血清MMP-7、MMP-9联合胃充盈超声在胃癌术前TNM分期的诊断价值

目的：通过检测血清MMP-7、MMP-9表达与胃癌患者分化程度、肿瘤浸润深度、淋巴结转移情况相关性后,再探讨胃充盈超声、血清MMP-7、MMP-9及联合筛查在不同分期胃癌中价值性目的表述不清楚,探索的是新方法或新技术的价值,不是探索结果。方法：回顾性分析的82例胃癌患者在2018年2月至2020年2月期间收治,均进行血清MMP-7、MMP-9以及胃充盈超声(FUS;Filling Ultrasound)检测,分析血清在胃癌患者分化程度、肿瘤浸润深度、淋巴结转移中表达情况后,以病理活检、《国际抗癌联盟及美国肿瘤联合会胃癌TNM分期系统(第8版)》为金标准,用ROC分析胃充盈超声、血清MMP-7、MMP-9及联合筛查在不同分期胃癌中价值性,指标用于胃癌术前分期的价值。缺乏分期的标准,如根据AJCC第八版？结果：MMP-7、MMP-9表达阳性率与分化程度、淋巴结转移情况、浸润深度存在一定相关性(P＜0.05)。而FUS对T1期~T4期总准确率84.51%,对N1期~N3期总准确率85.92%,对M1分期准确率84.51%;MMP-7对T1期~T4期总准确率81.69%,对N1期~N3期总准确率78.87%,对M1分期准确率83.10%;MMP-9对T1期~T4期总准确率80.28%,对N1期~N3期总准确率77.46%,对M1分期准确率81.69%。同时经血清检测,T4期患者MMP-7、MMP-9高于其他分期者;N3期患者MMP-7、MMP-9高于其他分期者;M1期患者MMP-7、MMP-9高于M0期者(P＜0.05)既然是对比,请列出单方面诊断结果,以及什么单方面诊断结果,是影像还是血清指标？。ROC曲线分析显示,FUS诊断对T分期的AUC为0.741;对N分期的AUC为0.748;对M分期的AUC为0.695;MMP-7诊断对T分期的AUC为0.681;对N分期的AUC为0.667;对M分期的AUC为0.643;MMP-9诊断对T分期的AUC为0.720;对N分期的AUC为0.674;对M分期的AUC为0.636;联合诊断对T分期的AUC为0.993;对N分期的AUC为0.993;对M分期的AUC为0.948,提示联合诊断具有一定准确率。结论：血清MMP-7、MMP-9表达与胃癌分期、分化程度、肿瘤浸润深度密切相关,联合FUS诊断,可提高对胃癌分期判断准确性。

The diagnostic value of serum MMP-7 and MMP-9 combined with gastric filling ultrasound in preoperative TNM staging of gastric cancer

Objective: After detecting the correlation between the expression of serum MMP-7 and MMP-9 and the degree of differentiation, depth of tumor invasion, and lymph node metastasis in patients with gastric cancer, gastric filling ultrasound, serum MMP-7, MMP-9 and combined screening in different stages of gastric cancer Middle value. Methods: A retrospective analysis of 82 patients with gastric cancer was admitted between February 2018 and February 2020, and they were all tested for serum MMP-7, MMP-9 and gastric filling ultrasound (FUS; Filling Ultra Ssound) to analyze the differentiation of serum in gastric cancer patients After the degree, the depth of tumor invasion, and the expression in lymph node metastasis, pathological biopsy, "International Anti-Cancer Alliance and American Cancer Federation TNM Staging System (8th Edition)" as the gold standard, use ROC to analyze gastric filling ultrasound and serum MMP -7. The value of MMP-9 and combined screening in different stages of gastric cancer. Results: The positive rate of MMP-7 and MMP-9 expression was correlated with the degree of differentiation, lymph node metastasis, and depth of invasion (P<0.05). The FUS has a total accuracy rate of 84.51% for T1 to T4, 85.92% for N1 to N3, and 84.51% for M1 staging; MMP-7 has a total accuracy of 81.69% for T1 to T4. The total accuracy of N1~N3 is 78.87%, the accuracy of M1 staging is 83.10%; the total accuracy of MMP-9 is 80.28% for T1~T4, the total accuracy of N1~N3 is 77.46%, and the accuracy of M1 staging is accurate The rate is 81.69%. At the same time, through serum testing, MMP-7 and MMP-9 in T4 stage patients are higher than those in other stages; MMP-7 and MMP-9 in N3 stage patients are higher than those in other stages; MMP-7 and MMP-9 in M1 stage patients are higher than M0 Period (P<0.05). ROC curve analysis showed that the AUC of FUS diagnosis for T staging was 0.741; the AUC for N staging was 0.748; the AUC for M staging was 0.695; the AUC of MMP-7 diagnosis was 0.681 for T staging; the AUC for N staging was 0.667 ; AUC for M staging is 0.643; MMP-9 diagnosis AUC for T staging is 0.720; AUC for N staging is 0.674; AUC for M staging is 0.636; AUC for T staging is 0.993 for combined diagnosis; N staging The AUC for M staging is 0.993; the AUC for M staging is 0.948, indicating that the combined diagnosis has a certain accuracy. Conclusion: Serum MMP-7 and MMP-9 expressions are closely related to gastric cancer staging, degree of differentiation, and depth of tumor invasion. Combined with FUS diagnosis, it can improve the accuracy of gastric cancer staging.