中文摘要：

目的检测可溶性人类白细胞抗原G（sHLA-G）在胃癌及癌前病变患者血浆中的表达水平，并探讨其临床诊断意义。方法采用ELISA法检测82例胃癌患者（胃癌组）、39例胃上皮内瘤变患者（胃上皮内瘤变组）、36例萎缩性胃炎患者（萎缩性胃炎组）、52例浅表性胃炎患者（浅表性胃炎组）及67名健康对照者（健康对照组）血浆中sHLK,A-G水平，同时检测血浆癌胚抗原（CEA）水平，分析二者对胃癌早期诊断的意义及sHLA—G与胃癌临床病理参数间的关系。结果胃癌组血浆sHLA-G水平明显高于胃上皮内瘤变组、萎缩性胃炎组、浅表性胃炎组及健康对照组（P均〈0．001）；胃上皮内瘤变组血浆sHLA-G水平明显高于健康对照组（P〈0．05）。胃癌组血浆CEA水平明显高于其他各组（P均〈0．01）。sHLA．G作为诊断指标的Roe曲线AUC为0．814，其诊断价值高于CEA（0．692，P=0．01）。sHLA-G和CEA联合检测的Roe。曲线AUC为0．846，明显高于sHLA-G或CEA（P〈0．05；P〈0．001）。ROC曲线确定sHLA-G诊断临界值为101．37U／mL，其敏感度为73．2％，特异度为82．5％，阳性预测值为63．8％，阴性预测值为87．9％，准确性为79．7％。胃癌患者血浆sHLA-G水平与患者年龄及肿瘤大小密切相关（P均〈0．05）。而与患者性别、分化类型、浸润程度、淋巴结转移及临床分期无关（P均〉0．05）。结论血浆sHLA-G可能参与了胃癌的发生和发展，检测其表达水平有助于早期发现胃癌及癌前病变，血浆sHLA—G有可能离_jlT脓虔冒疽早血．浍函}曲一小港赤．悻指旒

英文摘要：

Objective To detect expression of sHLA-G in the patients with gastric cancer or precanccrous lesions, and to explore its diagnostic significance. Methods sHLA-G was detected by ELISA in 82 cases with gastric cancer, 39 cases with gastric intraepithelial ncoplassia, 36 cases with atrophic gastritis, 52 cases with superficial gastritis and 67 cases of healthy controls, while the levels of carcino-embryonic antigen （CEA） was also simultaneously detected. The diagnostic value of sHLA-G and its correlations with clin/copathological features were analyzed. Results The level of sHLA-G was significantly higher in gastric cancer than those in gastric intracpithelial ncoplassia, atrophic gastritis, superficial gastritis and the control group（P 〈0.001, respectively）. The level of sHLA-G was significantly higher in gastricin traepithelial neoplassia than that in the control group （P 〈 0.05 ）. The levels of CEA in gastric cancer was significantly higher than that in the healthy control, superficial gastritis, atrophic gastritis, and gastric intraepithelial neoplassia（ P 〈 0.01, respectively）. ROC curve analysis showed that AUC for sHLA-G was 0. 814, which was significantly higher when compared with the AUC of CEA （0.692, P = 0.01 ）. The combined AUC of sHLA-G and CEA was 0. 846, which was significantly higher when compared with the AUC of sHLA-G or CEA（ P 〈 0. 05; P 〈 0.001 ）. The cutoff value of sHLA-G for diagnosis was 101.37 U/mL, while the diagnostic sensitivity, specificity, positive predictive value, negative predictive value and accuracy rate were 73.2%, 82.5%, 63.8%, 87.9% and 79.7%, respectively. The level of sHLA-G in gastric cancer was significantly correlated with age and tumor size （ P 〈 0.05, respectively）, and no significant correlations between the level of sHLA-G and other clinicopathological factors were identified（ P 〉0.05, respectively）. Conclusion sHLA-G plays an important role in the pathogenesis and progression of gastric cancer, and detection of sHLA-G is h