血清胃蛋白酶原Ⅰ和癌胚抗原联合检测在良、恶性胃溃疡患者的鉴别诊断中的应用（附402例病例）

目的评价联合检测血清胃蛋白酶原Ⅰ（PG）及其亚群（PGⅠ;PGⅡ）和癌胚抗原（CEA）临床价值和可行性。方法回顾性分析402例胃溃疡患者的血清胃蛋白酶原Ⅰ（PG）及其亚群（PGⅠ;PGⅡ）和癌胚抗原检测结果.在分别对良性溃疡及恶性溃疡患者（由本院手术或胃镜下活检证实而加以区分）的血清胃蛋白酶原和癌胚抗原做了检测的基础上,进行分类,统计。结果402例患者中有73例恶变,73例癌性溃疡患者中PG和CEA阳性表达分别为47和38例,两者皆表达阳性为22例,联合检测结果（即单独和、或表达阳性）63例,单独血清胃蛋白酶原和癌胚抗原检测与联合检测差异有统计学意义（P值分别〈0、05和0、01）。结论得出了对癌性溃疡患者,与单独检测相比,血清胃蛋白酶原和癌胚抗原联合检测提高了灵敏性,是临床上值得推广的一种方法。

Combined Determination of Serum PG and CEA and its Clinical Application in Distinctive Diagnosis of Benign and Malignant Gastric Ulcer

Objective To evaluate the clinical value and the possibilities of measuring the serum levels of pepsinogen Ⅰ （PG Ⅰ ）, pepsinogen Ⅱ （PG Ⅱ） and carcinoembryonic antigen （CEA） in 402 patients with gastric ulcer. Methods The patients with gastric ulcer were all confirmed by either operation or gastrofiberscope, and divided to two groups, benign and malignant gastric ulcer. After comparing the relationship between the patients clinical appearance and the Radioirnmunoassay （RIA） results, （CEA andPG Ⅰ ;PG Ⅱ ）. Results There were 73 patients confirmed malignant gastric ulcer in 402 patients. The positive rate of PG was 64.24% （47/73）. The positive rate of CEA was 52.05% （38/73）. Both were 30.01 % （22/73）. Then there were 63（63/73）patients who was positive in the Combined determination. Solo dctermination＇s positive rate of CEA and PG were significantly different from the Combined determination. （P 〈75 0.05 and 0.01）. Conclusions Feasibility and the necessity of combined determination were evaluated. Compared with solo determination,for patients with malignant gastric ulcer,it was more sensitive to determine and analyze the serum levels of PG Ⅰ ,PG Ⅱand CEA synthetically. So it is recommended to popularize the combined determination of serum PG Ⅰ ,PG Ⅱ and CEA in clinical distinctive diagnosis of benign and malignant gastric ulcer.