胃蛋白酶原的个体含量差异及对慢性萎缩性胃炎和早期胃癌鉴别诊断的价值

目的 研究胃蛋白酶原Ⅰ(PGⅠ)、PGⅡ和PGⅠ/PGⅡ在慢性萎缩性胃炎和早期胃癌患者体内含量的差异,为疾病的鉴别诊断及病情分级提供理论依据.方法 57例轻度胃炎患者作为对照组,29例慢性萎缩性胃炎患者作为萎缩性胃炎组和7例胃癌患者作为胃癌组,通过免疫定量分析仪比较3组患者血清中PGⅠ、PGⅡ和PGⅠ/PGⅡ比值的差异.结果 人口学因素中,性别和学历对萎缩性胃炎和胃癌的患病率不具有影响(P>0.05),但不同年龄月收入对患病率有一定影响(P<0.05).萎缩性胃炎组PGⅠ/PGⅡ水平低于对照组,PGⅡ水平高于对照组,差异均有统计学意义(P<0.05).胃癌组PGⅠ、PGⅠ/PGⅡ水平低于对照组、萎缩性胃炎胃组,PGⅡ高于对照组、萎缩性胃炎组,差异均有统计学意义(P<0.05).中、重度萎缩性胃炎PGⅠ、PGⅠ/PGⅡ水平低于轻度,PGⅡ高于轻度,差异均有统计学意义(P<0.05).重度萎缩性胃炎PGⅠ、PGⅠ/PGⅡ低于中度,PGⅡ水平高于中度,差异均有统计学意义(P<0.05).胃癌不同发展阶段PGⅡ水平比较,差异无统计学意义(P>0.05).进展期、晚期胃癌PGⅠ、PGⅠ/PGⅡ水平均低于早期,晚期胃癌PGⅠ、PGⅠ/PGⅡ水平低于进展期,差异均有统计学意义(P<0.05).结论 胃蛋白酶原的测定对慢性萎缩性胃炎和早期胃癌的诊断具有一定的鉴别诊断价值,具有简单、高效的优点,值得临床推广.

The individual differences of pepsinogen content and its value in differential diagnosis between chronic atrophic gastritis and early gastric cancer

Objective To investigate the differences of the contents of pepsinogen Ⅰ(PGⅠ),PGⅡ and PGⅠ/PGⅡ in patients with atrophic gastritis and patients with early gastric cancer patients in order to provide a theoretical basis for the differential diagnosis of disease and disease classification.Methods Fifty-seven patients with mild gastritis were enrolled as control group, 29 patients with chronic atrophic gastritis were enrolled as atrophic gastritis group and 7 patients with gastric cancer were enrolled as gastric cancer group,who were treated in our hospital from January 2016 to August 2016.The serum levels of PGⅠ,PGⅡ and PGⅠ/PGⅡ ratio were detected and compared among the three groups.Results The patient's sex and educational history had no effects on the prevalence of atrophic gastritis and gastric cancer (P>0.05),however, the monthly income in different age groups had effects on the prevalence (P<0.05).The levels of PGⅠ/PGⅡin atrophic gastritis group were significantly lower than those in contol group,however,the levels of PGⅡwere obviously higher than those in control group (P<0.05).The levels of PGⅠ,PGⅠ/PGⅡin gastric cancer group were significantly lower than those in contol group and those in atrophic gastritis group, but the levels of PGⅡwere significantly higher than those in contol group and those in atrophic gastritis group (P<0.05).The levels of PGⅠ,PGⅠ/PGⅡin moderate and severe atrophic gastritis groups were significantly lower than those in mild atrophic gastritis group,however,the levels of PGⅡwere significantly higher than those in mild atrophic gastritis group (P<0.05).The levels of PGⅠ,PGⅠ/PGⅡin severe atrophic gastritis groups were significantly lower than those in moderate atrophic gastritis group,but the levels of PGⅡwere significantly higher than those in moderate atrophic gastritis group (P<0.05).There were no significant differences in the levels of PGⅡin different developmental stages of gastric cancer (P>0.05).The levels of PGⅠ,PGⅠ/PGⅡ in aggressive-phase and advanced gastric cancer were significantly lower than those in early gastric cancer,moreover, the levels of PGⅠ,PGⅠ/PGⅡin advanced gastric cancer were significantly lower than those in aggressive-phase gastric cancer (P<0.05).Conclusion The detection of pepsinogen has a certain value in differential diagnosis between chronic atrophic gastritis and early gastric cancer,which has the advantages of simplicity and high-performance, therefor,which is worth using widely in clinical practice.