胃蛋白酶原亚群测定与萎缩性胃炎诊断的相关研究

目的研究血清中胃蛋白酶原(PG)亚群水平在健康体检者及胃部疾病患者中的变化规律,探讨血清中PG亚群测定对萎缩性胃炎诊断的意义。方法利用放射免疫法测定健康体检者和胃溃疡、萎缩性胃炎、胃癌患者中PGⅠ、PGⅡ及PGⅠ/PGⅡ值的变化,将正常对照组与疾病组及各疾病组之间进行统计学分析。结果①与正常对照组相比,萎缩性胃炎、胃癌患者血清PGⅠ、PGⅠ/PGⅡ比值降低(q=5.97、q=6.18,P均<0.05;q=6.24、q=6.34,P均<0.01),胃溃疡患者血清PGⅠ升高(q=5.01,P<0.05)、PGⅠ/PGⅡ比值降低(q=4.72,P<0.05);②与胃溃疡组相比,萎缩性胃炎和胃癌患者血清PGⅠ明显降低(q=7.20、q=7.03,P均<0.001),PGⅠ/PGⅡ比值也降低(q=7.20,P=0.001);③萎缩性胃炎组与胃癌组相比,PGⅠ和PGⅠ/PGⅡ比值均无统计学差异(q=1.05、q=1.36,P均>0.05)。血清PGⅠ≤80μg/L且PGⅠ/PGⅡ≤6时,检测萎缩性胃炎的灵敏度为53.3%,特异度为94.3%。结论血清PGⅠ和PGⅠ/PGⅡ的降低,是胃癌及萎缩性胃炎发生的危险因素,可以作为筛查和辅助诊断的一项血清学指标,血清PGⅠ≤80μg/L且PGⅠ/PGⅡ≤6对检测萎缩性胃炎有较好的灵敏度和特异性。

Related Research about Detecting Pepsinogen Subtypes in Atrophic Gastritis

Objective To study variation of serum pepsinogen（PG） subgroups content in healthy persons and patients with stomach diseases, and investgate serum PG subgroups significance for diagnosis of atrophic gastritis. Methods The changes of PG Ⅰ , PGⅡ and the PG Ⅰ/PGⅡwere measured with radioimmunoassay （ RIA ） in healthy persons, gastric ulcer, atrophic gastritis and gastric cancer patients. Data of the normal control group were statistically compared with every disease group. Results （1） Compared with the normal control group, serum PG Ⅰ ,PG I/PG II ratio of atrophic gastritis and gastric cancer patients was decreasing（q =5.97 ,q =6.18 ,P both 〈 0.05 ; q = 6.24, q = 6.34, P both 〈 0.01 ）, serum PG I of gastric ulcer patients increasing （ q = 5.01, P 〈 0.05 ） , PG Ⅰ/PG Ⅱ decreasing（ q = 4.72 ,P 〈 0.05 ）. （2） Compared with the gastric ulcer group, serum PG Ⅰ of atrophic gastritis and gastric cancer were significantly lower than gastric ulcer （ q = 7.20,q = 7.03, P both 〈 0. 001 ） , PG Ⅰ / PG Ⅱ ratio were also lower（ q = 7.20 ,P = 0. 001 ）. （3） PG I and PG I/PGⅡof atrophic gastritis and gastric cancer group were not significantly different（ q = 1.05, q = 1.36, P both 〉 0.05 ）. When serum PG ≤ 80μg,/L and the PG Ⅰ/PG Ⅱ ≤6 ,the sensitivity and specificity for detection of atrophic gastritis was 53.3% and 94.3% respectively. Conclusion The serum PG I and PG Ⅰ/PG Ⅱ decrease is a risk factor for gastric cancer and atrophic gastritis. It may he a screening and supplementary diagnosis of serum marker. Serum PG I ≤80p, g/L and the PG Ⅰ/PG Ⅱ ≤ 6 has better specificity and sensitivity for atrophic gastritis.