联合检测BRD4、SSBP1与PCDH17在胃癌早期诊断中的应用价值

目的 探讨溴结构域蛋白4（bromodomain protein 4，BRD4）、线粒体单链DNA结合蛋白（single-stranded DNA binding protein，SSBP1）与原钙黏附蛋白17（ proto-cadherin 17，PCDH17）诊断早期胃癌的临床价值。 方法 收集胃癌组织50例，癌前病变组织50例、正常胃黏膜组织50例，应用免疫组织化学染色法分别测定组织标本中BRD4、SSBP1及PCDH17蛋白的表达，分析不同组织样本中BRD4、SSBP1及PCDH17的表达情况，分别采集3组血液标本，检测3组相关血清指标，应用ROC曲线分析BRD4、SSBP1及PCDH17诊断胃癌的价值。 结果 胃癌组织中BRD4和SSBP1呈高表达，而PCDH17呈低表达。3组组织样本中BRD4、SSBP1及PCDH17的阳性率比较差异有统计学意义（P＜0.05）；3组血清癌抗原199（carbohydrate antigen,CA199）、血清胃蛋白酶原（pepsinogen，PG）Ⅰ、PGⅡ、胃泌素17（gastrin-17,G-17）水平及幽门螺杆菌（helicobacter pylori，HP）阳性率差异有统计学意义（P＜0.05）；胃癌组织组患者血清CA199、PGⅠ、G-17水平及HP阳性率明显高于癌前病变组织和正常胃黏膜组织组，而PGⅡ水平低于癌前病变组织和正常胃黏膜组织组，差异有统计学意义（P＜0.05）；临床分期为Ⅲ期~Ⅳ期、发生淋巴结转移的胃癌组织中BRD4、SSBP1、PCDH17的阳性率比较差异有统计学意义（P＜0.05）；BRD4+SSBP1+PCDH17联合诊断的敏感度和特异度均高于单一指标。 结论 联合检测BRD4、SSBP1与PCDH17有利于胃癌的鉴别诊断。

Application value of combined detection of BRD4, SSBP1 and PCDH17 in the diagnosis of early gastric cancer

Objective To explore the combined detection of bromodomain protein 4(BRD4), mitochondrial single-stranded DNA binding protein(SSBP1) and proto-cadherin 17(PCDH17) in the diagnosis of early gastric cancer.Methods We collected 50 cases of gastric cancer tissues, 50 cases of precancerous tissues, and 50 cases of normal gastric mucosa tissues. The expression of BRD4, SSBP1 and PCDH17 proteins in tissue specimens was determined by immunohistochemical staining, followed by analysis in different tissue samples. The three groups of blood samples were collected to detect related serum indicators in the three groups. Receiver operating characteristic(ROC) curve was used to analyze the value of BRD4, SSBP1 and PCDH17 in the diagnosis of gastric cancer.Results BRD4 and SSBP1 were highly expressed in gastric cancer tissues, while PCDH17 was poorly expressed. Comparison of the positive rates of BRD4, SSBP1 and PCDH17 in the three groups of tissue samples was statistically significant(P＜0.05). The serum carbohydrate antigen(CA199), pepsinogen(PG)Ⅰ, PGⅡ, gastrin-17(G-17) levels and positive rate of helicobacter pylori(HP) in the three groups were significantly different(P＜0.05). The serum CA199, PGⅠ, G-17 levels and HP positive rate of patients in gastric cancer tissue group were significantly higher than those in precancerous tissue group and normal gastric mucosal tissue group, while PGⅡ level was lower than that that in precancerous tissue group and normal gastric mucosal tissue group(P＜0.05). The positive rates of BRD4, SSBP1 and PCDH17 in gastric cancer tissues of patients with clinical stage Ⅲ to Ⅳ and lymph node metastasis were significantly different(P＜0.05). The sensitivity and specificity of combined detection of BRD4+SSBP1+PCDH17 were higher than an indicator alone.Conclusion Combined detection of BRD4, SSBP1 and PCDH17 is conductive to the differential diagnosis of gastric cancer.