Ning Peifang, Sun Liping, Dong Nannan, Yuan Yuan
Tumor Etiology and Screening Department of Cancer Institute and General Surgery, the First Hospital of China Medical University, Shenyang 110001, China.
Key Laboratory of Cancer Etiology and Prevention in Liaoning Education Department, the First Hospital of China Medical University, Shenyang 110001, China.
Chin J Cancer Res. 2020 Feb;32(1):89-95. doi: 10.21147/j.issn.1000-9604.2020.01.10.
The aim of this study was to investigate the value of the combined expression of the gastric mucosal differentiation protein pepsinogen C (PGC) and gastric cancer (GC)-associated antigen MG7 for the diagnosis of GC and prediction of the development from precancerous conditions to GC.
The gastric mucosal biopsies of 285 subjects enrolled from a region with a high incidence of GC were obtained and histopathologically examined. Subjects testing negative for GC (n=208) were followed up from 1998 to 2015. The levels of PGC and MG7 in the biopsies were determined by immunohistochemistry.
PGC was positive in 91.4% of the non-atrophic gastritis, 26.5% of the atrophic gastritis, and 0% of the GC. MG7 was positive in 15.0% of the non-atrophic gastritis, 82.4% of the atrophic gastritis, and 94.8% of the GC. The non-atrophic gastritis group was predominantly "PGC+MG7-". The atrophic gastritis and GC groups were predominantly "PGC-MG7+". The rate of GC in subjects with "PGC-MG7+" staining was 113.4-fold higher [95% confidence interval (95% CI): 15.3-869.4, P<0.001] than that in subjects with other staining patterns. The sensitivity and specificity of the "PGC-MG7+" pattern were 92.2% and 78.8% for the detection of GC and 77.2% and 97.9% for GC and precancerous disease, respectively. In the follow-up cohort of non-GC subjects, the risk of developing GC was higher in those with the "PGC-MG7+" staining pattern.
Our data suggest that the "PGC-MG7+" pattern can be employed as a useful follow-up panel for detecting individuals with a high risk of GC, and the dynamic assessment of the follow-up panel needs multi-centre large-scale validation in the future.
本研究旨在探讨胃黏膜分化蛋白胃蛋白酶原C（PGC）和胃癌（GC）相关抗原MG7联合表达对胃癌诊断及癌前病变向胃癌发展预测的价值。
获取285例来自胃癌高发地区受试者的胃黏膜活检组织并进行组织病理学检查。对GC检测呈阴性的受试者（n = 208）于1998年至2015年进行随访。采用免疫组织化学法测定活检组织中PGC和MG7的水平。
PGC在91.4%的非萎缩性胃炎、26.5%的萎缩性胃炎和0%的胃癌中呈阳性。MG7在15.0%的非萎缩性胃炎、82.4%的萎缩性胃炎和94.8%的胃癌中呈阳性。非萎缩性胃炎组主要为“PGC+MG7-”。萎缩性胃炎和胃癌组主要为“PGC-MG7+”。“PGC-MG7+”染色受试者的胃癌发生率比其他染色模式的受试者高113.4倍[95%置信区间（95%CI）：15.3 - 869.4，P<0.001]。“PGC-MG7+ ”模式检测GC的敏感性和特异性分别为92.2%和78.8%，检测GC和癌前疾病的敏感性和特异性分别为77.2%和97.9%。在非GC受试者的随访队列中，“PGC-MG7+ ”染色模式者发生GC的风险更高。
我们的数据表明，“PGC-MG7+ ”模式可作为检测GC高危个体的有用随访指标，该随访指标的动态评估未来需要多中心大规模验证。
