早期胃癌患者Hp感染情况与转化生长因子-β1、青霉素结合蛋白1A表达的关系

Relationship between Helicobacter pylori infection and the expressions of transforming growth factor-β1 and penicillin- binding protein 1A in patients with early gastric cancer

摘要:

目的 探讨早期胃癌患者幽门螺杆菌（Hp）感染情况与转化生长因子-β₁（TGF-β₁）、青霉素结合蛋白1A（PBP1A）表达水平的关系。方法 选取2020年1月—2023年1月在铜川市人民医院接受手术治疗，并经过病理检查确诊为早期胃癌的106例患者。将合并Hp感染患者作为阳性组，未感染Hp患者作为阴性组，分别有49和57例。收集患者的一般资料和病理特征，并比较两组术前血清中炎症因子［白细胞介素-6（IL-6）、IL-8、肿瘤坏死因子-α（TNF-α）］及TGF-β₁水平。术后检测患者肿瘤组织中PBP1A的表达情况。采用多因素一般Logistic回归模型分析早期胃癌患者Hp感染与TGF-β₁、PBP1A水平的关系，并通过受试者工作特征（ROC）曲线评估TGF-β₁、PBP1A对早期胃癌患者Hp感染情况的诊断效能。结果 两组患者性别构成、年龄、体质量指数、家族疾病史、肿瘤直径和部位、肿瘤类型、分期和淋巴结转移率的比较，差异均无统计学意义（P >0.05）。阳性组肿瘤低分化、浸润程度至黏膜下层的患者数均较阴性组多（P <0.05）。阳性组IL-6、IL-8、TNF-α及TGF-β₁水平均较阴性组高（P <0.05），PBP1A mRNA水平较阴性组低（P <0.05）。多因素一般Logistic分析，结果显示：肿瘤低分化［O^R=6.345（95% CI：1.571，25.630）］、高浸润性［O^R=7.853（95% CI：1.824，33.805）］、高TGF-β₁水平［O^R=1.541（95% CI：1.287，1.844）］、低PBP1A mRNA水平［O^R=0.003（95% CI：0.000，0.179）］是患者感染Hp的危险因素（P <0.05）。ROC曲线结果显示，TGF-β₁联合PBP1A在早期胃癌患者Hp感染的诊断中的曲线下面积为0.921，敏感性为81.6%（95% CI：0.680，0.912），特异性为86.0%（95% CI：0.742，0.937）。联合诊断的准确性高于单独指标检测。结论 TGF-β₁与PBP1A在Hp感染的早期胃癌患者中有较高的评估价值，可作为患者的诊断和预后的参考。

Abstract:

Objective To analyze the relationship between Helicobacter pylori (Hp) infection and the expressions of transforming growth factor (TGF)-β1 and penicillin-binding protein 1A (PBP1A) in patients with early gastric cancer.Methods A total of 106 patients who underwent surgical treatment and were pathologically diagnosed with early gastric cancer in Tongchuan People's Hospital between January 2020 and January 2023 were selected. Among these patients, 49 were Hp-positive and included as the positive group, and 57 were Hp-negative and included as the negative group. General data and pathological characteristics of patients were collected, and preoperative serum levels of inflammatory factors [interleukin (IL)-6, IL-8, and tumor necrosis factor (TNF)-α] and TGF-β₁ were compared between the two groups. The expression of PBP1A in tumor tissues was assessed after surgery. The multivariable Logistic regression model was used to explore the relationship between Hp infection and the levels of TGF-β₁ and PBP1A in patients with early gastric cancer, and the diagnostic efficacy of TGF-β₁ and PBP1RA for Hp infection in early gastric cancer patients was evaluated using receiver operating characteristic (ROC) curves.Results There were no statistically significant differences between the two groups in terms of sex composition, age, body mass index, family history of diseases, tumor diameter and location, tumor type, tumor staging, and lymph node metastasis rate (P > 0.05). The proportions of patients with poorly-differentiated tumors and tumor infiltration into the submucosa in the positive group were higher than those in the negative group (P < 0.05). The levels of IL-6, IL-8, TNF-α and TGF-β₁ in the positive group were higher than those in the negative group (P < 0.05), and the mRNA expression of PBP1A in the positive group was lower than that in the negative group (P < 0.05). The multivariable Logistic analysis exhibited that poorly-differentiated tumors [O^R = 6.345 (95% CI: 1.571, 25.630) ], highly invasive tumors [O^R = 7.853 (95% CI: 1.824, 33.805) ], high TGF-β₁ levels [O^R = 1.541 (95% CI: 1.287, 1.844) ], and low mRNA expression of PBP1A [O^R = 0.003 (95% CI: 0.000, 0.179) ] were risk factors for Hp infection (P < 0.05). The ROC curve indicated that the area under the curve of the combination of TGF-β₁ and PBP1A for diagnosing Hp infection in patients with early gastric cancer was 0.921, with a sensitivity of 81.6% (0.680, 0.912) and a specificity of 86.0% (0.742, 0.937). The diagnostic accuracy of the combined detection was higher that of the indicators alone.Conclusions TGF-β₁ and PBP1A are of great value in assessing Hp infection among patients with early gastric cancer and may indicate the diagnosis and prognosis of these patients.