Relationship of Serum c-Myc and PD-L1 with TN Staging of Gastric Cancer and Diagnostic Value of Endoscopic Ultrasonography Combined with Serum c-Myc and PD-L1 in Preoperative TN Staging

LIU Ying; LAN Yongzhen; ZHANG Panpan; LIU Suxiao; WANG Xiao; SUN Yaxiong; ZHANG Jingchao

doi:10.3969/j.issn.1002-3429.2025.12.006

Abstract：Objective Analysis of the Correlation between serum cellular myelocytomatosis oncogene(c-Myc),programmed death ligand-1(PD-L1)and TN staging of gastric cancer,and the diagnostic value of combined endoscop-ic ultrasonography(EUS)for preoperative TN Staging of gastric cancer.Methods In total,101 patients with gas-tric cancer admitted from January 2019 to January 2024 were selected as the gastric cancer group.All patients un-derwent EUS before operation,and the coincidence rate of EUS in the diagnosis of gastric cancer TN staging was calculated.In addition,101 patients with gastritis treated during the same period were selected as the gastritis group,and the serum levels of c-Myc and PD-L1 were detected in the two groups.The levels of serum c-Myc and PD-L1 in the two groups and the levels of serum c-Myc and PD-L1 in patients with different TN stages were compared.The correlation between serum levels of c-Myc and PD-L1 and TN stage was analyzed.The pathological characteristics of EUS in gastric cancer patients with different TN stages were compared.The diagnostic value of EUS combined with serum c-Myc and PD-L1 in preoperative TN staging of gastric cancer was analyzed.Results Preoperative EUS for gastric cancer showed that the coincidence rate of T staging and N staging with pathological results was 82.18%(83/101)and 84.16%(85/101),respec-tively.The serum levels of c-Myc and PD-L1 in the gastric cancer group were higher than those in the gastritis group(P<0.05).The incidence of gastric wall layer disorder,gastric cavity stenosis and deformation,gastric wall stiffness and disappearance of peristalsis in patients with stage Ⅲ-Ⅳ gastric cancer was higher than that in patients with stageⅠ-Ⅱ(P<0.05).The levels of serum c-Myc and PD-L1 in patients with stage Ⅲ gastric cancer were higher than those in stageⅠand Ⅱ,and the levels of serum c-Myc and PD-L1 in patients with stage Ⅳ gastric cancer were higher than those in stageⅠ,Ⅱ and Ⅲ(P<0.05).The serum levels of c-Myc and PD-L1 were positively correlated with TN staging of gastric cancer(r=0.608,0.591,P<0.05).The area under the receiver operating characteristic(ROC)curve(AUC)of EUS combined with serum c-Myc and PD-L1 in the diagnosis of preoperative TN staging of gas-tric cancer was the largest,which was 0.927(95%CI:0.858,0.969)(P<0.05).Conclusion The expression of serum c-Myc and PD-L1 in gastric cancer patients is increased,and is related to TN staging.The combination of EUS and serum c-Myc and PD-L1 can make a more accurate judgment of preoperative TN staging of gastric cancer.