不同胃癌前病变中医证型PG、G-17、CEA和叶酸水平变化及相关性研究

目的:对不同胃癌前病变中医证型和血清胃蛋白酶原(pepsinogen,PG)、胃泌素-17(gastrin-17,G-17)、癌胚抗原(carcinoembryonic antigen,CEA)和叶酸水平变化的关系进行探讨,为胃癌前病变的诊断提供一定的依据。方法:以80例胃癌前病变(precancerous lesion of gastric cancer,PLGC)患者研究组,80例健康者为对照组,对研究组患者进行中医临床辨证分型,对两组研究对象的血清PG、G-17、CEA和叶酸进行测定比较。结果:研究组PLGC患者中医证型分布不均匀,差异显著(P<0.05),由多到少依次为湿热蕴胃并/兼脾胃虚寒证>胃络瘀阻并/兼气阴两虚证>痰湿中阻并/兼脾胃气虚证>肝胃气滞并/兼气阴两虚证>肝胃气滞并/兼脾胃虚寒证>湿热蕴胃并/兼胃阴不足证。PLGC不同中医证型患者血清PG I和PG II水平差异显著(P<0.05);与对照组比较,各证型PG I水平均显著降低,PG II水平均显著升高(P<0.05)。且湿热蕴胃并/兼脾胃虚寒证和胃络瘀阻并/兼气阴两虚证的PG I水平显著低于其他证候,血清PG II水平显著高于其他(P<0.05)。与对照组比较,研究组不同证候的G-17、CEA水平显著升高,叶酸水平显著降低(P<0.05);观察组中湿热蕴胃并/兼脾胃虚寒证和胃络瘀阻并/兼气阴两虚证G-17、CEA显著高于其他证候,叶酸水平显著低于其他证候(P<0.05)。结论:胃癌前病变不同中医证型血清PG、G-17、CEA和叶酸存在明显差异。

Study on the Changes and Correlation of the Levels of PG, G-17, CEA and Folic Acid in Different Types of Gastric Precancerous Lesions

ABSTRACT Objective: The relationship between TCM syndrome types of different gastric precancerous lesions and the changes of serum PG, G-17, CEA and folic acid levels was explored to provide a certain basis for the diagnosis of gastric precancerous lesions. Methods: Taking the study group of 80 patients with gastric precancerous lesions and 80 healthy persons as the control group, the patients in the study group were classified by TCM clinical syndrome differentiation, and the serum PG, G-17, CEA and folic acid of the two groups of subjects were measured and compared. Results: The PLGC patients in the study group had uneven distribution of TCM syndromes, and the difference was significant (P<0.05). From the most to the least, they were damp heat and stomach combined with spleen and stomach deficiency syndrome>Stomach stasis combined with both qi and yin deficiency syndrome> Phlegm Dampness and dampness combined with spleen and stomach qi deficiency syndrome>Liver and stomach stagnation combined with both qi and yin deficiency syndrome>Liver and stomach stagnation combined with spleen and stomach deficiency cold syndrome>Dampness and heat stagnation combined with qi deficiency syndrome. The levels of serum PG I and PG II in patients with different TCM syndrome types of PLGC were significantly different (P<0.05). Compared with the control group, the level of PG I in each syndrome type was significantly reduced, and the level of PG II was significantly increased (P<0.05). In addition, the PG I level of the damp heat syndrome combined with both spleen and stomach deficiency syndrome and gastric collateral stasis combined with both qi and yin deficiency syndrome was significantly lower than other syndromes, and the serum PG II level was significantly higher than other (P<0.05). Compared with the control group, the G-17 and CEA levels of the different syndromes in the study group were significantly increased, and the folic acid level was significantly reduced (P<0.05). The dampness and heat in the observation group were combined with spleen and stomach deficiency syndrome and gastric collateral stasis, G-17 and CEA with both Qi and Yin deficiency syndromes were significantly higher than other syndromes, and folic acid levels were significantly lower than other syndromes (P<0.05). Conclusion: There are obvious differences in serum PG, G-17, CEA and folic acid in different TCM syndrome types of gastric precancerous lesions.