Objective: Gastric cancer(GC) is one of the leading causes of death in China and other Asian countries.Recently, gastric endoscopy has become the main approach for GC screening, but the identification of high-risk individuals remains a challenge in GC screening programs.Methods: There were 7,302 patients with chronic gastritis involved in this study. Endoscopic examinations were performed, and their demographic characteristics and lifestyle data were collected. Each possible associated factor of GC/premalignant and precursor lesions was evaluated by univariate and multivariate logistic regressions.Nomograms were used for visualization of those models, and receiver operating characteristic(ROC) curve analysis was used to present the predictive accuracy.Results: We detected 8(0.11%) gastric adenocarcinomas, 17(0.23%) dysplasia cases, 14(0.19%) hyperplasia cases, 52(0.71%) intestinal metaplasia cases, 217(2.97%) inflammatory lesions, 141(1.93%) gastric ulcers, 10(0.14%) atrophic gastritis cases, 1,365(18.69%) erosive gastritis cases, and 5,957(81.58%) superficial gastritis cases in 7,302 patients. The age(P<0.001), gender(P=0.086), labor intensity(P=0.018) and leek food intake(P=0.143)were identified as independent predictive factors of GC/premalignant lesions possibility. The corresponding nomogram exhibited an area under the curve(AUC) [95% confidence interval(95% CI)] of 0.82(0.74–0.89) for the modeling group and 0.80(0.75–0.85) for the validation group. The age(P=0.002), gender(P=0.024), smoking(P=0.002) and leek food intake(P=0.039) were independent predictive factors of precursor lesions possibility. The corresponding nomogram exhibited an AUC(95% CI) of 0.62(0.60–0.65) for the modeling group and 0.61(0.59–0.63) for the validation group.Conclusions: We identified several potential associated factors and provided a preclinical nomogram with the potential to predict the possibility of GC/premalignant and precursor lesions.
Jie XingLi MinShengtao ZhuHao ZhangYu ZhaoHengcun LiZheng ZhangPeng LiShutian Zhang
本研究利用TCGA数据库提供的胃腺癌数据集,结合cBio Cancer Genomics Portal数据库和GeneCards数据库筛选出与肿瘤转移相关基因(MTA1)存在共表达和相互作用的83个基因。利用DAVID、STRING等分析软件发现这些基因主要富集在细胞周期、WNT通路、P53信号通路、胃癌和DNA修复等癌症相关通路上,并进一步利用String数据库和Cytoscape筛选出与MTA1紧密联系基因,同时结合大样本临床数据的生存曲线分析认为这些基因与胃腺癌生存率密切相关,MTA1可能与这些基因相互作用调控细胞增殖,影响胃腺癌细胞侵袭转移。通过研究胃腺癌组织中MTA1调控的基因网络,有助于揭示胃腺癌发病机制。找到有效生物学标记物组合作为胃癌的预测指标,可以为相关药物研发及临床诊断治疗提供新的思路和依据。
