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外周血炎症标志物作为中年人群胃黏膜化生变化的可靠预测指标

Peripheral Blood Inflammatory Markers as A Reliable Predictor of Gastric Mucosal Metaplasia Change in the Middle-aged Population.

作者信息

Lai Chia-Yu, Lee Chieh, Yeh Ta-Sen, Chang Ming-Ling, Lin Yu-Sheng, Chen Tsung-Hsing

机构信息

Department of Management Information Systems, National Pingtung University of Science and Technology, Pingtung, Taiwan.

Department of Information and Management, National Sun Yat-sen University, Kaohsiung, Taiwan.

出版信息

J Cancer. 2024 Apr 23;15(11):3313-3320. doi: 10.7150/jca.95159. eCollection 2024.

Abstract

The study aims to evaluate the efficacy of peripheral blood inflammatory markers as clinical predictors for gastric intestinal metaplasia (IM), a known precursor to gastric cancer. This research investigates the potential of these markers to serve as reliable indicators for detecting gastric IM. A retrospective cohort study was conducted on 59,143 individuals who underwent checkups at the Taoyuan Chang Gung Memorial Hospital Health Clinic Center from 2010 to 2014. Of these, 11,355 subjects who received gastroscopic biopsies were recruited. After omitting cases with incomplete blood data, the sample was narrowed to 10,380 participants. After exclusion and propensity score matching, subjects in the group with IM and control patients without IM were balanced and included in the study. These subjects were stratified by gender and age, and predictors such as the Systemic Inflammation Response Index (SIRI), Systemic Immune Inflammation Index (SII), and Monocyte-to-Lymphocyte Ratio (MLR) were evaluated. Multivariate logistic regression models were employed to analyze the presence or absence of IM accurately. Out of the 10,380 subjects, 2,088 (20.1%) were diagnosed with IM, while 8,292 (79.9%) did not have IM. In our analysis, inflammation indices were found to have a limited impact on younger patients. For middle-aged and elderly individuals, SII showed statistical significance for predicting IM in males (), while SIRI and MLR were significant for females (). Additionally, the Area Under the Curve (AUC) value indicated that inflammation indices were more influential in females (55.1%) than males. The study results reveal that peripheral blood inflammatory markers could be useful in predicting gastric mucosal metaplasia changes, particularly in middle-aged and elderly populations. Although the markers' predictive power varies with gender, they represent a significant step forward in the non-invasive detection of gastric IM. This could aid in the early identification and management of precancerous conditions.

摘要

本研究旨在评估外周血炎症标志物作为胃癌已知癌前病变——胃肠化生(IM)临床预测指标的有效性。本研究调查了这些标志物作为检测胃IM可靠指标的潜力。对2010年至2014年在桃园长庚纪念医院健康检查中心接受体检的59143人进行了一项回顾性队列研究。其中,招募了11355名接受胃镜活检的受试者。在剔除血液数据不完整的病例后,样本缩小至10380名参与者。经过排除和倾向得分匹配后,IM组和无IM的对照患者在研究中达到平衡并纳入研究。这些受试者按性别和年龄分层,并评估了全身炎症反应指数(SIRI)、全身免疫炎症指数(SII)和单核细胞与淋巴细胞比值(MLR)等预测指标。采用多因素逻辑回归模型准确分析IM的存在与否。在10380名受试者中,2088人(20.1%)被诊断为IM,而8292人(79.9%)没有IM。在我们的分析中,炎症指标对年轻患者的影响有限。对于中年和老年个体,SII在预测男性IM方面具有统计学意义(),而SIRI和MLR在女性中具有统计学意义()。此外,曲线下面积(AUC)值表明炎症指标对女性(55.1%)的影响大于男性。研究结果表明,外周血炎症标志物可用于预测胃黏膜化生变化,特别是在中年和老年人群中。尽管这些标志物的预测能力因性别而异,但它们在胃IM的无创检测方面迈出了重要一步。这有助于早期识别和管理癌前病变。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d70c/11134446/79f398b1374d/jcav15p3313g001.jpg

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