血清胃蛋白酶原联合G-17对萎缩性胃炎及胃癌早期诊断价值

目的:探索检测血清胃蛋白酶原Ⅰ(PGⅠ)、胃蛋白酶原Ⅱ(PGⅡ)、胃泌素-17(G-17)在萎缩性胃炎及胃癌中的诊断价值。方法:收集医院2015年2月至12月门诊及住院的慢性非萎缩性胃炎44例(非萎缩性胃炎组),慢性萎缩性胃炎47例(萎缩性胃炎组),早期胃癌42例(胃癌组)。采用酶联免疫吸附试验(ELISA)测定各组血清PGⅠ、PGⅡ、G-17的水平,同时计算PGⅠ/PGⅡ的比值(PGR),比较各组指标间的差异,同时绘制各指标筛查萎缩性胃炎及胃癌的受试者工作曲线(ROC)曲线,分别评价其诊断价值。结果:胃癌组及萎缩性胃炎组的血清PGⅠ、PGR水平较非萎缩性胃炎组明显下降,且胃癌组下降更明显,差异均具有统计学意义(P0.05),萎缩性胃炎组血清PGⅡ显著低于非萎缩性胃炎组,差异均具有统计学意义(P0.05);胃癌组的血清G-17水平较非萎缩性胃炎组及萎缩性胃炎组均升高,差异有统计学意义(P0.05)。血清PGⅠ筛查萎缩性胃炎的最佳界值为PGⅠ90 ng/m L,其灵敏度和特异度分别为71.5%和51.0%,血清PGR筛查萎缩性胃炎的最佳界值为PGR8,其灵敏度和特异度分别为71.9%和54.0%,血清G-17筛查萎缩性胃炎的最佳界值为G-175 pmol/L,其灵敏度和特异度分别为66.1%和64.0%。血清PGⅠ筛查胃癌的最佳界值为PGⅠ73 ng/m L,其灵敏度和特异度分别为86.0%和74.9%;血清PGR筛查胃癌的最佳界值为PGR3,其灵敏度和特异度分别为90.2%和62.5%;血清G-17筛查胃癌的最佳界值为G-174 pmol/L,其灵敏度和特异度分别为62.5%和61.3%。结论:胃癌及萎缩性胃炎患者血清PGⅠ、PGR水平下降明显,且胃癌患者的血清G-17异常升高,血清PG联合GS-17测定可用于萎缩性胃炎及胃癌的早期筛查。

Early Diagnosis Value of Serum Pepsinogen Combined with G-17 for Atrophic Gastritis and Gastric Cancer

ABSTRACT Objective: To research the diagnostic value of measuring serum pepsinogen I(PGI),pepsinogen II(PGII) and gastrin-17 (G-17) for atrophic gastritis and gastric cancer. Methods: A total of 44 patients were diagnosed with non-atrophic gastritis(non-atrophic gastritis group), 47 patients were chronic atrophic gastritis(atrophic gastritis group),42 were gastric cancer(gastric cancer group)were en- rolled in the hospital February 2015 to December 2015.The serum PGI, PGII and G-17 levels were detected by enzyme-linked im- munosorbent assay (ELISA), and PGI/II ratio (PGR) was calculated, compared above indexes in different groups, and drew the receiver operating curve (ROC) of above indexes, and analyzed their diagnostic value. Results: The levels of serum PGI and PGR in gastric cancer group and chronic atrophic gastritis group were significantly decreased than that of non-atrophic gastritis group, and gastric cancer group decreased more, the differences were statistically significant (P<0.05), the level of PGII in atrophic gastritis group was lower than non-at- rophic gastritis group, the difference was statistically significant (P<0.05), the level of serum G-17 in gastric cancer were significantly in- creased than chronic atrophic gastritis and non-atrophic gastritis group, the differences were statistically significant (P<0.05). The opti- mal value of PGI screening for atrophic gastritis was PGI<90 ng/mL, its sensitivity and specificity were 71.5% and 51.0%, respectively.The optimal value of PGR screening for atrophic gastritis was PGR<8, its sensitivity and specificity were 71.9% and 54.0%, respectively.The optimal value of G-17 screening for atrophic gastritis was G-17<5 pmol/L, its sensitivity and specificity were 66.1% and 64.0%, re- spectively. The optimal value of PGI screening for gastric cancer was PGI<73 ng/mL, its sensitivity and specificity were 86.0% and 74.9%, respectively. The optimal value of PGR screening for gastric cancer was PGR<3, its sensitivity and specificity were 90.2% and 62.5%, respectively. The optimal value of G-17 screening for gastric cancer was G-17<4 pmol/L, its sensitivity and specificity were 62.5% and 61.3%, respectively. Conclusion: The levels of serum PGI and PGR in patients with gastric cancer and atrophic gastritis are significantly decreased, and the serum G-17 of the patients with gastric cancer are abnormally increased, detecting serum PG combined with G-17 can be used to screen early gastric cancer and chronic atrophic gastritis.