临床研究(Clinical Research)

胃双重超声造影结合血清巨噬细胞炎症蛋白1与血管细胞黏附分子1检测对胃癌术前分期的价值

Published at: 2016年第25卷第4期

张超贤 1 , 郭李柯 2 , 秦咏梅 1 , 李光艳 1
1 新乡医学院第一附属医院消化内科,河南 卫辉 453100
2 新乡医学院第一附属医院口腔科,河南 卫辉 453100
通讯作者 超贤 张 Email: g75zh@aliyun.com
DOI: 10.3978/j.issn.1005-6947.10.3978/j.issn.1005-6947.2016.04.018
基金:

摘要

目的:探讨胃双重超声造影(DCEUS)联合血清巨噬细胞炎症蛋白1(MIP-1)与血管细胞黏附分子1(VCAM-1)检测对胃癌术前分期的临床价值。方法:685例胃癌患者术前行胃镜和DCEUS检查并进行术前分期,同时运用ELISA法检测术前血清MIP-1与VCAM-1水平,根据术后病理分期,比较DCEUS与DCEUS联合MIP-1与VCAM-1检测对胃癌术前分期判断准确性。结果:DCEUS对胃癌T分期判断的敏感性(特异性)分别为T1 93.10%(92.05%)、T2 67.47%(65.50%)、T3 78.62%(80.47%)、T4 91.41%(90.70%),总准确率为80.15%;对N分期判断的敏感性(特异性)分别为N0 90.55%(80.99%)、N1 63.57%(73.87%)、N2 88.40%(92.50%)、N3 82.35%(73.68%),总准确率为82.92%;对M分期判断的敏感性(特异性)分别为:M0 99.29%(84.82%)、M1 71.48%(98.43%),总准确率为88.61%。血清MIP-1和VCAM-1水平与胃癌组织浸润程度、淋巴结转移、远处转移和病理分期均有关(均P<0.05)。DCEUS联合MIP-1、VCAM-1检测对T分期判断的敏感性(特异性)分别为T1 93.10%(92.05%)、T2 87.95%(94.19%)、T3 95.07%(92.33%)、T4 91.41%(90.70%),总准确率为92.41%;对N分期判断的敏感性(特异性)分别为:N0 98.43%(96.90%)、N1 89.15%(94.26%)、N2 95.22%(95.22%)、N3 92.65%(89.36%),总准确率为94.16%;对M分期判断的敏感性(特异性)分别为M0 99.76%(97.68%)、M1 96.20%(99.61%),总准确率为98.39%。DCEUS联合MIP-1、VCAM-1检测对判断胃癌T、N、M分期的准确率均明显高于DCEUS(均P<0.05)。结论:胃癌的病理分期与血清MIP-1和VCAM-1表达密切相关,DCEUS联合术前检测MIP-1和VCAM-1血清水平,有利于提高胃癌术前分期判断的准确性。


Value of double contrast-enhanced ultrasonography combined with measurement of serum macrophage inflammatory protein 1 and vascular cell adhesion molecule 1 in preoperative staging for gastric carcinoma

Abstract

Objective: To assess the clinical value of double contrast-enhanced ultrasonography (DCEUS) of the stomach combined with determination of serum macrophage inflammatory protein 1 (MIP-1) and vascular cell adhesion molecule 1 (VCAM-1) in preoperative staging for gastric cancer. Methods: Six-hundred and eighty-five patients with gastric cancer underwent gastroscopy and DCEUS examination for preoperative staging, and meanwhile, their preoperative MIP-1 and VCAM-1 levels were measured by ELISA assay. According to the results of postoperative pathological tumor staging, the accuracy in preoperative stage estimation of gastric carcinoma between DCEUS and DCEUS plus MIP-1 and VCAM-1 measurement was compared. Results: The sensitivity (specificity) of DCEUS in estimating T stage of gastric cancer was 93.10% (92.05%) for T1, 67.47% (65.50%) for T2, 78.62% (80.47%) for T3 and 91.41% (90.70%) T4 respectively, with an overall accuracy rate of 80.15%, in estimating N stage was 90.55% (80.99%) for N0, 63.57 % (73.87%) for N1, 88.40% (92.50%) for N2 and 82.35% (73.68%) for N3 respectively, with an overall accuracy rate of 82.92%, and in estimating M stage was 99.29% (84.82%) for M0 and 71.48% (98.43%) for M1 respectively, with an overall accuracy rate of 88.61%. Both serum levels of MIP-1 and VCAM-1 were significantly related to the degree of invasion, lymphatic metastasis, distant metastasis and pathological stage of gastric carcinoma (all P<0.05). The sensitivity (specificity) of DCEUS plus MIP-1 and VCAM-1 measurement in estimating T stage of gastric cancer was 93.10% (92.05%) for T1, 87.95% (94.19%) for T2, 95.07% (92.33%) for T3 and 91.41% (90.70%) for T4 respectively, with an overall accuracy rate of 92.41%, in estimating N stage was 98.43% (96.90%) for N0, 89.15% (94.26%) for N1, 95.22 % (95.22%) for N2 and 92.65% (89.36%) for N3 respectively, with an overall accuracy rate of 94.16%, and in estimating M stage was 99.76% (97.68%) for M0 and 96.20%(99.61%) for M1 respectively, with an overall accuracy rate of 98.39%. The overall accuracy rates of DCEUS plus MIP-1 and VCAM-1 measurement in estimating either T, N or M stage of gastric cancer was significantly higher than that of DCEUS alone (all P<0.05). Conclusion: Serum levels of MIP-1 and VCAM-1 are closely related to pathological stage of gastric cancer, and DCEUS in combination with MIP-1 and VCAM-1 detection may help increase the accuracy rate of preoperative staging of gastric cancer.


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引用本文: 超贤 张, 李柯 郭, 咏梅 秦, 光艳 李. 胃双重超声造影结合血清巨噬细胞炎症蛋白1与血管细胞黏附分子1检测对胃癌术前分期的价值[J]. 中国普通外科杂志, 2016, 25(4): 573-580.
Cite this article as: ZHANG Chaoxian, GUO Like, QIN Yongmei, LI Guangyan . Value of double contrast-enhanced ultrasonography combined with measurement of serum macrophage inflammatory protein 1 and vascular cell adhesion molecule 1 in preoperative staging for gastric carcinoma [J]. Chin J Gen Surg, 2016, 25(4): 573-580.