血清胃蛋白酶原和胃泌素-17 对萎缩性胃炎及胃癌患者诊断价值

目的 探索血清胃蛋白酶原(pepsinogen,PG)Ⅰ,PGⅡ和胃泌素-17(gastrin-17,G-17)对萎缩性胃炎及胃癌患者的早期临床诊断价值。方法 研究采用观察性病例-对照研究,共430例受检者纳入研究。血清测试前,受检者经活检组织病理学检查证实。根据病理结果将受检者分为非萎缩性胃炎160例、萎缩性胃炎118例、胃癌152例,用酶联免疫吸附试验方法(enzyme-linked immunosorbent assay,ELISA)检测血清PGⅠ,PGⅡ和G-17含量,并计算PGⅠ/PGⅡ比值。结果与非萎缩性胃炎组相比,萎缩性胃炎组血清PGⅠ和G-17均降低,差异具有统计学意义(P<0.05),胃癌组血清PGⅠ,PGⅡ,PGⅠ/PGⅡ及G-17均降低,差异具有统计学意义(P<0.05); 与萎缩性胃炎组相比,胃癌组血清PGⅠ和G-17均降低,差异具有统计学意义(P<0.05)。根据受试者工作特征曲线(receiver operating characteristiccurve, ROC),PGⅠ,PGⅡ,PGⅠ/PGⅡ及G-17诊断萎缩性胃炎的最佳临界值为84.706 μg/L,10.873 μg/L,11.008和8.265 pg/L,诊断胃癌的最佳临界值为65.145 μg/L,10.089 μg/L,6.375和4.971 pg/L。结论 血清PGⅠ,PGⅡ,PGⅠ/PGⅡ及G-17水平低下是萎缩性胃炎及胃癌生物学标志,对胃癌早期诊断具有重要的临床意义。

Clinical Value of Serum Pepsinogen and Gastrin-17 Levels in Patients with Atrophic Gastritis and Gastric Cancer

Objective To investigate the clinical value ofserum pepsinogen(PG)Ⅰ,Ⅱ and gastrin-17(G-17)levels in early diagnosis foratrophic gastritis and gastric cancer.Methods The studywas performed on a case-control trial,and 430 subjects were recruited.Each of them underwent endoscopy biopsies before serum tests were performed.These patients were further divided into three groups based on endoscopic and histological findings:160 non-atrophic gastritis group,118 atrophic gastritis group and152 gastric cancer group.Serum samples of PGⅠ,PGⅡ and G-17 were analyzed byenzyme-linked immunosorbent assay(ELSIA),and calculated the values of PGⅠ/PGⅡratio.Results Compared with the non-atrophic gastritis group,serum PGⅠ and G-17 values in atrophic gastritis and serum PGⅠ,PGⅡ,PGⅠ/PGⅡratio and G-17 values in gastric cancer group decreased significantly(P<0.05); compared with the atrophic gastritis group,serum PGⅠ and G-17 values in gastric cancer group decreased significantly(P<0.05).By usingreceiver operating characteristic curves(ROC),the cut-off points of PGⅠ84.706 μg/L,PGⅡ 10.873 μg/L,PGⅠ/PGⅡ ratio 11.008 and G -178.265 pg/L inatrophic gastritis group,PGⅠ65.145 μg/L,PGⅡ 10.089 μg/L,PGⅠ/PGⅡ ratio6.375 and G-17 4.971 pg/L in gastric cancer group.Conclusion Low serum PGⅠ,PGⅡ,PGⅠ/PGⅡ ratio and G-17 values are biomarkers of atrophic gastritis and gastric cancer and valuable for the early diagnosisofgastric cancer.