内科

目的分析胃癌患者血清DKK-1、人附睾蛋白（HE）4、多腺苷二磷酸核糖聚合酶（PARP）-1和淋巴细胞活化基因（LAG）-3水平及其与临床病理特征的关系。方法选取60例胃癌患者作为研究组，另选60例同期进行健康体检的体检者作为对照组。比较两组研究对象、不同临床病理特征胃癌患者的血清DKK-1、HE4、PARP-1和LAG-3的表达水平，并分析胃癌患者预后的影响因素。结果研究组血清DKK-1、HE4、PARP-1、LAG-3水平均高于对照组（均P＜0.05）。不同TNM分期、胃癌细胞分化程度、淋巴结转移情况胃癌患者的血清DKK-1、HE4、PARP-1、LAG-3水平差异均有统计学意义（均P＜0.05）。TNM分期Ⅲ～Ⅳ期胃癌患者的血清DKK-1、HE4、PARP-1水平均高于Ⅰ～Ⅱ期胃癌患者，血清LAG-3水平低于Ⅰ～Ⅱ期胃癌患者；胃癌细胞分化程度越高，患者的血清DKK-1、HE4、PARP-1表达水平越高，血清LAG-3表达水平越低;伴有淋巴结转移胃癌患者的血清DKK-1、HE4、PARP-1、LAG-3水平均高于无淋巴结转移患者（均P＜0.05）。多因素logistic回归分析结果显示，TNM分期和血清DKK-1、HE4、PARP-1、LAG-3水平是胃癌患者死亡的独立危险因素（均P＜0.05）。结论胃癌患者血清DKK-1、HE4、PARP-1、LAG-3呈高表达水平，其与胃癌的临床分期、淋巴结转移、胃癌细胞分化程度密切相关，均为胃癌患者死亡的独立危险因素。

ObjectiveTo analyze the serum levels of DKK-1, human epididymis protein (HE) 4, poly (ADP-ribose) polymerase (PARP)-1, and lymphocyte activation gene (LAG)-3 in patients with gastric cancer and their correlations with clinicopathological characteristics. MethodsSixty patients with gastric cancer were selected as the study group, and another 60 individuals who underwent physical examination at the same time were selected as the control group. The expression levels of serum DKK-1, HE4, PARP-1 and LAG-3 were compared between the two groups and among gastric cancer patients with different clinicopathological characteristics, and the prognostic factors of gastric cancer patients were analyzed. ResultsThe serum levels of DKK-1, HE4, PARP-1 and LAG-3 in the study group were higher than those in the control group (all P＜0.05). There were statistically significant differences in serum levels of DKK-1, HE4, PARP-1 and LAG-3 among gastric cancer patients with different TNM stages, gastric cancer cells differentiation, and lymph node metastasis (all P＜0.05). The serum levels of DKK-1, HE4 and PARP-1 in gastric cancer patients with TNM stage Ⅲ - Ⅳ were higher than those in gastric cancer patients with stage Ⅰ-Ⅱ, while the serum LAG-3 level was lower in gastric cancer patients with TNM stage Ⅲ - Ⅳ than in gastric cancer patients with stage Ⅰ-Ⅱ. The higher the differentiation degree of gastric cancer cells, the higher the expression levels of serum DKK-1, HE4 and PARP-1, and the lower the expression level of serum LAG-3. The serum levels of DKK-1, HE4, PARP-1 and LAG-3 in gastric cancer patients with lymph node metastasis were higher than those in patients without lymph node metastasis (all P＜0.05). The result of multivariate logistic regression analysis showed that TNM stage and serum DKK-1, HE4, PARP-1 and LAG-3 levels were independent risk factors for death of gastric cancer patients (all P＜0.05). ConclusionThe serum levels of DKK-1, HE4, PARP-1 and LAG-3 in gastric cancer patients are highly expressed, which are closely correlated with the clinical stage, lymph node metastasis and differentiation degree of gastric cancer cells, and they are independent risk factors for death in gastric cancer patients.