血清胃蛋白酶原在胃腺癌诊断中的临床价值

目的：探讨血清胃蛋白酶原（PG）在胃腺癌诊断中的应用价值。方法使用胶乳增强免疫透射比浊法分别检测20例浅表性胃炎、20例萎缩性胃炎、20例胃溃疡及68例胃腺癌患者的血清PGⅠ和PGⅡ含量，计算胃蛋白酶原比值（PGR），并结合病理和病情分期进行比较和ROC曲线分析。结果胃腺癌组患者血清PG I含量和PGR显著低于浅表性胃炎组、萎缩性胃炎组和胃溃疡组，差异有统计学意义（P均＜0.05）；胃溃疡组患者PG Ⅰ含量明显高于浅表性胃炎组、萎缩性胃炎组和胃腺癌组，差异有统计学意义（P均＜0.05）。萎缩性胃炎组患者血清PGⅠ含量和PGR也较浅表性胃炎组和胃溃疡组明显降低，差异具有统计学意义（P均＜0.05）；而浅表性胃炎组、萎缩性胃炎组、胃溃疡组和胃腺癌组患者的血清PGⅡ含量基本保持一致，差异无统计学意义（P均＞0.05）。此外，血清PGⅠ含量和PGR的ROC曲线下的面积（AUC）为0.961和0.963（P均＜0.05）；胃腺癌患者PGR水平与胃腺癌分化程度具有一定的相关性。结论血清PGⅠ含量和PGR对胃腺癌的诊断价值较高。

Clinical evaluation of serum pepsinogen in diagnosis of gastric adenocarcinoma

Objective To explore the clinical significance of serum pepsinogen （PG） in diagnosis of gastric adenocarcinoma. Methods The serum concentrations of PG I and PG II in 20 cases of superficial gastritis, 20 cases of atrophic gastritis, 20 cases of gastric ulcer, and 68 cases of gastric cancer were detected with latex enhanced immunoturbidimetric assay, and PG ratio（PGR） was subsequently calculated. Results The serum PG I level and PGR in gastric adenocarcinoma group were significantly lower than those in superficial gastritis, atrophic gastritis, or gastric ulcer group （P〈0.05）. The serum PG I concentration in gastric ulcer group was significantly higher than that in superficial gastritis, atrophic gastritis, or gastric adenocarcinoma group （P〈0.05）. The PG I level and PGR decreased significantly in atrophic gastritis group compared to superficial gastritis and gastric ulcer groups（P〈0.05）. But for PG II, there was no statistical difference in patients of four groups（P〉0.05）. In addition, ROC curves analysis revealed PG I and PGR with an area under curve（AUC） of 0.961 and 0.963, respectively. There was certain correlation between PGR and differentiation of gastric adenocarcinoma. Conclusions Serum PG I concentration and PGR were remarkably valuable for diagnosis of the gastric adenocarcinoma.