血清胃蛋白酶原及骨桥蛋白联合筛查胃癌的应用价值

目的 探讨血清胃蛋白酶原（PG）Ⅰ、PGⅡ和骨桥蛋白（OPN）联合检测筛查胃癌的应用价值。方法 选择570例受检者,其中胃癌144例,不典型增生60例,慢性萎缩性胃炎113例,糜烂、溃疡70例,慢性浅表性胃炎92例,健康者91例。采用ELISA方法检测受检者血清PGⅠ、PGⅡ、OPN的含量。应用受试者工作特征曲线（ROC）确定PG联合OPN筛查胃癌的检验效率。结果 PGI≤80ng／ml＋PGⅠ／PGⅡ≤5联合OPN≥34ng／ml或≥30．4ng／ml筛查胃癌与PG单筛相比,其特异度、阳性预测值、阴性预测值差异均有统计学意义;PGⅠ≤50ng／ml＋PGⅠ／PGⅡ≤5联合OPN≥35．2ng／ml或≥29．2ng／ml筛查胃癌与PG单筛相比,其灵敏度、阳性预测值、阴性预测值差异均有统计学意义。PG联合OPN筛查与OPN单筛相比,其灵敏度、特异度可同时达到双高;而OPN单筛仅特异度较高。结论 利用血清PG与OPN联合筛查胃癌均优于血清PG或OPN单筛,此法可能成为胃癌人群筛查的一种新方法。

Evaluation of serum pepsinogen I , II and osteopontin co-detection in gastric cancer screening

OBJECTIVE: To explore the value of combined assay of serum PG and OPN concentration for gastric cancer screening. METHODS: Pepsinogen I , II and osteopontin (OPN) concentrations in fasting serum were measured by ELISA in 570 subjects, including 144 gastric cancer, 60 dysplasia, 113 atrophic gastritis, 70 erosion or ulcer, 92 superficial gastritis and 91 healthy control. The cut off point for PG and OPN was determined using receiver operator characteristics curves (ROC). RESULTS: Using a serum PG I concentration < or =80 ng/ml, I: II ration < or =5.0 and OPN concentration > or =34 ng/ml or > or =30.4 ng/ml (based on ROC) for gastric cancer screening,the specificity, positive and negative predictive values were superior to that obtained by PG concentration only. Using a serumPGI concentration < or =50 ng/ml, I : II ration C 5. 0 and OPN concentration > or =35.2 ng/ml or > or =29. 2 ng/ml (based on ROC), the sensitivity, positive and negative predictive values were superior to that obtained by PG concentration only. Combining PG and OPN for gastric cancer screening, both sensitivity and specificity were more than 70% , while with OPN alone, only good specificity can be achieved. CONCLUSION: Combining different serum PG and OPN concentration for gastric cancer screening is superior to PG or OPN only. This may be used as a new method in gastric cancer mass screening.