血清胃蛋白酶原、NEDD4-1及FoxP3对早期胃癌病人ESD术后复发的预测价值

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[关键词] 胃蛋白酶原类;Ned4泛素蛋白连接酶类;叉头转录因子类;胃肿瘤;内镜黏膜切除术;复发;预测

[Abstract] Objective Toinvestigatethevalueofserumpepsinogen（PG），theE3ubiquitinligaseNEDD4bindingprotein1 （NEDD4-1），andforkheadboxP3（FoxP3）inpredictingrecurenceafterendoscopicsubmucosaldisection（ESD）inpatientswith early-stagegastriccancer. Methods Aretrospectiveanalysiswasperformedfor650patientswithearly-stagegastriccancerwho underwentESDinourhospitalfrom April2019toApril2023，andacordingtothepresenceorabsenceofrecurenceaftersurgery， theyweredividedintorecurencegroupwith31patientsandnon-recurencegroupwith619patients.ThelevelsofPG，NEDD4-1， andFoxP3weremeasuredtoanalyzetheirasociationwithrecurenceandpredictiveeficacy. Results Therewerestatisticaly significantdiferencesinthedegre oftisuediferentiation，infiltrationdepth，lymphnodemetastasisandTNMstagingbetwen therecurentgroupandthenon-recurentgroup （χ2=11.744-229.536，P<0.05） ）.Comparedwiththenon-recurencegroup，the recurencegrouphadasignificantlyhigherlevelofpepsinogen Ⅰ （PGⅠ）andsignificantlyhigherpositiveratesofNEDD4-1and FoxP3at4weksafterESD ），aswelasasignificantlylowerlevelofpepsinogenⅡ （PG Ⅱ）at4weksafterESD ）.Themultivariateanalysisshowedthatpordiferentiation，submucosalinvasion， lymphnodemetastasis，anincreaseinPGⅠat4weksafterESD，areductionin PGII at4weksafterESD，andpositiveNEDD4- 1/FoxP3wereindependentriskfactorsforrecurence ）.PGⅠ， PGII ，NEDD4-1，orFoxP3alonehadanareaunderthe ROCcurve（AUC）of0.701，0.767，0.77，and0.790，respectively，inpredictingrecurence，andthecombinationofthesefourindicatorshadanAUCof0.860. Conclusion PG，NEDD4-1，andFoxP3areefectivepredictivefactorsforpostoperativerecurrenceafterESDinpatientswithearly-stagegastriccancer，andcombinedmeasurementoftheseindicatorscansignificantlyimprove predictiveacuracy.

[Keywords] pepsinogens;Ned4ubiquitinproteinligases;forkheadtranscriptionfactors;stomachneoplasms;endoscopic mucosalresection;recurence;forecasting

内镜下黏膜剥离术（ESD）是目前治疗早期胃癌的首选微创治疗手段，但术后复发仍是影响预后的关键问题[1-3]。（剩余6745字）