Diagnostic value of combined detection of serum TNF-α, IL-10 and Helicobacter pylori infection for early gastric cancer

doi:10.11958/20241556

Abstract

Abstract:

Objective To explore changes of serum levels of tumor necrosis factor alpha (TNF-α), interleukin-10 (IL-10), and Helicobacter pylori (HP) positivity rate in patients with early gastric cancer, and the diagnostic value of three factors in early gastric cancer. Methods A total of 312 patients with gastric discomfort were included in this study and used as the observation subjects. Patients were divided into the gastritis group (n=100), the precancerous lesion group (n=110) and the early gastric cancer group (n=102) based on their gastroscopy. Enzyme linked immunosorbent assay (ELISA) was used to detect serum levels of TNF-α and IL-10. HP infection was detected in the three groups. Multivariate Logistic regression was used to analyze influencing factors of early gastric cancer. Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic value of serum TNF-α, IL-10 and HP infection in early gastric cancer. Results The levels of TNF-α, IL-10 and HP positivity rate were increased in the gastritis group, the precancerous lesion group and the early gastric cancer group in sequence (all P<0.05). Hot food, heavy salt, pepsinogen Ⅱ (PG Ⅱ), HP positivity and elevated levels of TNF-α and IL-10 were independent risk factors for early gastric cancer, while elevated PGⅠ was a protective factor (all P<0.05). The areas under the curve for serum TNF-α, IL-10, HP infection and their combined diagnosis of early gastric cancer were 0.694, 0.698, 0.763, and 0.870, respectively. The combined diagnostic efficacy of the three was better than that of individual diagnosis (all P<0.05). Conclusion The serum levels of TNF-α, IL-10 and HP positivity rate are significantly increased in patients with early gastric cancer, and all three have certain diagnostic value for early gastric cancer.

Key words: stomach neoplasms, Helicobacter pylori, tumor necrosis factor alpha, interleukin-10

CLC Number:

R735.2

Figures/Tables 4

References 24

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组别	n		性别（男/女）		年龄/岁	BMI/（kg/m²）		吸烟史		饮酒史		恶性肿瘤家族史		喜烫食		喜干硬食
胃炎组	100		57/43		66.6±9.1	22.6±2.6		38（38.0）		52（52.0）		3（3.0）		18（18.0）		12（12.0）
癌前病变组	110		69/41		66.4±9.2	22.9±2.7		42（38.2）		54（49.1）		6（5.5）		27（24.6）^a		16（14.6）
早期胃癌组	102		64/38		67.6±9.5	23.0±2.6		44（43.1）		57（55.9）		6（5.9）		34（33.3）^ab		15（14.7）
χ²或F			0.939		0.779	0.798		0.730		0.982		1.072		6.332^＊		0.394
组别		喜重盐		白蛋白/（g/L）			PGⅠ/（g/L）		PGⅡ/（g/L）		HP阳性		TNF-α/（ng/L）		IL-10/（ng/L）
胃炎组		27（27.0）		30.0±4.4			75.2±17.0		12.2±2.8		16（16.0）		178.7±20.8		16.2±1.9
癌前病变组		31（28.2）^a		30.6±4.5			70.0±16.7^a		13.5±3.1^a		61（55.4）^a		196.3±23.6^a		17.4±2.3^a
早期胃癌组		43（42.2）^ab		31.1±4.2			64.2±12.8^ab		14.5±3.5^ab		91（89.2）^ab		208.7±27.7^ab		18.5±2.3^ab
χ²或F		6.661^＊		1.730			12.525^＊＊		13.956^＊＊		76.284^＊＊		6.786^＊＊		6.523^＊＊

组别	n		性别（男/女）		年龄/岁	BMI/（kg/m²）		吸烟史		饮酒史		恶性肿瘤家族史		喜烫食		喜干硬食
胃炎组	100		57/43		66.6±9.1	22.6±2.6		38（38.0）		52（52.0）		3（3.0）		18（18.0）		12（12.0）
癌前病变组	110		69/41		66.4±9.2	22.9±2.7		42（38.2）		54（49.1）		6（5.5）		27（24.6）^a		16（14.6）
早期胃癌组	102		64/38		67.6±9.5	23.0±2.6		44（43.1）		57（55.9）		6（5.9）		34（33.3）^ab		15（14.7）
χ²或F			0.939		0.779	0.798		0.730		0.982		1.072		6.332^＊		0.394
组别		喜重盐		白蛋白/（g/L）			PGⅠ/（g/L）		PGⅡ/（g/L）		HP阳性		TNF-α/（ng/L）		IL-10/（ng/L）
胃炎组		27（27.0）		30.0±4.4			75.2±17.0		12.2±2.8		16（16.0）		178.7±20.8		16.2±1.9
癌前病变组		31（28.2）^a		30.6±4.5			70.0±16.7^a		13.5±3.1^a		61（55.4）^a		196.3±23.6^a		17.4±2.3^a
早期胃癌组		43（42.2）^ab		31.1±4.2			64.2±12.8^ab		14.5±3.5^ab		91（89.2）^ab		208.7±27.7^ab		18.5±2.3^ab
χ²或F		6.661^＊		1.730			12.525^＊＊		13.956^＊＊		76.284^＊＊		6.786^＊＊		6.523^＊＊

变量	B	SE	Wald χ²	P	OR	OR 95%CI
TNF-α	1.276	0.479	7.095	0.008	3.582	1.401~9.159
IL-10	1.169	0.446	6.871	0.009	3.219	1.343~7.715
PGⅠ	-0.270	0.105	6.637	0.010	0.763	0.621~0.937
PGⅡ	1.250	0.483	6.703	0.010	3.492	1.355~9.000
HP感染	0.954	0.364	6.874	0.009	2.597	1.272~5.300
喜烫食	0.845	0.357	5.597	0.018	2.327	1.156~4.685
喜重盐	1.052	0.481	4.785	0.029	2.864	1.116~7.352
常数项	-1.201	0.598	4.031	0.045	0.301	-

变量	B	SE	Wald χ²	P	OR	OR 95%CI
TNF-α	1.276	0.479	7.095	0.008	3.582	1.401~9.159
IL-10	1.169	0.446	6.871	0.009	3.219	1.343~7.715
PGⅠ	-0.270	0.105	6.637	0.010	0.763	0.621~0.937
PGⅡ	1.250	0.483	6.703	0.010	3.492	1.355~9.000
HP感染	0.954	0.364	6.874	0.009	2.597	1.272~5.300
喜烫食	0.845	0.357	5.597	0.018	2.327	1.156~4.685
喜重盐	1.052	0.481	4.785	0.029	2.864	1.116~7.352
常数项	-1.201	0.598	4.031	0.045	0.301	-

指标	AUC （95%CI）	截断值	敏感度/%	特异度/%
TNF-α	0.694（0.640~0.745）	198 ng/L	70.59	66.67
IL-10	0.698（0.644~0.748）	17.8 ng/L	61.76	70.00
HP感染	0.763（0.712~0.809）	-	89.22	63.33
三者联合	0.870（0.827~0.905）	-	76.47	82.38