临床误诊误治2025，Vol.38Issue(15)：26-31,6.DOI:10.3969/j.issn.1002-3429.2025.15.006
抗幽门螺杆菌抗体联合检测在早期胃癌诊断中的作用及与T淋巴细胞水平的关系
Role of Combined Detection of Anti-Helicobacter Pylori Antibodies in the Diagnosis of Early Gastric Cancer and Its Relationship with T Lymphocyte Levels
摘要
Abstract
Objective To investigate the role of combined detection of anti-Helicobacter(anti-H.)pylori antibodies(IgA,IgG,IgM)in the diagnosis of early gastric cancer and its relationship with T lymphocyte levels.Methods A total of 121 patients who underwent gastroscopy and five-site biopsy for gastric discomfort between January 2020 and April 2023 were selected.Based on gastroscopy results,patients were divided into the non-gastric cancer group(n=91)and the gastric cancer group(n=30).Serum levels of anti-H.pylori antibodies(IgA,IgG,IgM)of all patients were measured at 1 d before gastroscopy.Postoperative pathological tissues were collected to assess the expression of CD3+,CD4+,CD8+,and CD68+and determine immune infiltration positivity.Receiver operating characteristic(ROC)curve analysis was used to evaluate the diagnostic value of combined anti-H.pylori antibody detection in early gastric cancer.Binary logistic regression analysis was performed to explore the relationship between serum anti-H.pylori antibody levels and immune infiltration in early gastric cancer.Results The age of the gastric cancer group was significantly greater than that of the non-gastric cancer group(P<0.01).The positivity rate of anti-H.pylori antibodies in the gastric cancer group[66.67%(20/30)]was higher than that in the non-gastric cancer group[32.97%(30/91)],and serum IgA,IgG,and IgM levels were higher than those of the non-gastric cancer group(P<0.01).The expression levels of CD3+and CD4+in gastric cancer tissues of gastric cancer group were significantly higher than those in non-gastric cancer mucosal tissues of non-gastric cancer group,while the expression levels of CD8+and CD68+were lower than those in non-gastric cancer group(P<0.01).ROC curve analysis showed that the area under the curve(AUC)for combined IgA+IgG detection was greater than that for individual indicator.Binary logistic regression analysis indicated a correlation between CD8+and CD68+expression and serum IgA levels(P<0.05),but no significant correlation was found between CD3+,CD4+,and anti-H.pylori antibody levels(P>0.05).At 3,6,and 12 months after treatment,the positivity rate of anti-H.pylori antibodies in the gastric cancer group remained consistently higher than that in the non-gastric cancer group,with persistently lower immunoglobulin levels and CD8+and CD68+expression,as compared with the non-gastric cancer group(P<0.05),while CD3+and CD4+levels were consistently higher in the gastric cancer group than in non-gastric cancer group(P<0.01).Conclusion Gastric cancer patients exhibit elevated positivity rates and expression levels of serum anti-H.pylori antibody,with upregulated CD3+and CD4+expression and downregulated CD8+expression and CD68+expression in cancer tissues.Serum anti-H.pylori antibody levels are associated with immune infiltration in early gastric cancer.Combined detection of IgA and IgG can serve as an effective biomarker for diagnosing early gastric cancer and assessing immune status.关键词
胃肿瘤/幽门螺杆菌/免疫球蛋白A/免疫球蛋白G/免疫浸润/CD3+/CD4+Key words
stomach neoplasms/helicobacter pylori/immunoglobulin A/immunoglobulin G/immune infiltrations/CD3+/CD4+引用本文复制引用
侯花屏,年亮,张鹏飞,刘新奇..抗幽门螺杆菌抗体联合检测在早期胃癌诊断中的作用及与T淋巴细胞水平的关系[J].临床误诊误治,2025,38(15):26-31,6.基金项目
陕西省重点研发计划项目(2023-YBSF-620) （2023-YBSF-620）
