Value of Hp,RASAL2,CDH1 and TP53 in Differential Diagnosis of Gastric Precancerous Lesions and Early Gastric Cancer

MA Yue; CHEN Wei; LIU Baoying; FU Dandan; ZHOU Tong

doi:10.3969/j.issn.1002-3429.2024.11.008

Abstract：Objective To investigate the value of Helicobacter pylori(Hp),RAS protein activator-like factor 2(RAS-AL2),cadherin 1(CDH1)and tumor suppressor gene P53(TP53)in differential diagnosis of gastric precancerous lesions and early gastric cancer.Methods Fifty-two patients with early gastric cancer admitted from June 2021 to June 2023 were selected,and another 52 patients with gastric precancerous lesions and 52 patients with gastritis were selected at a ratio of 1∶1 according to the selection principle,and were included in the gastric cancer group,pre-cancer group and gastritis group,re-spectively.The positive expression rates of Hp,RASAL2,CDH1 and TP53 in the three groups and in early gastric cancer pa-tients with different pathological characteristics were compared,and the positive expression rates of RASAL2,CDH1 and TP53 in patients with Hp positive and negative gastric cancer in the gastric cancer group were compared.Spearman correlation anal-ysis was used to explore the correlation between the positive expression rates of each index and several pathological character-istics of early gastric cancer.Receiver operating characteristic(ROC)curve was used to analyze the value of combined detec-tion in the differential diagnosis of early gastric cancer and gastric precancerous lesions.Results The positive expression rate of Hp,CDH1 and TP53 was the highest in gastric cancer group,followed by pre-cancer group and gastritis group,while the positive expression rate of RASAL2 was the lowest in gastric cancer group,followed by pre-cancer group and gastritis group,suggesting significant differences(P<0.05,P<0.01).The positive expression rates of CDH1 and TP53 in Hp-positive patients than those in Hp-negative patients in early gastric cancer group,while the positive expression rates of RASAL2 were lower than those in Hp-negative patients(P<0.05,P<0.01).The positive expression rates of Hp,RASAL2,CDH1 and TP53 in early gas-tric cancer patients were significantly different in terms of the depth of tumor invasion and presence of lymph node metastasis(P<0.05,P<0.01).The positive expression of Hp,CDH1 and TP53 were positively correlated with the depth of tumor invasion and lymph node metastasis in early gastric cancer,while the positive expression of RASAL2 were negatively correlated with the depth of tumor invasion and lymph node metastasis in early gastric cancer(P<0.01).ROC curve analysis results showed that the area under the ROC curve(AUC)of the combined diagnosis of Hp,RASAL2,CDH1 and TP53 was 0.904(95%CI:0.846,0.945),and the AUC of their combination in the diagnosis of early gastric cancer was 0.894(95%CI:0.819,0.946).Conclu-sion The positive expression rate of Hp,CDH1 and TP53 is higher in early gastric cancer tissues,while the positive expres-sion rate of RASAL2 is lower.The combined detection has a certain value in the differential diagnosis of precancerous lesions and early gastric cancer,which can be used as an auxiliary index in the differential diagnosis of precancerous lesions and early gastric cancer in clinical practice.