胃液高效液相荧光光谱对胃癌诊断的价值

目的：探讨胃液高效液相荧光光谱在胃癌诊断中的应用价值。方法：胃液高速离心后,进行高效液相分析,色谱柱选用反相C－18柱,流动相为20％甲醇－水溶液,流速为1ml/min,采用荧光检测器进行检测。结果：共测定了251例各种胃内良、恶性病变患者（其中进展期胃癌39例,重度异型增生1例）的胃液高效液相荧光光谱,发现荧光光谱有2个峰,胃癌与胃内良性病变胃液高效液相荧光光谱的峰位和峰数基本相同, 其差别在于胃癌两峰峰面积均较胃内良性病变增大（P＜0．05）。用CARTV2．0软件进行分析,用于诊断进展期胃癌的先验概率的敏感度为92．5％,特异度为92．4％;后验概率的敏感度为85．0％,特异度为89．1％。结论：胃液高效液相荧光光谱在胃癌诊断中具有临床应用价值。     

荧光胃液分析对胃癌癌前病变诊断的临床研究

目的评估胃液荧光分析对胃癌癌前病变诊断的价值。方法收集980例胃内良、恶性疾病患者的胃液,用荧光胃液分析仪进行胃液荧光光谱检测。结果以ROC曲线最佳截断点KJF≥0.85为判断指标,诊断胃癌的灵敏度达82.0%,特异性为79.2%;重度萎缩性胃炎伴肠化及不典型增生的KJF值接近胃癌患者的值。结论荧光胃液分析对胃癌的诊断是一种安全、有效的方法,对胃癌癌前病变的诊断有一定的特异性。     

胃液紫外光吸收光谱对胃癌诊断价值的初步探讨

目的 探讨胃液高效液相紫外光吸收光谱诊断胃癌的价值。方法 以市郊和液相方法分析了１４４例胃内良恶性病变患者的胃液并以紫外光检测器检测，其中进展其胃癌３７例，萎缩性胃炎３０例，消化性溃疡３０例，慢性浅表性胃炎４７例。结果 进展期胃癌与胃内良性病变患者胃液的高效液相紫外光吸收光谱明显不同，胃癌患者峰位数明显多于胃内良性病变患者，这表明进展期胃癌与胃内良性病变患者胃液的成分明显存在差异。经单因素方差分析     

DNA甲基化和胃液固有荧光光谱联合检测在胃癌诊断中的意义

目的探索在胃癌患者胃液、外周血清中检测基因甲基化的可行性，并结合胃液稀释固有荧光光谱评价二者在胃癌诊断中的作用。方法采用甲基化特异性PCR方法，检测50例胃癌患者的原发肿瘤组织、外周血清和胃液脱落细胞的死亡相关蛋白（DAP）激酶、p16基因启动子区域甲基化状态，并以胃良性溃疡和慢性浅表性胃炎各20例、慢性萎缩性胃炎30例作为对照，同时检测胃癌患者和对照者的胃液稀释固有荧光光谱。结果50例胃癌患者的肿瘤组织、外周血清和胃液脱落细胞中p16和DAP激酶基因甲基化阳性率分别为74．4％和68．1％、52．0％和58．0％、58．6％和76．0％，20例慢性浅表性胃炎患者中均未检测到基因异常甲基化；20例胃溃疡患者溃疡周边组织、胃液脱落细胞中p16和DAP激酶甲基化阳性率为10．0％和20．0％、5．0％和15．0％，在外周血清中未检测到异常甲基化；30例慢性萎缩性胃炎患者胃黏膜组织、外周血清、胃液脱落细胞p16和DAP激酶基因甲基化阳性率分别为10．0％和23．3％、3．3％和3．3％、3．3％和20．0％。胃癌患者胃液固有荧光光谱强度较对照者明显增强（P〈0．05）；以P1FI≥111．8为分界点分析胃液固有荧光光谱诊断胃癌的敏感性和特异性分别为76．1％和78．6％。p16和DAP激酶基因甲基化和胃液固有荧光光谱结合后诊断胃癌的敏感性提高到95．6％和97．8％。结论胃癌患者外周血清及胃液脱落细胞中可检测到与原发肿瘤组织一致的基因异常甲基化，胃液固有荧光光谱和DNA甲基化联合对检测胃癌有良好的临床应用价值。     

胃液氨基酸谱作为胃癌标志物的潜在价值

早期胃癌的预后显著优于进展期胃癌,积极开展早期胃癌的筛查可以大大降低胃癌死亡率.然而传统胃癌生物学标志物癌胚抗原、糖链抗原199等灵敏度和特异性较差,准确性较高的胃镜或影像学检查不适合大规模的筛查.正常生理条件下胃液氨基酸含量极少,需要使用高效液相色谱分析才能分离和检测,而胃癌早期甚至癌前病变期的胃液多种氨基酸浓度异常升高,以丙氨酸升高最为显著.胃液色氨酸荧光检测已经被证实为可靠的早期胃癌诊断方法.随着色谱和质谱等氨基酸检测技术的进步,胃液氨基酸谱有可能成为诊断监测胃癌发生发展的新型标志物.本文就胃癌组织及体液氨基酸变化特点及其可能机制作一综述.     

胃液固有荧光光谱对胃癌诊断价值的初步探讨

目的探讨胃液固有荧光光谱在胃癌诊断中的应用价值。方法胃液高速离心后，应用ＲＦ５０００荧光分光光度计，以２５０ｎｍ紫外光为激发光，测定３００～８００ｎｍ发射光范围内的固有荧光光谱。结果发现胃液荧光光谱有２个峰。胃癌患者与胃内良性病变患者胃液荧光光谱的峰位和峰数基本相同，不同的是胃癌患者第一峰（位于４００ｎｍ处）的相对荧光强度指数（Ｐ１ＦＩ）增大，而第二峰（位于４２０～４３０ｎｍ之间）的相对荧光强度指数（Ｐ２ＦＩ）相对减低。共测定了２４８例各种胃内良、恶性病变患者（其中进展期胃癌３６例）的胃液荧光光谱，计算Ｐ２ＦＩ／Ｐ１ＦＩ，以该比值＜２并且Ｐ１ＦＩ＞２０００为胃癌阳性判断标准，用于进展期胃癌的诊断，其敏感度为８８８９％，特异度为８４９５％。结论胃液固有荧光光谱在胃癌诊断中具有广阔的应用前景     

胃液固有荧光光谱、pH值和潜血检测对胃癌诊断价值的临床研究

背景:胃癌是人类最常见的恶性肿瘤之一,已有研究显示胃液固有荧光光谱检测对于胃癌的诊断具有一定意义。目的:评价胃液固有荧光光谱、pH值和潜血检测用于胃癌诊断的临床价值。方法:随机选取719例行胃镜检查者的胃液标本,有效例数为712例(其中胃癌24例,重度异型增生1例)。将胃液离心、过滤、稀释10倍,使用荧光分光光度计进行固有荧光光谱检测;使用试纸检测胃液pH值和潜血。结果:稀释胃液固有荧光光谱有P1、P2、P3和P4四个峰,胃癌组P2、P4的荧光强度P2FI、P4FI显著高于各胃内良性病变组(P<0.05)。参照既往研究结果,以P2FI≥111.80(发射光波长为320～360nm)作为恶性病变判定标准,以胃镜活检标本病理检查结果作为金标准,胃液固有荧光光谱检测诊断胃癌的敏感性为70.8%,特异性为80.3%。胃癌组的胃液pH值显著高于除胃溃疡组外的其他胃内良性病变组(P<0.05),但其胃液潜血阳性率与各胃内良性病变组相比无显著差异(P>0.05)。在45岁以上的受检者中,以P2FI≥111.80或胃液pH≥5作为恶性病变判定标准,其诊断胃癌的敏感性为83.3%,特异性为71.4%。结论:胃液固有荧光光谱检测如要推广应用于胃癌的筛查和诊断,还需进行进一步的临床研究加以验证。但在高危人群中进行包括胃液固有荧光光谱和pH值检测在内的胃液检测,将是一种     

胃液固有荧光光谱标准化检测方法用于胃癌诊断的意义

目的采用标准化检测方法检测胃液固有荧光光谱分析在诊断胃癌中的价值。方法选择2006年8月~2008年5月在我院胃镜检查患者的胃液,离心过滤、PBS溶液(pH11.0)稀释20倍后检测其固有荧光光谱,比较光谱峰的差异并进行统计学分析。结果胃液固有荧光光谱检测结果显示,第一荧光峰在胃良、恶性疾病间有显著性差异(P0.001)。以荧光强度78.5 AU为界值,诊断胃癌的敏感性为80.4%,特异性为77.4%。与常规检测方法相比,采用标准化方法检测的敏感性无明显差异(80.4%vs81.5%,P=0.07),特异性显著提高(77.4%vs71.7%,P=0.02)。结论胃液固有荧光光谱是一种比较简便、有效的诊断胃癌的实验室手段,标准化检测方法进一步提高了诊断特异性,更有利于在临床上推广应用。     

胃液固有荧光光谱对胃癌诊断价值的初步研究

目的：显示胃癌患者及非癌患者胃液固有荧光光谱的荧光强度的差异,以期用于胃癌的筛查及诊断。方法：收集202例各种胃内疾病患者的胃液,经1：10释释后,检测激发波长为288nm,发射波长范围为300－800nm的固有荧光光谱。用CART V2．0统计软件建立判别模型,计算先验概率及后验概率。结果：各种胃内疾病患者的胃液固有荧光光谱均有3个峰（发射小分别为320－360nm、576nm及670－690nm),胃癌患者的第一荧光峰（发射波长320－360nm)的强度（P1FI）较其他胃内良性疾病患者明显增强。以P1FI≥111．80作为判别指标,用于胃癌诊断的先验概率的敏感度为91．4％,特异度为83．2％,准确度为84．7％。其后验概率的敏感度为85．7％,特异度为82．6％,准确度为83．1％。结论：胃液固有荧光光谱有希望成为一种胃癌的诊断和筛查方法。     

胃液固有荧光光谱对胃癌筛查应用价值的研究

目的 验证和评估胃液固有荧光光谱检测在胃癌临床筛查中的实际应用价值。方法收集1506例胃内良、恶性疾病患者胃液，以缓冲液稀释62．5倍。应用MpF-4型荧光分光光度计进行稀释胃液固有荧光光谱检测。应用Epi6统计软件将实验数据双录入计算机，核查后建立数据库。结果以285nm为激发光，在300～800nm范围内发光光谱有2个峰，分别位于320～400nm及570～600nm处。特征性改变是胃癌患者的第一个荧光峰值(P1FI)比胃内良性病变患者增高。应用SPSSl0．0软件进行单因素分析，选择胃液固有荧光光谱诊断胃癌的工作特征曲线(ROC)最佳临界点P．FI≥76．5作为判别指标，诊断胃癌敏感度为83.2％，特异度为80．7％，准确度为82.0％。应用CARTV2．0软件建立诊断胃癌分类树判别模型，以P1FI≥78.5为判定标准，诊断胃癌先验概率敏感度为93．6％，特异度为79．5％，准确度为80．7％；后验概率敏感度为83．2％，特异度为81．3％，准确度为81．4％。结论稀释胃液固有荧光光谱在胃癌临床筛查中的敏感度、特异度和准确度均较高，是一种可以用于胃癌临床筛查的安全简便、经济有效的方法。     

The electrophoretic pattern of normal human gastric juice and of the gastric juice of patients with gastric ulcer and gastric cancer

This study reports the electrophoretic pattern of the proteins in human gastric juice of control patients and patients with gastric ulcer and gastric carcinoma. Autodigestion was prevented by intragastric neutralization. The statistical limits of normal are defined and the changes found in the gastric juice of gastric ulcer and gastric patients with gastric carcinoma described.     

Rapid high-performance liquid chromatography method for determination of tryptophan in gastric juice

OBJECTIVE: To develop a rapid, high‐performance liquid chromatography (HPLC) method for the determination of tryptophan in gastric juice to help the differentiation between gastric cancer and benign gastric disease. METHODS: HPLC was performed on a restricted access material Shiseido Capcell Pak MF SCX SG80 column. Phosphate buffered solution (90 mmol/L, pH 3.5)‐acetonitrile (ACN; 80/20, V/V) was chosen as the mobile phase. Separation was done at room temperature using a constant flow rate of 1.0 mL/min. Fluorescence emission signal intensity at 330 nm excited by 288 nm ultra violet light was detected and measured. RESULTS: Thirty‐eight gastric juice samples from patients with gastric cancer and 48 gastric juice samples of patients with benign gastric disease were tested. A linear relationship in the range of 0.20–100 mg/L was obtained between the concentration of tryptophan and its fluorescence emission signal intensity at 330 nm. The limit of detection was 0.05 mg/L. The recovery rate was 77.4–90.6%. CONCLUSIONS: An HPLC method based on strong cation‐exchange restricted access columns for determination of concentration of tryptophan in gastric juice was developed. The method has excellent precision and stability. It is compatible with the analysis of gastric juice and has the potential to be used for gastric cancer screening.     

Cortisol excretion into gastric juice

Gastric juice cortisol concentrations in 36 healthy subjects in the basal state was 10.5±2.1 ng/ml. After stimulation with pentagastrin it was 11.5±3.2 ng/ml. There were no differences related to age or sex. Cortisol outputs were 25.9±12.1 ng/min in the basal state and 35.9±13.2 during pentagastrin stimulation. After stimulation with ACTH in 6 subjects gastric juice cortisol concentration increased 5.4 times while gastric cortisol output increased 19-fold. The plasma cortisol rose by a factor of 2.3 while the plasma free cortisol rose by a factor of 2.6. Gastric juice cortisol concentration increases correlated with concentrations of free and total plasma cortisol in plasma. When plasma levels of cortisol or dexamethasone were raised by intravenous infusions, the concentration in gastric juice depended on the free corticoid concentration in plasma. Gastric juice cortisol concentrations in 38 patients with gastric, duodenal, or combined gastric and duodenal ulcers were the same as in normal subjects. In 6 patients studied up to 6 days following abdominal surgery, both plasma and gastric cortisol concentrations were elevated but the increase in gastric juice cortisol was proportionally greater. This was not due to vagal stimulation, as shown by the failure of gastric juice cortisol concentrations to rise similarly during insulin hypoglycemia. Postsurgical increases in gastric juice cortisol may reflect the loss of protein-bound cortisol into the gastrointestinal tract as a result of injury to the gastric mucosa.     

Elevated gastric juice enzymes--a marker for increased gastric cancer risk?

Measurement of beta-glucuronidase and lactic dehydrogenase in the fasting gastric juice of dyspeptic patients is a useful test for gastric cancer, but about 10% of patients tested have positive results without a demonstrable carcinoma. We have compared the histological features of multiple endoscopic gastric biopsies from 17 such patients with apparently false positive enzyme tests with gastric biopsies from 17 age and sex matched patients with negative enzyme tests. Epithelial dysplasia, a precancerous lesion, was found in 3 patients with positive enzyme tests but was not found in those with negative enzyme tests. Sulphomucin-containing intestinal metaplasia, another lesion which is associated with carcinoma of the stomach, was found in 8 patients with a positive enzyme test (including all 3 with dysplasia) but in only one patient with a negative enzyme test. These findings suggest that patients with positive gastric juice enzyme tests who do not have an established carcinoma form a group who are at increased risk of developing gastric cancer in the future and who may be worthy of long-term follow-up.     

非溃疡性消化不良病人胃粘膜分泌维生素C的研究

目的：研究非溃疡性消化不良病人胃粘膜分泌维生素Ｃ（ＶｉｔＣ）的变化以及与幽门螺杆菌（Ｈｐ）感染、胃酸分泌、年龄和性别的关系。方法：用高铁还原法测定血浆和胃液中ＶｉｔＣ浓度，以１小时内ＶｉｔＣ从血液到胃液中的清除率代表胃粘膜分泌Ｖｉｔｃ的能力。结果：胃粘膜的ＶｉｔＣ分泌与Ｈｐ感染与否无关（Ｐ＞０．０５）：ＶｉｔＣ分泌与胃酸分泌呈明显正相关（ｒ＝０．８４），在给五肽胃泌素后，随着胃酸分泌的增加，ＶｉｔＣ分泌也增加：４０岁以上病人的ＶｉｔＣ分泌明显低于３９岁以下病人（Ｐ＜０．０１）。结论：胃粘膜的ＶｉｔＣ分泌不受Ｈｐ感染的影响：ＶｉｔＣ分泌与胃酸分泌明显相关；另外，ＶｉｔＣ分泌也与年龄有关，４０岁以上病人的Ｖｉｔｃ分泌明显减少，推测其胃癌发生率增高可能与ＶｉｔＣ分泌减少有关。     

Mutagenicity in gastric juice.

Mutagenicity has been measured in the gastric juice of 228 patients using the Ames bacteriological test system; while mutagenicity in control and duodenal ulcer patients did not differ from saline controls, mutagenicity was significantly increased compared with controls in patients suffering gastric ulcer (p less than 0.002), carcinoma (p less than 0.002), and in patients after gastric resection (p less than 0.01). A transient rise in mutagenicity was seen following H2 antagonist ingestion (p less than 0.002). Increased levels of mutagenicity were found to correlate closely with gastric juice pH and bacterial count. Histidine concentrations in gastric juice did not explain the mutagenicity results.