CAJ | 학술논문

目的：通过测定组织及血清组织因子途径抑制物2（TFPI-2）基因甲基化，探讨其作为一种肿瘤标志物对胃癌诊断的临床价值。方法收集32例胃癌、29例萎缩性胃炎作为研究对象，以30例不排除浅表性胃炎的正常对象作为对照。应用甲基化特异性聚合酶链反应（MSP）方法，测定组织及血清 TFPI-2基因甲基化状态。应用电化学发光免疫法测定癌胚抗原（CEA）、糖类抗原199（CA199）。结果组织 TFPI-2基因甲基化检出率胃癌组为53．13％、萎缩性胃炎组为37．93％、对照组为3．33％。胃癌组明显高于对照组（P ＜0．05）。血清 TFPI-2基因甲基化检出率胃癌组为28．13％，萎缩性胃炎组为6．90％，对照组未检出。胃癌组明显高于萎缩性胃炎组（P ＜0．05）和对照组（P ＜0．05）。血清 TFPI-2基因甲基化检测灵敏度为28．13％，特异性为96．61％。血清检出阳性占组织检出阳性的比率为37．93％。胃癌组血清 TFPI-2基因甲基化与性别、年龄、Borrmann′s 分期、CEA 和CA199检测结果无关（P ＞0．05）。胃癌组血清 TFPI-2基因甲基化与 CEA、CA199阳性检出率分别为28．13％、21．88％、18．75％。联合3项阳性检出率为53．13％，显著高于3项各自单独检测（P ＜0．05）。结论血清TFPI-2基因甲基化来源于组织，其对胃癌诊断特异性较高，但灵敏度较差。联合检测血清 CEA、CA199有利于提高其灵敏度。血清 TFPI-2基因甲基化测定对胃癌的诊断有一定价值。
목적：통과측정조직급혈청조직인자도경억제물2（TFPI-2）기인갑기화，탐토기작위일충종류표지물대위암진단적림상개치。방법수집32례위암、29례위축성위염작위연구대상，이30례불배제천표성위염적정상대상작위대조。응용갑기화특이성취합매련반응（MSP）방법，측정조직급혈청 TFPI-2기인갑기화상태。응용전화학발광면역법측정암배항원（CEA）、당류항원199（CA199）。결과조직 TFPI-2기인갑기화검출솔위암조위53．13％、위축성위염조위37．93％、대조조위3．33％。위암조명현고우대조조（P ＜0．05）。혈청 TFPI-2기인갑기화검출솔위암조위28．13％，위축성위염조위6．90％，대조조미검출。위암조명현고우위축성위염조（P ＜0．05）화대조조（P ＜0．05）。혈청 TFPI-2기인갑기화검측령민도위28．13％，특이성위96．61％。혈청검출양성점조직검출양성적비솔위37．93％。위암조혈청 TFPI-2기인갑기화여성별、년령、Borrmann′s 분기、CEA 화CA199검측결과무관（P ＞0．05）。위암조혈청 TFPI-2기인갑기화여 CEA、CA199양성검출솔분별위28．13％、21．88％、18．75％。연합3항양성검출솔위53．13％，현저고우3항각자단독검측（P ＜0．05）。결론혈청TFPI-2기인갑기화래원우조직，기대위암진단특이성교고，단령민도교차。연합검측혈청 CEA、CA199유리우제고기령민도。혈청 TFPI-2기인갑기화측정대위암적진단유일정개치。
Objective Through the detection of serum and tissue methylated tissue factor pathway inhibitor 2 (TFPI-2)gene,to investigate its clinical significance as a tumor marker for the diagnosis of gastric cancer.Methods A total of 32 gastric cancer patients and 29 atrophic gastritis patients were enrolled,and 32 healthy subjects including superficial gastritis were enrolled as control group.Methylated TFPI-2 gene was detected by methylation-specific polymerase chain reaction (MSP).Carcinoembryonic antigen (CEA)and carbohydrate antigen 199 (CA199)were determined by electrochemiluminescence immunoassay.Results The positive rates of methylated TFPI-2 gene in tissue were 53.13% in gastric cancer group,37.93% in atrophic gastritis group and 3.33% in control group.Tissue methylated TFPI-2 gene was significantly higher in gastric cancer group than in control group (P <0.05).The positive rates of methylated TFPI-2 gene in serum were 28.13% in gastric cancer group,6.90% in atrophic gastritis group,but none in control group.Serum methylated TFPI-2 gene was significantly higher in gastric cancer group than in atrophic gastritis group (P <0.05)and in control group (P <0.05).The sensitivity and specificity of serum methylated TFPI-2 gene for the diagnosis of gastric cancer were 28.13% and 96.61%.The 37.93% positive rate was got in serum against tissue.The TFPI-2 gene methylation in serum showed no correlation with sex,age,Borrmann′s classification,CEA and CA199 in gastric cancer group (P >0.05).In gastric cancer group,the positive rates of methylated TFPI-2 gene,CEA and CA199 were 28.13%,21.88% and 18.75%,respectively.If performing the combined determination of all the 3 parameters,the positive rate was 53.13%,and the positive rate was significantly higher than those of the single determinations (P <0.05).Conclusions The TFPI-2 gene methylation in serum derives from gastric cancer tissues, and it shows high specificity for the diagnosis of gastric cancer,but the sensitivity is relatively low.It can improve the sensitivity if performing the combined determination with CEA and CA199.The detection of serum TFPI-2 gene methylation has certain significance for diagnosing gastric cancer.