Diagnostic value of gastric filling contrast-enhanced ultrasound combined with serum TGFBI and PD-L1 for preoperative staging of elderly gastric cancer

doi:10.3877/cma.j.issn.2095-2015.2025.05.006

Abstract

Abstract:

Objective

To explore the diagnostic value of gastric filling contrast-enhanced ultrasound combined with serum transforming growth factor beta inducer (TGFBI) and programmed death molecule ligand 1 (PD-L1) in preoperative staging of elderly gastric cancer.

Methods

From March 2021 to March 2024, 205 elderly gastric cancer patients who visited our hospital were included as subjects. According to pathological results, they were assigned into an early gastric cancer group of 69 cases and an advanced gastric cancer group of 136 cases. All patients underwent gastric filling contrast-enhanced ultrasound examination. Enzyme linked immunosorbent assay was applied to detect the levels of TGFBI and PD-L1 in serum. The ROC curve was used to analyze the diagnostic value of gastric filling contrast-enhanced ultrasound, serum TGFBI, and PD-L1 levels alone and in combination for preoperative staging of elderly gastric cancer. Multivariate logistic regression analysis was used to screen independent risk factors for staging errors.

Results

The levels of serum TGFBI and PD-L1 in the advanced gastric cancer group were higher than those in the early gastric cancer group (P<0.05). The AUC of preoperative staging for elderly gastric cancer diagnosed by gastric filling contrast-enhanced ultrasound, TGFBI, and PD-L1 alone were 0.866, 0.855, and 0.801, respectively. The AUC of combined diagnosis was 0.989, with the AUC of combined diagnosis being higher than that of the three diagnoses alone (Z=3.798, 5.061, 5.805, P<0.05). According to the diagnosis results of gastric filling ultrasound contrast imaging, there were 185 cases in the correct staging group and 20 cases in the incorrect staging group. The proportions of concave morphology and tumor diameter greater than 3 cm in the incorrect staging group were higher than those in the correct staging group (P<0.05). Concave type and tumor diameter greater than 3 cm were independent risk factors for staging errors (P<0.05).

Conclusion

Gastric filling contrast-enhanced ultrasound combined with serum TGFBI and PD-L1 has high diagnostic value for preoperative staging of elderly gastric cancer.

Key words: Gastric neoplasms, Preoperative staging, Gastric filling contrast-enhanced ultrasound, Transforming growth factor beta inducer, Programmed death molecule ligand 1

Xudong Qiao, Miaomiao Du, Ruichuang Luo. Diagnostic value of gastric filling contrast-enhanced ultrasound combined with serum TGFBI and PD-L1 for preoperative staging of elderly gastric cancer[J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2025, 15(05): 449-453.

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References 23

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组别	例数	TGFBI(ng/mL)	PD-L1(pg/mL)
早期胃癌组	69	11.64±3.53	257.14±67.61
进展期胃癌组	136	16.82±4.75	352.40±89.72
t		8.351	8.102
P		<0.001	<0.001

组别	例数	TGFBI(ng/mL)	PD-L1(pg/mL)
早期胃癌组	69	11.64±3.53	257.14±67.61
进展期胃癌组	136	16.82±4.75	352.40±89.72
t		8.351	8.102
P		<0.001	<0.001

诊断方法	敏感度	特异度	AUC	95% CI	P	约登指数	截断值
胃充盈超声造影	97.79	75.36	0.866	0.802~0.929	<0.001	0.73	0.84
TGFBI	77.21	81.16	0.855	0.803~0.906	<0.001	0.58	13.79 ng/mL
PD-L1	71.32	81.16	0.801	0.739~0.863	<0.001	0.52	292.75 pg/mL
联合	97.06	97.10	0.989	0.978~0.998	<0.001	0.94	0.96

诊断方法	敏感度	特异度	AUC	95% CI	P	约登指数	截断值
胃充盈超声造影	97.79	75.36	0.866	0.802~0.929	<0.001	0.73	0.84
TGFBI	77.21	81.16	0.855	0.803~0.906	<0.001	0.58	13.79 ng/mL
PD-L1	71.32	81.16	0.801	0.739~0.863	<0.001	0.52	292.75 pg/mL
联合	97.06	97.10	0.989	0.978~0.998	<0.001	0.94	0.96

指标	分期正确组(n=185)	分期错误组(n=20)	t/χ²	P
年龄(岁,±s)	73.95±10.24	75.15±10.82	0.495	0.621
男性[例(%)]	114(61.62)	13(65.00)	0.087	0.768
病变部位[例(%)]			0.124	0.989
胃窦	108(58.38)	11(55.00)
胃体	34(18.38)	4(20.00)
胃底	27(14.59)	3(15.00)
贲门	16(8.65)	2(10.00)
内镜下形态[例(%)]			17.146	<0.001
平坦型	82(44.32)	3(15.00)
隆起型	66(35.68)	4(20.00)
凹陷型	37(20.00)	13(65.00)
肿瘤直径[例(%)]			11.832	0.001
≤3 cm	127(68.65)	6(30.00)
>3 cm	58(31.35)	14(70.00)
分化程度[例(%)]			0.391	0.532
中/高分化	115(62.16)	11(55.00)
低分化	70(37.84)	9(45.00)
浸润深度[例(%)]			0.231	0.630
≤1/2	121(65.41)	12(60.00)
>1/2	64(34.59)	8(40.00)

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