47%?and 84 females?51.53%?.Mean age:44.64�8.85 years;HC group:N=150,including 86 males?57.33%?and 64 females?42.67%?.The average age was 46.13�9.11 years.2.The comparison of serum gastric function levels between the FDRs group and the HC group found that the ratios of PGI and PGR in the FDRs group were lower than those in the control group,and the difference was statistically significant?p?0.05?;the levels of PGII and G-17 in the FDRs group were higher than those in the control group,and there were differences Statistical significance?p?0.05?.3.There were 163 cases in the FDRs group,of which 76 cases were positive with¹⁴C-UBT results,and the Hp infection rate was 46.63%;150 cases were in the HC group,and 42 cases were positive with¹⁴C-UBT results.The Hp infection rate was 28.00%The difference between the two groups is significant?p?0.05?.4.The serum CA199 level in the FDRs group was higher than that in the control group,and the difference was statistically significant?p?0.05?;however,there was no significant difference in serum CEA levels between the two groups?p?0.05?.5.Gastroscopy and pathological examination results:The differences in gastroscopy and pathological results between the two groups were statistically significant?p?0.05?.Among them,PLGC in the FDRs group accounted for 62.58%,and HC group accounted for 38.00%.The difference between the two groups was statistically significant?p?0.05?.It can be seen that the incidence of PLGC and GC in the FDRs group was higher than that in the healthy control group.6.Draw ROC curve to evaluate PGI,PGII,PGR,G-17,14C-UBT alone and joint detection to predict the value of PLGC and GC,and use PGI,PGII,PGR,G-17,14C-UBT against PLGC and The AUC during the GC prediction was 0.652,0.655,0.612,0.613,and 0.841;the AUC increased to 0.912?95%CI:0.867 to 0.956,p?0.05?when the prediction was performed by the combined test,which was higher than any of the indicators used alone,and The sensitivity is 93.80%and the specificity is 80.50%;However,the diagnostic value of PGI,PGII,PGR,and G-17 in healthy people is low,and their AUCs are all less than 0.5.7.The relationship between the family history of gastric cancer in the first-degree relatives and the incidence of PLGC and GC:the family history of gastric cancer increases the risk of GC and PLGC,and the OR value increases with the number of first-degree relatives with gastric cancer in the family?P?0.01?;PLGC and GC risk of gastric cancer in fathers,mothers,and siblings with gastric cancer were 1.82 times,2.44times,and 4.41 times that of those without family history,respectively;The siblings had the highest prevalence?OR=4.41,95%CI:2.25-8.63?.Conclusion1.The first-degree relatives of patients with gastric cancer are more likely to develop precancerous lesions and gastric cancer than healthy people.2.The serum gastric function combined with ¹⁴C-UBT has higher predictive value for screening in first-degree relatives of gastric cancer.3.In the kin category,siblings have higher associations with gastric cancer and precancerous lesions,which can provide a certain basis for screening in high-risk populations.