血清胃蛋白酶原和胃泌素-17与萎缩性胃炎关系的研究

目的:通过检测血清PGI、PGI/PGII比值(PGR)和G-17水平,以评价其能否作为筛查萎缩性胃炎的指标,以期提高早期胃癌的诊断率。方法:将经胃镜检查确诊的218例萎缩性胃炎患者纳入研究。胃镜检查前抽取空腹血4ml,分离血清,-70℃冰箱保存。于胃窦和胃体各取1块活检组织,以组织病理学检查结果将受检者分为两组:①正常对照组(包括轻度非萎缩性胃炎)224例,②萎缩性胃炎组(AG)218例,检测受检者空腹血清PGI、PGⅡ和G-17水平。结果:AG组的PGI、PGI/PGII比值及G-17水平显著降低,根据ROC曲线,三者诊断AG的最佳界值分别为82.6μg/L、6.05和7.35pg/ml。AG组的PGI、PGI/PGII比值和G-17水平与萎缩部位显著相关,胃体萎缩组及全胃多灶萎缩组PGI、PGI/PGII比值明显低于胃窦萎缩组;胃窦萎缩组、全胃多灶萎缩组血清G-17水平明显低于胃体萎缩组。结论:血清PGI、PGI/PGII值和G-17水平低下分别是胃体和胃窦萎缩的生物学标志,可根据血清PGI、PGI/PGII比值及G-17水平临界值进行AG的筛查。

Significance of detection of serum pepsinogen levels and gastrin-17 levels in patients with atrophic gastritis

Objectives ：To investigate the relationship between serum pepsinogen levels 、gastrin-17 levels and chronic gastritis .We wanted to know if they ware regarded as new tests for screening chronic atrophic gastri-tis so as to increase the early diagnosis rate of gastric cancer .Methods ：A total of 218patients with atrophic gastritis diagnosed by gastroscopy in Xi’an ,high incidence area of gastric cancer ,were recruited ,and each of them underwent endoscopy with biopsies after serum Tests were performed .These patients were divided into 2 groups based on en-doscopic and histopathologic findings ：218 patients in atrophic gastritis group and 224 （including mild non-atrophic gastritis） served as control group .Fasting serum samples for PG I 、PG II and G-17 determ ination were analyzed by enzyme linked immunosorbent assay （ELISA） .Results ：PG I、PGR and G-17 values decreased significantly in atroph-ic gastritis groups .For the best discrimination of atrophic gastritis ,the cut-of values of PG I、PGR and G-17 calculat-ed by receiver operating characteristic （ROC） curve were 82 .60 μg/L、6 .05 and 7 .35 pg/ml respectively .PG I、PGR and G-17 values were related significantly with location of atrophic gastritis .Patients with gastric atrophic gastritis and multifocal atrophic gastritis had low PG I and PGR with antral gastritis .Patients with antral gastritis and mul-tifocal atrophic gastritis had low G-17 level with gastric atrophic gastritis .Conclusions ：Low serum PG I ,PGR and G-17 values are biomarkers of gastric and antral atrophic gastritis ,respectively .Atrophic gastritis can be screened by se-rum PG I 、PGR and G-17 alues .