胃蛋白酶原在胃癌患者血清中变化的意义及其与幽门螺杆菌感染的相关性

目的 探讨胃癌患者血清中胃蛋白酶原Ⅰ(PGⅠ)、胃蛋白酶原Ⅱ(PGⅡ)以及胃蛋白酶原Ⅰ和Ⅱ比值(PGR)的变化在临床病理研究中的意义及其与幽门螺杆菌感染的相关性。 方法 选取2015年1月-2016年6月浙江省肿瘤医院收治的胃癌患者250例作为研究组,120例体检健康者作为对照组,采用化学发光法检测2组血清中PGⅠ、PGⅡ、PGR的水平,采用胶乳免疫比浊法检测2组血清中幽门螺旋杆菌(Hp)抗体IgG的水平并判断幽门螺旋杆菌感染状态,比较2组间的差异;并用ROC曲线评价PGⅠ、PGⅡ以及PGR对胃癌的诊断价值;同时分析胃癌组、健康对照组组内不同性别、不同年龄组间PGⅠ、PGⅡ和PGR水平的差异以及胃癌组不同临床病理因素下PGⅠ、PGⅡ以及PGR水平的差异。 结果 胃癌组血清PGⅡ水平和Hp阳性率显著高于健康对照组(P<0.05),而PGR水平显著低于健康对照组(P<0.05);PGR对胃癌的诊断价值较高,ROC曲线下面积(AUC)为0.803;在健康对照组中,男性血清PGⅠ、PGⅡ水平均显著高于女性(P<0.05),60岁以上者血清PGⅠ、PGⅡ水平均显著高于60岁以下者(P<0.05);在胃癌TNM分期中Ⅲ、Ⅳ期患者的PGⅠ水平显著低于Ⅰ、Ⅱ期(P<0.05);同时PGR水平与Hp感染与否有相关性。 结论 检测患者血清的PGⅠ、PGⅡ、PGR水平有助于胃癌的诊断,而PGⅠ的水平有助于胃癌的TNM分期。 

Variation of serum pepsinogen in gastric cancer patients and its relation to Helicobacter pylori infection

Objective To investigate the variation of pepsinogen (PG)Ⅰ,pepsinogen (PG)Ⅱ and ratio of PGⅠ/PGⅡ(PGR) in serum of gastric cancer patients and its relation to Helicobacter pylori infection,and discuss its role in clinicopathologic study of this disease. Methods A total of 250 gastric cancer patients were selected as study group,and 120 healthy people were selected as control group in our hospital from January,2015 to June,2016.The serum levels of PGⅠ,PGⅡ,PGR were tested by chemical luminescence method and the serum level of Helicobacter pylori (Hp) IgG antibody was tested by latex immunoturbidimetry method to detect Hp infection.The results were compared between the two groups,the values of PGⅠ,PGⅡ,PGR to the diagnosis of gastric cancer were evaluated by ROC curve and the levels of PGⅠ,PGⅡ and PGR of different gender and age were compared both in study group and control group,and the relation between the levels of PGⅠ,PGⅡ,PGR and clinicopathologic features of the disease was analyzed. Results The levels of PGⅡ and positive rate of Hp in gastric cancer group were significantly higher than those in control group,while PGR in gastric cancer group was significantly lower (P<0.05).The area under ROC curve of PGR was 0.803,which was higher diagnostic value of gastric cancer than PGI or PGII.The levels of PGⅠ,PGⅡ in male or ≥ 60 years were significantly higher than female or <60 years in control group,and the level of PGI in advanced cancer was significantly lower than those in early cancer (P<0.05),and the level of PGR was correlated with Hp infection status. Conclusion The serum levels of PGⅠ,PGⅡ and PGR may be valuable to the diagnosis of gastric cancer,and PGⅠ may be useful to the TNM classification of gastric cancer.