The Value Of Detection Of Alpha 1-antitrypsin In Gastric Juice In The Diagnosis Of Gastric Cancer

Objective:Objective to investigate the value of detection of alpha 1-antitrypsin in gastric juice in the diagnosis of gastric cancer by detecting the expression of alpha 1-antitrypsin in gastric juice of patients with high risk of gastric cancer.It provides a new choice for the clinical application of gastric cancer screening.Methods:Gastric juice was collected from 193 patients with gastric cancer and high risk of gastric cancer.All patients were subjected to gastroscopy and histopathological examination.Enzyme linked immunosorbent assay(ELISA)was used to detect the concentration of alpha 1-antitrypsin in gastric juice of all subjects.The subjects were grouped according to the gold standard of gastroscopy and histopathological findings,There were 30 cases of gastric cancer,62 cases of peptic ulcer(including 21 cases of gastric ulcer,41 cases of duodenal ulcer),73 cases of gastritis group(including 25 cases of chronic non-atrophic gastritis,48 cases of chronic atrophic gastritis),The control group came from 28 cases of physical examination in our hospital health examination center.The atrophic gastritis group consisted of pathological diagnosis of atypical hyperplasia and intestinal metaplasia.The concentration of alpha 1-antitrypsin in gastric juice of each group was compared,and the best critical value for the diagnosis of gastric cancer was determined.Finally,the value of alpha 1-antitrypsin test in the diagnosis of gastric cancer was evaluated.Results:There was no significant difference in age,sex,Helicobacter pylori infection and family history of gastric cancer in gastric cancer group,peptic ulcer group,gastritis group and control group(P>0.05).Gastric juice p H value of gastric cancer group was significantly higher than that of other groups,the difference was statistically significant(P<0.05).The concentration of alpha 1-antitrypsin in gastric juice of gastric cancer group was higher than that of peptic ulcer,gastritis and control group,the difference was statistically significant(P<0.05).The concentration of alpha 1-antitrypsin in gastric juice of peptic ulcer group was higher than that of control group and gastritis group,lower than that in gastric cancer group,and the difference was statistically significant(P<0.05).There was no significant difference in the concentration of alpha 1-antitrypsin in gastric juice between gastritis group and control group(P>0.05).The concentration of alpha 1-antitrypsin in gastric ulcer group was higher than that in duodenal ulcer group,the difference was statistically significant(P<0.05).There was no significant difference in the concentration of alpha 1-antitrypsin in gastric juice in chronic non-atrophic gastritis and atrophic gastritis group(P>0.05).There was a positive correlation between the size of ulcer and tumor in gastric ulcer group and gastric cancer group,the correlation coefficient r=0.745,P<0.05 was statistically significant.Alpha 1-antitrypsin concentration in gastric juice for detection of ROC curve diagnosis of gastric cancer was 0.973,95% confidence interval(95%CI,0.95-0.99),the Youden index of the largest point 1040.9ug/dl to determine the optimal critical value.Therefore,the optimal threshold value is calculated for the concentration of alpha 1-trypsin in gastric juice and the evaluation index for the diagnosis of gastric cancer.Reflect the authenticity of the index,the sensitivity was 83.3%,specificity was 98.8%,false negative rate 16.7%,false positive rate was 1.2%,Youden index was 0.82,the positive likelihood ratio was 69.4%,negative likelihood ratio was 0.2%;The index reflecting reliability: compliance rate of 96.4%,consistency test(Kappa analysis),Kappa value of 0.856,P<0.001,the results were statistically significant;Indicators reflecting income: positive predictive value of 92.6% and negative predictive value of 97%.Conclusion:The concentrations of alpha 1-antitrypsin in gastric juice of patients with gastric cancer were significantly increased.The detection of alpha 1-antitrypsin in gastric juice is of great value in the diagnosis of gastric cancer.It can be used as a marker of gastric cancer for screening gastric cancer.It provides a new choice for the future screening of gastric cancer in clinical practice.