CAJ | 학술논문

目的探讨组织三叶因子1(TFF1)蛋白表达水平与血清胃蛋向酶原(PG)在鉴别良、恶性胃溃疡中的临床意义.方法筛选自2011年1-6月在浙江医院行胃镜及病理组织学检查的18例对照、25例胃溃疡和13例溃疡型胃癌患者的胃黏膜组织,采用免疫组织化学法测定胃黏膜中TFF1蛋白的表达；酶联免疫吸附法( EUSA)检测血清PG Ⅰ、Ⅱ含量并计算PGⅠ与PGⅡ的比值(PGR).结果胃溃疡、溃疡旁组织、胃癌旁组织中TFF1表达明显均高于对照胃黏膜和胃癌组织(3.04％±0.20％、3.00％±0.20％、3.23％±0.26％比1.67％±0.18％和0.46％±0.18％,均P＜0.01).TFF1升高增加患者罹患胃溃疡风险(OR:1.365,95％ CI1.065 - 1.749,P=0.014)；TFF1表达下调则增高患者罹患胃癌风险(OR:3.067,95％ CI 1.391 ～6.757,P =0.005).胃溃疡组患者血清PGⅠ、PGⅡ水平均明显高于对照及胃癌组[(150±27)、(28±9)比(121±22)、(17±7),(79±12)、(20±5)μg/L,均P＜0.01]；胃癌组血清PGⅠ、PGR均显著低于对照组(均P＜0.01),PGⅡ水平则与对照组差异无统计学意义(P＞0.05).受试者特征曲线分析:血清PGI及PGR对胃癌的诊断价值较高(曲线下面积分别为0.975和0.914).结论 TFF1蛋白在胃溃疡中高表达,而在胃癌中表达明显降低；血清PGⅠ、PGⅡ显著升高提示良性溃疡,而血清PGI、PGR明显降低是恶性溃疡的危险信号.检测TFF1蛋白表达和血清PG水平有利于良、恶性胃溃疡的鉴别诊断.
목적 탐토조직삼협인자1(TFF1)단백표체수평여혈청위단향매원(PG)재감별량、악성위궤양중적림상의의.방법 사선자2011년1-6월재절강의원행위경급병리조직학검사적18례대조、25례위궤양화13례궤양형위암환자적위점막조직,채용면역조직화학법측정위점막중TFF1단백적표체；매련면역흡부법( EUSA)검측혈청PG Ⅰ、Ⅱ함량병계산PGⅠ여PGⅡ적비치(PGR).결과 위궤양、궤양방조직、위암방조직중TFF1표체명현균고우대조위점막화위암조직(3.04％±0.20％、3.00％±0.20％、3.23％±0.26％비1.67％±0.18％화0.46％±0.18％,균P＜0.01).TFF1승고증가환자리환위궤양풍험(OR:1.365,95％ CI1.065 - 1.749,P=0.014)；TFF1표체하조칙증고환자리환위암풍험(OR:3.067,95％ CI 1.391 ～6.757,P =0.005).위궤양조환자혈청PGⅠ、PGⅡ수평균명현고우대조급위암조[(150±27)、(28±9)비(121±22)、(17±7),(79±12)、(20±5)μg/L,균P＜0.01]；위암조혈청PGⅠ、PGR균현저저우대조조(균P＜0.01),PGⅡ수평칙여대조조차이무통계학의의(P＞0.05).수시자특정곡선분석:혈청PGI급PGR대위암적진단개치교고(곡선하면적분별위0.975화0.914).결론 TFF1단백재위궤양중고표체,이재위암중표체명현강저；혈청PGⅠ、PGⅡ현저승고제시량성궤양,이혈청PGI、PGR명현강저시악성궤양적위험신호.검측TFF1단백표체화혈청PG수평유리우량、악성위궤양적감별진단.
Objective To explore the clinical significance of trefoil factor 1 ( TFF1 ) protein expression and serum pepsinogen(PG) concentration in benign and malignant gastric ulcers.Methods The TFF1 protein expression was evaluated by immunohistochemistry in biopsies of gastric mucosa from 18 normal controls,25 patients with gastric ulcer and 13 patients with ulcerative gastric cancer at our hospital during January to June 2011. The serum concentrations of PG Ⅰ and PG Ⅱ were detected by enzyme-linked immunosorbent assay (ELISA) and PG/PG Ⅱ (PGR) was subsequently calculated.Results The expression of TFF1 protein increased significantly in ulcerative and peripheral gastric mocusa and peripheral mocusa of gastric cancers versus that in normal controls and the ulcerocancer group ( 3.04％ ± 0.20％,3.00％ ±0.20％,3.23％ ±0.26％ vs 1.67％ ± 0.18％,0.46％ ±0.18％,all P ＜0.01 ).The elevated expression of TFF1 increased the risk of gastric ulcer ( OR:1.365,95％ CI:1.065 - 1.749,P =0.014) while the down-regulation of TFF1 significantly increased the risk of ulcerocancer ( OR:3.067,95％ CI:1.391 -6.757,P =0.005).The serum levels of PG Ⅰ and PG Ⅱ in gastric ulcer group were significantly higher than that in normal control and ulcerocancer group( (150 ±27),(28 ±9) vs (121 ±22).(17 ±7),(79 ±12),(20 ± 5 )μg/L,all P ＜ 0.01 ).The PG Ⅰ level and PGR decreased significantly in the ulcerocancer group versus normal control (both P＜0.01).But there was no statistical difference in PGⅡ (P＞0.05).Receiver operating characteristic curve analysis revealed that PG Ⅰ and PGR were valuable for the diagnosis of malignant gastric cancer with an area under curve of 0.975 and 0.914 respectively.Conclusions The expression of TFF1 protein increases in gastric ulcer but decreases in gastric ulcerocancer.The elevated serum levels of PG Ⅰ and PG Ⅱ indicate benign ulcer while a marked decline of serum PG Ⅰ and PGR serves as a risk signal of malignant gastric ulcer.The evaluation of expression profiles of TFF1 protein and PGs is helpful for the differentiation of benign gastric ulcer from malignant ulcerocancer.