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Quantitative Study of Multiple Biomarkers and Its High Risk Cut Off Value and Fuzzy Discrimination in Microcosmic Dialectic Type Gastric Dysplassia

Author: LinYiFan
Tutor: ZhouXueWen
School: Liaoning College of Traditional Chinese Medicine
Course: Basic TCM
Keywords: microcosmic dialectic gastric mucosa dysplasia image analysis Biomarkers Fuzzy discrimination
CLC: R259.7
Type: PhD thesis
Year: 2003
Downloads: 73
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Abstract


In this study, in order to discuss the relationship between the different type of microcosmic dialectic and Quantitative analysis of multiple biomarkers and the potential tendency of cancer formation, the types of gastric dysplasia were microcosmic dialectic analyzed by the endoscopies according to gut dialectic theory of traditional Chinese medicine in 120 cases of gastric dysplasia. The techniques of AgNOR and Feulgen’s stained method, and ABC immunohistochemical method were applied for the AgNOR dots , DNA stain and the expression of MG7 antigen. The AgNOR dots and nuclear DNA content and morphologic indices of its paraffin sections were qualitatively determined by image analysis technique and the clinical follow-up study was performed. The result show that 120 patients were divided into four groups: Type gastric cold (TGC)(45) (37.5 % ) , Type Gastric Hot (TGH)(40) (33.3 %), Type Gastric Net Resort (TGNR)(32) (26.7 %), and Type Gastric Net Burn (TGNB)(3) (2.5 %). The AgNOR dots were small and round in shape in Type TGC and TGH, but were big and different in shape and size in TGNR and TGNB. The AgNOR sites and its large dots per nucleus in the groups of TGNR and TGNB (6.92 0.91, 8.27 0.44) (0.48 0.12, 0.56 0.29) were higher than that of the groups of TGC(3.84 0.72, 0.22 0.88) and TGH(4.11 0.79, 0.23 0.99 ) (p<0.05). The result of image analisis showed that DNA content (8.82 1.76, 11.97 0.22) , percentage of >2c (89.62%, 106.66% ) and >4c (61.65%, 80.33%) cells, and the nuclear morphologic indices (NA, NP, NV) (24.65 3.01, 24.53 3.84, 199.31 31.8) (26.98 1.16, 26.67 1.52, 229.91 21.35), in the groups of the TGNR and TGNB were higher than that of the groups of TGH (6.01 1.35), (61.13%, 20.05%) (18.80 3.83,18.48 2.34,125.00 37.55) and TGC(5.77 1.36), (59.87%, 20.28%), (20.03 1.85, 19.84 2.60, 136.20 37.69) (p<0.05 ~ 0.01). The cases of TGNR in DNA aneuploid pattern group (26/47) were higher than that in euploid (8/73) (p<0.01). Again, the expression of MG7 antigen in TGNR and TGNB (37.5 %, 66.7 %) were higher than that of the groups of TGC and TGH (7.1 %, 16.7 % )(p< 0.01). Sixty-three cases werefollowed up for 6 to 72 month. There were 23 cases of TGNR in the 30 cases of cancer formation group, but nine in 33 cases of no cancer formation group (p<0.01). The analysis of Image measurements with MG7 and AgNOR and the results of the follow-up study showed an average MG7-Ag density equal to or greater than 0.19 or an average AgNOR dots equal to or greater than 7.0 were regarded as the critical value for high-risk in gastric cancer, which could be used to discriminate dysplasia from canceration, with a sensitivity of 73.3%, a specificity of 87.9%, and an accuracy of 81.0%, and a sensitivity of 82.4%, a specificity of 78.9%, and an accuracy of 80.6%. Meanwhile, the Theories and method of fuzzy mathematics was used to set up the probability of canceration, and fuzzy discrimination model of gastric dysplasia and the computer software with multiple indexes. The results showed that, with this grouping, the mean values of DNA content, the value of mean number times mane diameter of AgNOR and the greyvalue of MG7Ag were three most distinctive indices. Value > 0.5 was taken as the discriminating criterion of probability of cancer the same samples were rechecked by the above-mentioned model, the concordance rates of cancer group and non-cancer group were 93.5% and 90.3%, respectively. These indicate this discrimination model is of predictive and practical value.Thus, It is suggest that the microcosmic dialectic analyzed by the endoscopies according to gut dialectic theory of traditional Chinese medicine is valuable distinguish the character of canceration of dysplasia. Three biomarkers AgNOR, DNA content and MG7 are related to the microcosmic dialectic analysis of gastric dysplasia and its character of canceration. The gastric dysplasia with TGNR has a close relationship to cancer formation, and need to pay more attention in the dialectic treatment. An average MG7-Ag density equal to or greater than 0.19

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