生长激素调素和胃蛋白酶原对萎缩性胃炎及胃癌诊断的临床意义

目的 通过检测浅表性胃炎、萎缩性胃炎及胃癌患者血清中胃蛋白酶原Ⅰ/胃蛋白酶原Ⅱ(PG Ⅰ/PGⅡ)和生长激素调素的水平,探讨其对胃黏膜萎缩及胃癌的诊断价值.方法 应用酶联免疫法测定血清PGⅠ、PGⅡ及生长激素调素的水平,计算PG Ⅰ/PGⅡ,结果进行统计学分析.结果 萎缩性胃炎组、胃癌组的PG Ⅰ/PGⅡ水平分别为9.14±1.80和7.50±2.06,低于浅表性胃炎组11.55±2.29；萎缩性胃炎组、胃癌组的生长激素调素水平分别为(18.59±8.19) μg/L和(17.10±7.13) μg/L,低于浅表性胃炎组(26.08±9.15) μg/L,其结果有统计学意义.PG Ⅰ/PGⅡ及生长激素调素水平变化呈正相关( r=0.668,P＜0.01).PG Ⅰ/PGⅡ对萎缩性胃炎及胃癌诊断的ROC曲线下面积分别为0.635和0.811,生长激素调素对萎缩性胃炎及胃癌诊断的ROC曲线下面积分别为0.680和0.695.结论 PGⅠ/PGⅡ及生长激素调素水平的检测可以作为胃黏膜萎缩及胃癌的筛查及辅助诊断的指标之一.

Clinical value of serum ghrelin and pepsinogen in patients with chronic atropic gastritis and gastric cancer

Objective To investigate the diagnostic value of serum pepsinogen Ⅰ/pepsinogen Ⅱ （PG Ⅰ/PGⅡ） and ghrelin in atrophy of gastric mucosa and gastric cancer,by testing serum PG Ⅰ/PGⅡ and ghrelin in patients with superficial gastritis,atrophic gastritis or gastric cancer. Methods Enzyme immunoassay was used to detect serum PGPG Ⅰ/PGⅡand ghrelin. PG Ⅰ/PGⅡ was calculated,and the results were processed in statistical analysis. Results In atrophic gastritis or gastric cancer patients, PG Ⅰ/PGⅡ was respectively 9.14 ± 1.80 and 7.50 ± 2.06, which were significantly lower than that in superficial gastritis patients, 11.55±2.29. Serum ghrelin in atrophic gastritis or gastric cancer patients was （18.59± 8.19）μg/L and （ 17.10±7.13） μg/L, which were significantly lower than that in superficial gastritis patients, （26.08±9.15）μg/L. The difference had statistical significance. PG Ⅰ/PGⅡ was positively correlated with the change of ghrelin （ r =0. 668, P〈0.01）. The area under the ROC curve of PG PG Ⅰ/PGⅡ in diagnosis of atrophic gastritis was 0. 635,and that in diagnosis of gastric cancer was 0. 811. Thearea under the ROC curve of ghrelin in diagnosis of atrophic gastritis was 0,680, and that in diagnosis of gastric cancer was 0. 695. Conclusion PG PG Ⅰ/PGⅡ and serum ghrelin level could be used as targets in screening and diagnosing atrophic gastritis and gastric cancer.