Li Hailin, Zhang Bing, Hu Xiaomeng, Dong Yingzi, Fan Qing, Guo Fang, Ren Xiyun, Zhou Haibo, Tian Wenjing, Zhao Yashuang
Department of Epidemiology, College of Public Health, Harbin Medical University, Harbin, Heilongjiang Province, P. R. China.
Xiangfang Center for Disease Control and Prevention, Harbin, Heilongjiang Province, P. R. China.
Oncotarget. 2016 Apr 19;7(16):22397-408. doi: 10.18632/oncotarget.7981.
FliD and CagA are important virulence factors of H. pylori. We aimed to evaluate the screening values of FliD and CagA for gastric cancer (GC). Serum samples were obtained from 232 cases and 266 controls in a case-control study. Unconditional multivariate logistic regression with odds ratios (ORs) and 95% confidence intervals (CIs) was used to analyze the relationships between FliD, CagA and GC. The sensitivities, specificities and receiver operating characteristic (ROC) curves were calculated. Finally, the combined screening values of FliD, FlaA, NapA and CagA were assessed based on discriminant analysis. In all subjects, the associations of FliD and CagA with GC were evident with ORs (95% CIs) of 7.6 (4.7-12.3) and 2.5 (1.6-3.8), respectively (*p<0.001). The areas under ROC curves (AUCs) for FliD and CagA were 0.800 and 0.653, respectively. The AUC for the combination of FliD, FlaA and NapA was 0.915, which represented an increase of 0.115 over that of FliD alone (*p<0.001). These findings indicate that the FliD antibody is associated with GC and could exhibit high validity as a biomarker in screening for GC patients. The combination of FliD, FlaA and NapA improved the screening validity.
鞭毛蛋白D（FliD）和细胞毒素相关基因A（CagA）是幽门螺杆菌重要的毒力因子。我们旨在评估FliD和CagA对胃癌（GC）的筛查价值。在一项病例对照研究中，收集了232例病例和266例对照的血清样本。采用无条件多因素logistic回归分析，计算比值比（OR）和95%置信区间（CI），以分析FliD、CagA与GC之间的关系。计算敏感度、特异度及受试者工作特征（ROC）曲线。最后，基于判别分析评估FliD、鞭毛蛋白A（FlaA）、中性粒细胞激活蛋白A（NapA）和CagA的联合筛查价值。在所有受试者中，FliD和CagA与GC的关联显著，OR（95%CI）分别为7.6（4.7 - 12.3）和2.5（1.6 - 3.8）（*p<0.001）。FliD和CagA的ROC曲线下面积（AUC）分别为0.800和0.653。FliD、FlaA和NapA联合检测的AUC为0.915，比单独检测FliD时增加了0.ll5（*p<0.001）。这些结果表明，FliD抗体与GC相关，作为GC患者筛查的生物标志物具有较高的有效性。FliD、FlaA和NapA联合检测提高了筛查的有效性。
