血清胃蛋白酶原水平与胃粘膜病变的关系

目的:探讨血清胃蛋白酶原(Pepsinogen,PG)水平与胃黏膜病变的关系以及血清PG检测在胃癌筛查中的应用价值。方法:采用时间分辨荧光免疫分析法,进行血清PG检测与胃镜活检、病理形态学观察结果相结合,对比分析625例接受胃镜观察的患者血清PGⅠ、PGⅡ水平的变化和胃黏膜病变的关系。结果:与正常组相比慢性萎缩性胃炎患者血清PGⅠ水平有所下降(P<0.05)、胃溃疡患者PGⅠ、PGⅡ水平明显升高(P<0.05)、慢性浅表性胃炎患者PGⅠ、PGⅡ变化不明显、胃癌患者PGⅠ、PGⅠ/PGⅡ明显下降;在慢性萎缩性胃炎组,各组之间PGⅠ、PGⅡ水平没有明显差异,但伴异型增生组血清PGⅠ、PGⅡ水平有增高趋势,PGⅠ/PGⅡ有降低趋势。在浅表性胃炎组伴有异型增生患者,PGⅠ、PGⅡ水平均明显升高,PGⅠ/PGⅡ均明显下降。结论:血清PGⅠ、PGⅡ含量的变化与胃黏膜的病变密切相关,血清PG异常可作为癌前病变及胃癌的早期筛查的指标。

Correlation of serum pepsinogen level and gastric mucosal changes of residents

Objective: To study the correlation between serum pepsinogen(PG) and gastric mucosal changes,and investigate the value of serum pepsinogen level in screening for gastric cancer(GC).Methods: Serum pepsinogen level was detected with time resolved fluorescence immunoassay(TRFIA).The correlation between serum PG and gastric mucosal changes were analyzed through endoscopic biopsy and pathological examination in 625 adult residents.Results: Serum pepsinogenI(PGI) level of the chronic atrophic gastritis(CAG) was significantly lower than that of the normal group(P<0.05).Serum pepsinogenⅠand pepsinogenⅡlevels of gastric ulcer(GU) were significantly higher than those of the normal groups(P<0.05).There exited no significant differences between serum pepsinogenⅠand pepsinogenⅡlevels of CSG group compared with the normal group(P>0.05).PGⅠand PGⅠ/ PGⅡ levels of the gastric cancer group(GC) were significant lower than those of the normal group.Serum pepsinogenⅠand pepsinogenⅡlevels were significantly higher while PGⅠ/ PGⅡ levels were significantly lower in epithelia dysplasia among CAG and CSG groups than those of the normal group.Conclusion: The percentage change of serum pepsinogen is correlated with gastric mucosal changes.Dynamic detection of serum pepsinogen can be applied in monitoring the populations of gastric cancer.