膜联蛋白A7水平在胃癌患者癌组织及外周血液中的变化及其临床意义
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袁虎方, Email: yuanhufang78@sina.com

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Changes of annexin A7 level in cancer tissue and peripheral blood in patients with gastric cancer and its clinical significance
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    摘要:

    目的:探讨膜联蛋白A7(ANXA7)水平在胃癌患者癌组织和外周血中的变化及其对胃癌的诊断价值。
    方法:选择2013年1月—2015年12月间手术治疗的105例胃癌患者为研究对象,用qRT-PCR及Western blot法检测患者癌组织和癌旁组织中ANXA7的表达;用ELISA法检测患者及50例正常人血清中ANXA7水平,分析胃癌组织及血清中ANXA7水平与胃癌患者临床病理因素的关系,并ROC曲线分析血清ANXA7水平对胃癌的诊断效能。
    结果:ANXA7 mRNA和蛋白在胃癌组织中的表达量均明显高于癌旁组织(t=17.361,P<0.01;t=15.368,P<0.01);胃癌患者血清ANXA7蛋白浓度明显高于正常对照人群(t=12.823,P<0.01)。ANXA7 mRNA和蛋白在胃癌组织的表达量及血清ANXA7水平均与肿瘤分化程度、T分期有关,且ANXA7 mRNA在胃癌组织的表达量与血清ANXA7水平还与淋巴结转移有关(均P<0.05);胃癌组织与外周血中ANXA7蛋白水平呈正相关(r=0.789,P<0.01)。血清ANXA7蛋白浓度以67.21 ng/L为临界值,对胃癌诊断的敏感性为96.59%,特异性为70.15%,阳性预测值为80.95%,阴性预测值为94.00%。
    结论:胃癌组织中ANXA7表达升高,其表达水平与胃癌的恶性程度与进展密切相关;胃癌患者外周血液中ANXA7水平能较好反映其在在癌组织中的表达水平,故ANXA7有望成为胃癌标志物应用于临床。

    Abstract:

    Objective: To investigate the changes of annexin A7 (ANXA7) level in cancer tissue and peripheral blood in patients with gastric cancer, and its diagnostic value for gastric cancer. 
    Methods: One-hundred and five patients with gastric cancer undergoing surgical treatment from January 2013 to December 2015 were enrolled as study subjects. The mRNA and protein expressions of ANXA7 in the cancer tissues and their adjacent tissues of the patients were determined by qRT-PCR and Western blot analysis, and the serum levels of ANXA7 in these patients and 50 healthy individuals were measured by ELISA assay. The relations of ANXA7 expression in cancer tissue and serum ANXA7 level with the clinicopathologic factors of gastric cancer patients were analyzed, and the diagnostic efficiency of serum ANXA7 level for gastric cancer was evaluated by using ROC curve. 
    Results: Both mRNA and protein expression levels of ANXA7 in gastric cancer tissue were significantly higher than those in cancer-adjacent tissue (t=17.361, P<0.01; t=15.368, P<0.01); the serum ANXA7 level in gastric cancer patients was significantly higher than that in healthy population (t=12.823, P<0.01). The mRNA and protein expression levels of ANXA7 in gastric cancer tissue as well as the serum ANXA7 level were significantly related to the degree of differentiation and T stage of the tumor, and the mRNA expression level of ANXA7 in gastric cancer tissue and serum ANXA7 level were also significantly related to lymph node metastasis (all P<0.05). There was a significant correlation between the protein level of ANXA7 in cancer tissue and serum (r=0.789, P<0.01). At a cut-off value of concentration of 67.21 ng/L, the sensitivity, specificity, positive predictive value and negative predictive value of the serum ANXA7 level for diagnosis of gastric cancer were 96.59%, 70.15%, 80.95% and 94.00%, respectively.
    Conclusion: The ANXA7 expression is increased in gastric cancer tissue, and its expression level is closely related to the degree of malignancy and progression of gastric cancer. The peripheral blood ANXA7 level can better reflect its expression level in cancer tissue, so ANXA7 is likely to become a gastric cancer marker for use in clinical practice.

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叶卫华, 袁虎方.膜联蛋白A7水平在胃癌患者癌组织及外周血液中的变化及其临床意义[J].中国普通外科杂志,2019,28(10):1261-1268.
DOI:10.7659/j. issn.1005-6947.2019.10.014

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  • 收稿日期:2019-04-26
  • 最后修改日期:2019-09-18
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  • 在线发布日期: 2019-10-25