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1.
目的探讨血清胃蛋白酶原Ⅰ(PGⅠ)、胃蛋白酶原Ⅱ(PGⅡ)、胃蛋白酶原比值(PGR)、胃泌素-17(G-17)及幽门螺杆菌IgG抗体(Hp-IgG)联合检测对胃癌早期诊断的临床价值。方法选取2018年1月至2019年6月四川省广元市第四人民医院收治的120例胃癌患者(早期胃癌组)、60例萎缩性胃炎患者(萎缩性胃炎组)、同期体检的120例健康志愿者(对照组)为研究对象。比较3组受试者血清PGⅠ、PGⅡ、PGR、G-17和Hp-IgG的水平,通过ROC曲线分析各指标及联合诊断的价值。结果早期胃癌组、萎缩性胃炎组及对照组受试者血清PGⅠ分别为(59.85±8.59)ng/ml、(72.19±9.89)ng/ml、(96.83±8.66)ng/ml,差异具有统计学意义(F=530.504,P<0.001);3组受试者PGⅡ分别为(23.19±2.45)ng/ml、(20.60±4.19)ng/ml、(16.52±3.34)ng/ml,差异具有统计学意义(F=130.085,P<0.001);3组受试者PGR分别为2.78±0.69、4.33±0.95、6.21±1.46,差异具有统计学意义(F=288.801,P<0.001);3组受试者G-17分别为(77.04±10.09)ng/ml、(64.69±7.22)ng/ml、(55.91±8.32)ng/ml,差异具有统计学意义(F=170.770,P<0.001);3组受试者Hp-IgG分别为(70.23±8.11)IU、(58.30±9.37)IU、(33.00±5.24)IU,差异具有统计学意义(F=778.431,P<0.001)。早期胃癌组和萎缩性胃炎组患者的血清PGⅠ和PGR水平明显低于对照组患者(均P<0.05),且早期胃癌组血清PGⅠ和PGR水平显著低于萎缩性胃炎组患者(均P<0.05);早期胃癌组和萎缩性胃炎组患者的PGⅡ、G-17和Hp-IgG水平明显高于对照组(均P<0.05),且早期胃癌组患者PGⅡ、G-17和Hp-IgG水平显著高于萎缩性胃炎组(均P<0.05)。ROC曲线显示,血清PGⅠ诊断胃癌的临界值为73.11 ng/ml,敏感性为63.33%,特异性为83.33%,曲线下面积(AUC)为0.801;血清PGⅡ诊断的临界值为19.55 ng/ml,敏感性为75.83%,特异性为72.22%,AUC为0.760;血清PGR诊断的临界值为4.60,敏感性为82.50%,特异性为77.22%,AUC为0.816;血清G-17诊断的临界值为64.33 ng/ml,敏感性为64.17%,特异性为65.56%,AUC为0.631;血清Hp-IgG诊断的临界值为53.80 IU,敏感性为59.17%,特异性为75.00%,AUC为0.708;在最佳临界切点时,PGⅠ+Hp-IgG二者联合检测敏感性为69.17%,特异性为76.67%,AUC为0.754;PGR+Hp-IgG二者联合检测敏感性为88.33%,特异性为74.44%,AUC为0.798;G-17+Hp-IgG敏感性为71.67%,特异性为65.56%,AUC为0.718;五者联合检测的敏感性为92.50%,特异性为72.22%,AUC为0.869。五者联合检测敏感性显著高于各指标单独检测(均P<0.05),且五者联合诊断的AUC显著高于各项指标单独检测(Z=1.848,P=0.032;Z=3.145,P=0.001;Z=1.688,P=0.046;Z=7.726,P<0.001;Z=4.931,P<0.001;Z=3.188,P=0.001;Z=1.783,P=0.037;Z=4.534,P<0.001)。结论血清PGⅠ、PGⅡ、PGR、G-17和IgG anti-Hp联合检测可提高胃癌诊断的敏感性,对于胃癌早期诊断有重要的意义和价值。  相似文献   

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目的 分析检测血清胃蛋白酶原Ⅰ(PGⅠ)、胃蛋白酶原Ⅱ(PGⅡ)及胃泌素17(G-17)在胃癌及萎缩性胃炎中的诊断价值.方法 选取接受胃镜检查的患者865例,其中浅表性胃炎患者339例作为浅表性胃炎组,萎缩性胃炎患者318例作为萎缩性胃炎组,胃癌患者208例作为胃癌组.采用酶联免疫吸附试验(ELISA)检测3组患者的血清G-17水平;采用胶乳免疫比浊法检测3组患者的血清PGⅠ、PGⅡ水平,并计算胃蛋白酶原比值(PGR);采用单纯取胃体组织做快速尿素酶测定(RUT)法和幽门螺旋杆菌(HP)尿素酶抗体检测试剂盒检测HP值.对3组患者的各指标进行比较,评价其诊断胃癌和萎缩性胃炎的价值.结果 胃癌组患者的PGⅠ水平低于萎缩性胃炎组和浅表性胃炎组(P﹤0.05);萎缩性胃炎组和胃癌组患者的PGⅡ水平低于浅表性胃炎组(P﹤0.05);胃癌组患者的G-17水平高于浅表性胃炎组和萎缩性胃炎组(P﹤0.05);胃癌组患者的PGR值小于浅表性胃炎组和萎缩性胃炎组,萎缩性胃炎组患者的PGR值小于浅表性胃炎组(P﹤0.05).PGⅠ和PGR检测胃癌的灵敏度分别为88.9%、86.9%,特异度分别为73.6%、59.4%;PGⅠ、PGR和G-17检测萎缩性胃炎的灵敏度分别为69.9%、70.8%、66.1%,特异度分别为49.8%、51.4%、64.2%.HP阳性患者的PGⅠ和PGⅡ水平均高于HP阴性患者,PGR值小于HP阴性患者(P﹤0.05).结论 血清检测PG水平的方法在诊断胃癌时的特异度和灵敏度均较高,是胃癌患者诊断的一个重要血清学指标,可用于胃癌的早期诊断.  相似文献   

3.
赵建芳  石芳 《实用癌症杂志》2017,(12):1940-1942
目的 探讨血清胃癌相关抗原(MG7-Ag)联合胃泌素-17(G-17)检测用于诊断胃癌的临床价值.方法 选择胃癌患者60例(胃癌组),胃部良性病变患者50例(良性病变组),癌前病变患者58例(癌前病变组),同时选择同期进行体检的健康志愿者50例作为对照组.检测所有患者以及健康对照组志愿者血清中MG7-Ag以及G-17的表达含量,分析2种检测指标用于诊断胃癌的临床效能.结果良性病变组、癌前病变组以及胃癌组患者血清中MG7-Ag以及G-17的表达含量显著高于健康对照组(P<0.05).胃癌进展期患者血清中MG7-Ag和G-17的含量水平显著高于早期胃癌患者(P<0.05);淋巴结转移患者血清中MG7-Ag和G-17的含量水平显著高于淋巴结非转移胃癌患者(P<0.05).与MG7-Ag、G-17单独用于诊断胃癌相比,MG7-Ag联合G-17用于诊断胃癌的敏感性、特异性更强,且阳性预测值和阴性预测值升高,其中,MG7-Ag联合G-17的敏感性、特异性,阳性预测值和阴性预测值均比MG7-Ag检测显著升高(P<0.05).结论MG7-Ag联合G-17用于诊断胃癌的特异度高,误诊率低,可以提高诊断准确性.  相似文献   

4.
目的:探讨福建省胃癌高、中、低发地区居民血清胃蛋白酶原(PG)Ⅰ、PGⅡ、胃泌素(G-17)水平及幽门螺杆菌(Hp)感染的分布趋势。方法:选择长乐市江田镇、同安区大同镇和福安市赛歧镇分别代表福建省胃癌的高、中、低发地区,以ELISA检测3地区居民(共725人)的血清PGⅠ、PGⅡ、G-17含量及Hp IgG抗体,统计学检验比较各指标在3地区间的差异。结果:长乐江田镇、同安大同镇和福安赛歧镇PGⅠ中位数分别为110.75、131.00和107.32μg/L,PGⅡ为13.90、14.70和7.79μg/L,PGⅠ/PGⅡ比值为7.91、8.66和13.09,G-17为2.90、1.10和1.00ρmol/L,Hp感染率分别为49.6%、33.5%和29.3%。各指标在3个地区间的差异均有统计学意义,z值为47.15~121.76,χ2=22.47,P值均<0.001。3地区居民血清指标异常者(PGI<25μg/L、PGⅠ/PGⅡ比值<2.5或G-17≥2ρmol/L)所占的比例差异有统计学意义,χ2值为13.45~94.46,P值均≤0.001。Hp感染阳性者的血清PGⅠ、PGⅡ和G-17均高于阴性者,而PGⅠ/PGⅡ比值则低于阴性者。无论Hp阳性或阴性,3个地区居民的血清学指标差异都有统计学意义,z值为-3.32~70.36,P值均<0.05。结论:福建省胃癌高、中、低发地区居民血清PGⅠ、PGⅡ、G-17水平及Hp感染率分布有明显的地区差异,提示这些血清学指标的变化可能与胃癌的发生密切相关。  相似文献   

5.
李梅  许佳  刘玉萍 《现代肿瘤医学》2023,(16):3041-3045
目的:探讨血清胃蛋白酶原Ⅰ(pepsinogenⅠ,PGⅠ)、PGⅡ、PGⅠ/PGⅡ、胃泌素-17(gastrin-17,G-17)和胃幽门螺杆菌(Helicobacter pylori, H.pylori)等血清学筛查指标在健康体检人群胃癌筛查中的应用价值。方法:回顾性纳入2020年01月至2021年12月期间在我院健康管理中心进行血清PG、G-17检测及13C尿素呼气试验(13C urea breathing test,13C-UBT)的健康体检人群共25 387例作为研究对象,将PG(+)、G-17(+)、H.pylori(+)任意满足2项及以上或PG、G-17单独异常定义为高危组,对高危组患者行内镜检查及进一步病理活检,根据病理诊断分为胃癌前状态、胃癌前病变、早期胃癌、进展期胃癌及对照组(胃黏膜正常组),分析PG、G-17、H.pylori水平与胃黏膜各级病变发生的关系及对胃癌的筛查价值。结果:血清学筛查高危组7 592例,占29.9%;高危组男性的构成、H.pylori感染率、平均年龄高于低危组,PGⅠ、PGⅠ...  相似文献   

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李俊  姚保栋  李为希 《中国肿瘤》2019,28(8):629-635
摘 要:[目的] 探讨血清幽门螺杆菌抗体(Hp-IgG)、胃蛋白酶原(PG)、胃泌素-17(G-17)检测对社区胃癌高危人群的筛查效果,分析不同胃部疾病的血清学指标特点。[方法] 2016年5月至2017年12月在社区招募40岁以上具有胃癌家族史或高危疾病史的胃癌高危人群参与筛查,采用酶联免疫吸附法测定血清中的PGⅠ、PGⅡ、G-17、Hp-IgG抗体,任意两项及以上指标阳性或PG、G-17单独阳性为筛查阳性,建议胃镜检查、随访并追踪其结果,由区内二、三级医院临床专家集中评定胃癌前期和胃癌。[结果] 共招募5552名居民参与血清学筛查,随访追踪659例筛查阳性居民的胃镜结果,发现胃癌前病变176例,包括息肉48例,低级别上皮内瘤变10例,术后残胃80例,中/重度萎缩性胃炎伴或不伴肠化38例;胃癌10例,早期5例,进展期5例,胃癌检出率0.18%,早期率50%。其他胃病组、胃癌前期组和胃癌组的PGⅠ水平和PGⅠ/Ⅱ比值(PGR)呈依次递减趋势(χ2=45.704,P<0.001;χ2=17.746,P<0.001);与非萎缩胃炎组比较,萎缩性胃炎组和中/重度萎缩性胃炎伴或不伴肠化组的PGR降低(Z=-2.514,P=0.012;Z=-2.094,P=0.036);息肉组的PGⅠ水平降低(Z=-2.032,P=0.042),G-17水平升高(Z=-2.294,P=0.022);低级别上皮内瘤变组的PGⅠ、PGⅡ、G-17水平无显著变化(P>0.05);术后残胃组的PGⅠ、PGⅡ、G-17水平和PGR均降低(Z=-8.241,P<0.001;Z=-2.767,P=0.006;Z=-4.208,P<0.001;Z=-4.394,P<0.001);胃癌组PGⅠ水平和PGR明显降低(Z=-1.996,P=0.046;Z=-2.500,P=0.012);各组间Hp-IgG抗体阳性率无显著差异(P>0.05)。 [结论]不同胃部疾病患者的血清PG、G-17特点不同,PGⅠ和PGR降低有助于发现胃癌前期和胃癌患者;血清学筛查是社区人群肿瘤早发现工作的探索和创新,但仍需进一步评估不同血清学指标的筛查价值。  相似文献   

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陈红男  奚凤瑜  张赟  李春娟 《癌症进展》2023,(6):625-627+631
目的 探讨血清胃泌素-17、胃蛋白酶原水平与胃癌患者预后的关系。方法 选取106例胃癌患者及87例健康体检者,分别作为胃癌组和对照组,比较两组受试者血清胃泌素-17、胃蛋白酶原水平,比较不同临床分期胃癌患者血清胃泌素-17、胃蛋白酶原水平;胃癌患者预后的影响因素采用多因素Logistic回归分析;绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC),评估胃泌素-17、胃蛋白酶原对胃癌患者预后的预测价值。结果胃癌组患者血清胃泌素-17水平明显高于对照组,胃蛋白酶原水平明显低于对照组,差异均有统计学意义(P﹤0.01)。TNM分期为Ⅳ期胃癌患者血清胃泌素-17水平明显高于Ⅰ~Ⅱ期和Ⅲ期患者,胃蛋白酶原水平明显低于Ⅰ~Ⅱ期和Ⅲ期患者,Ⅲ期患者血清胃泌素-17水平明显高于Ⅰ~Ⅱ期患者,胃蛋白酶原水平明显低于Ⅰ~Ⅱ期患者,差异均有统计学意义(P﹤0.01)。多因素Logistic回归分析结果显示,TNM分期为Ⅲ~Ⅳ期、淋巴结转移、胃泌素-17水平升高、胃蛋白酶原水平降低均为胃癌患者预后的独立危险因素(P﹤0.01)。胃泌素-17、胃蛋白酶原联合检测预测胃癌患者预后的AUC为0.841(95...  相似文献   

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赵丽华  何谦  张磊  周挺  张妮 《陕西肿瘤医学》2013,(10):2283-2286
目的:探讨血清胃蛋白酶原PG Ⅰ、PGⅡ及癌胚抗原CEA、糖类抗原CA72-4联合检测对胃癌的诊断价值.方法:采用全自动生化分析仪及电化学发光仪检测40例胃癌患者和50例健康人血清中胃蛋白酶原PG Ⅰ、PGⅡ、PG Ⅰ/PGⅡ比值、CEA及CA72-4的水平并进行比较.结果:胃癌患者血清胃蛋白酶原PG Ⅰ水平和PG Ⅰ/PGⅡ比值明显低于正常对照组(P<0.01).而CEA和CA72-4水平明显高于正常对照组(P<0.01).血清胃蛋白酶原PG Ⅰ、PG Ⅰ/PGⅡ比值的敏感性和特异性要优于CEA、CA72-4.联合检测与单项检测相比,敏感度、特异性显著提高,与临床诊断相符性显著提高(kappa值分别为0.663,0.660).结论:胃癌患者血清PG Ⅰ、PG Ⅰ/PGⅡ比值、CEA和CA72-4的检测对胃癌的诊断有一定的临床意义.四项标志物联合检测可有效提高胃癌诊断的敏感度和特异性,可以作为胃癌的筛查手段.  相似文献   

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目的 探讨胃癌患者围术期胃蛋白酶原(PG)和胃泌素-17变化对术后医院感染的影响,为胃癌患者术后医院感染的防治提供参考.方法 选取拟行胃癌手术治疗的患者150例(胃癌组),选取门诊同期行健康体检无异常者150例为对照(对照组),胃癌组在术前和术后7 d时、对照组在纳入研究时检测血清PG-Ⅰ和PG-Ⅱ、胃泌素-17水平,...  相似文献   

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BackgroundGastric cancer is a common malignant tumor. The aim of the present study was to analyze the application value of serum pepsinogen (PG), carbohydrate antigen 72-4 (CA72-4), and gastrin-17 (G-17) detection in the screening, diagnosis, and evaluation of early gastric cancer.MethodsIn total, 122 patients with gastric cancer treated in our hospital from January 2018 to January 2021 were selected as the gastric cancer group and subdivided into the early gastric cancer (group A) and advanced gastric cancer (group B) groups. Sixty-five patients with benign gastric disease treated in the same hospital during the same period were selected as the control group, and 122 healthy people who underwent physical examination during the same period were allocated to the control group. The differences in the levels of G-17, PGI, PGII, PGI/PGII, and CA72-4 were compared; receiver-operating characteristic curves were drawn; and the efficacy of different factors in the diagnosis of early gastric cancer was calculated.ResultsG-17, PGI, and PGI/PGII levels in the gastric cancer group were significantly lower than those in the healthy group, and CA72-4 was significantly higher than that in the healthy group (P<0.05), but there was no significant difference in PGII between the 2 groups (P>0.05). G-17, PGI, and PGI/PGII levels in groups A and B were significantly lower than those in the control group. CA72-4 in groups A and B was significantly higher than that of the control group, and was highest in group B (P<0.05). The areas under the curve (AUC) of G-17, PGI, PGI/PGII, and CA72-4 were 0.671, 0.726, 0.769, and 0.602, respectively, and the AUC of combined detection was 0.883, which was significantly higher than that of single detection.ConclusionsSerum PG, CA72-4 combined with G-17 detection has high sensitivity and specificity in the screening and diagnosis of early gastric cancer, and has high clinical application value.  相似文献   

13.
目的:检测 NEDD9在食管鳞状细胞癌组织中的表达,分析 NEDD9与食管癌预后之间的关系。方法:随机收集56例食管鳞状细胞癌手术标本,采用 Western 印迹方法分别检测 NEDD9在食管癌组织及癌旁组织中的表达。术后随诊3年,收集56例患者生存数据,采用 Cox 单因素及多因素分析方法分析 NEDD9的表达与食管癌预后的关系。结果:56例食管癌组织中,NEDD9高表达占64.3%(36例);癌旁组织中,NEDD9表达32.1%(18例),癌组织中 NEDD9表达高于癌旁组织(P <0.05)。生存分析数据,NEDD9高表达组患者生存率较低表达组低(P <0.05)。Cox 单因素分析及多因素分析结果表明,TNM 分期及 NEDD9高表达为影响预后的独立危险因素。结论:NEDD9在食管癌组织中特异高表达,参与食管癌的侵袭及转移,与食管癌预后相关。  相似文献   

14.
BACKGROUND: To investigate the feasibility of combining several serum markers into a valid serum screening tool for gastric cancer, we performed a study evaluating the association between gastric cancer and precancerous conditions and a blood test for gastric acidity (the blood quininium resin test [QRT]) combined with serum pepsinogen levels. METHODS: We performed immunoradiometric assays of serum pepsinogen I (PG I), II (PG II) levels, and QRT's in 10 endoscopically normal subjects, in 20 patients with chronic atrophic gastritis, and in 13 patients with biopsy-confirmed gastric adenocarcinoma. RESULTS: Serum PG I, II levels, I/II ratio were significantly different among normal, gastritis, and cancer patients. Serum PG I/II ratios were much lower in cancer patients. Serum quinine levels by QRT were correlated with PG I/II ratio (rs=0.39, p<0.01). Age was negatively correlated both with PG I/II ratio (rs=-0.58, p<0.01) and serum quinine level (rs=-0.45, p<0.01). The screening using serum PG levels was more valid (sensitivity of 69%, specificity of 77%) than that using QRT alone. The combination of serum PG levels and QRT increased specificity for detecting gastric cancer to 87% without altering sensitivity. CONCLUSION: Although blood QRT is a useful addition to other serum screening tests for gastric cancer, these tests alone are not sufficiently accurate as screening tools for gastric cancer.  相似文献   

15.
Objective: To estimate the practical values of pepsinogen C (PGC) dynamic expression and the levels of serum pepsinogens in gastric cancer screening and diagnosis. Methods: 129 cases gastric mucosa biopsies and serum specimens were examined. The expression of PGC in stomach mucosa was detected by immunohistochemistry. The serum concentration of pepsinogen A (sPGA) and pepsinogen C (sPGC) were determined by ELISA. Results: The positive rate of PGC antigen expression decreased in superficial gastritis (100%), gastric ulcer or erosion (80.00%), atrophic gastritis (34.48%) and gastric cancer (11.43%) in sequence (P〈0.05). There was no statistics difference in concentration of sPGA and sPGC among the above 4 groups. The ratio of sPGA/sPGC decreased in superficial gastritis, gastric ulcer or erosion, atrophic gastritis and gastric cancer in sequence (P〈0.05). There was specific correlation between the expression of PGC in stomach mucosa and the levels of sPGA/sPGC ratio in serum (rs =0.297, P=0.001). Conclusion: Tissue expression of PGC has close relationship with different gastric diseases. The ratio of sPGA/sPGC is relative with the tissue expression of PGC antigen and may be a convenient and economic maker in screening and diagnosis of gastric cancer.  相似文献   

16.
Objective: To investigate the value of combined assay of serum pepsinogen (PG) and osteopontin (OPN) levels for gastric cancer screening. Methods: Fasting serum pepsinogen Ⅰ, Ⅱ and OPN concentration were measured by ELISA in 570 subjects. The cut off points for PG and OPN were determined using ROC. Results: Using serum PGI concentration 〈80 ng/ml, Ⅰ, Ⅱ ration 〈5.0 and OPN concentration ≥34 ng/ml or ≥30.44 ng/ml (based on ROC) for gastric cancer screening had superior specificity, positive and negative predictive values compared with PG or OPN screening only. The sensitive and specificity of combining serum PG and OPN assay were both more than 70% compared with PG or OPN screening alone. Conclusion: Combining serum PG and OPN assay for gastric cancer screening is superior to PG or OPN level only. This may be a new method for gastric cancer mass screening.  相似文献   

17.
目的:探究胃癌组织中NEDD9、CD44和Ki67的表达及与胃癌临床病理特征的关系。方法:选取2017年05月-2019年05月于我院住院治疗的胃癌患者120例作为观察组,同时选取正常胃黏膜50例作为参照组,检测NEDD9、CD44和Ki67在早期胃癌、进展期胃癌与正常胃黏膜组织中阳性率的表达,分析3种指标与临床病理特征的关系。结果:早期胃癌患者与进展期胃癌患者的NEDD9阳性表达率均显著高于正常胃黏膜患者,且进展期胃癌患者高于早期胃癌。NEDD9高表达随浸润程度、分化程度的增加而增强,与年龄、性别、肿瘤大小、淋巴结转移无关。CD44与患者年龄、性别无关,但与TNM分期、肿瘤大小、浸润程度、分化程度、淋巴结转移有关。Ki67在进展期胃癌中的阳性表达率高于早期胃癌,与性别、TNM分期、肿瘤大小、浸润程度有关,与年龄、分化程度及有无淋巴结转移无关。NEDD9、CD44、Ki67在早期胃癌患者中已有较高表达率。结论:检测NEDD9、CD44、Ki67指标对早期胃癌的诊断、评估胃癌的恶性程度有重要意义,或为胃癌的诊断、治疗、预后提供帮助,为胃癌临床治疗提供新的潜在靶点。  相似文献   

18.
Background: Our aim was to study the serum pepsinogen levels in gastric cancer patients in our population in relation to histology and the presence of Helicobacter pylori . Methods: Forty-six patients with gastric cancer and 70 controls were studied prospectively in a 1-year period. Serum levels of pepsinogen I (PG I), pepsinogen II (PG II), and gastrin were measured by radioimmunoassay. Results: The mean PG I levels for cancer patients and controls were 83.5 μg/l and 60.9 μg/l, respectively ( P = 0.03), the mean PG II levels were 27.2 μg/l and 12.1 μg/l respectively ( P < 0.0001). The PG I/II ratio was significantly lower in cancer patients ( P = 0.04) and in those with Helicobacter infection. Serum pepsinogen levels were not affected by any pathological characteristics. Histology showed that the prevalence of chronic gastritis, intestinal metaplasia, and gastric atrophy was 97%, 56%, and 15%, respectively. Conclusion: The prevalence of gastric atrophy is low in our population, and serum pepsinogen measurement is not useful as a screening tool for gastric cancer in this population. Received: July 8, 2002 / Accepted: September 2, 2002 Offprint requests to: J.B.-Y. So  相似文献   

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