胃蛋白酶原联合幽门螺杆菌对早期胃癌筛查的价值

目的探讨血清胃蛋白酶原和粪便幽门螺杆菌抗原联合检测对于胃癌早期诊断的价值。方法检测血清胃蛋白酶原水平及比值、粪便HP抗原阳性百分率。采用ROC曲线分析血清胃蛋白酶原及粪便HP抗原对胃癌早期诊断的价值;并比较多项指标单一检测和联合检测的敏感度、特异度。结果胃癌组的血清胃蛋白酶原水平及比值低于其他2组,粪便幽门螺杆菌抗原的阳性率高于其他2组(P<0.05),萎缩性胃炎的胃蛋白酶原Ⅱ水平低于非萎缩性胃炎(P<0.05);ROC曲线显示血清胃蛋白酶原I、胃蛋白酶原Ⅱ、胃蛋白酶原比值及粪便幽门螺杆菌抗原的AUC值分别为0.864、0.717、0.772、0.417。胃蛋白酶原与幽门螺杆菌联合检测的敏感度为88.4%,较单一检测的敏感度高(P<0.05)。结论血清胃蛋白酶原水平及比值、粪便幽门螺杆菌抗原可用于胃癌及胃癌癌前病变的大规模筛查。联合检测对早期胃癌的诊断有一定的价值。

Value of pepsinogen combined with Helicobacter pylori in screening early gastric cancer

Objective To investigate the value of combined detection of serum pepsinogen and stool Helicobacter pylori antigen in the early diagnosis of gastric cancer.Methods The serum pepsinogen level and ratio,and the positive percentage of stool HP antigen were detected.The ROC curve was used to analyze the value of serum pepsinogen and fecal HP antigen in the early diagnosis of gastric cancer.The sensitivity and specificity of single detection and combined detection of multiple indexes were compared.Results The level and ratio of serum pepsinogen in gastric cancer group were significantly lower than the other two groups,and the positive rate of stool HP antigen was higher than the other two groups,with the difference statistically significant(P<0.05).The level of pepsinogen II in atrophic gastritis was lower than that in non-atrophic gastritis(P<0.05).ROC curve showed that the AUC values of serum pepsinogen I,pepsinogen II,pepsinogen ratio and stool Helicobacter pylori antigen were 0.864,0.717,0.772 and 0.417,respectively.The sensitivity of the combined detection was 88.4%,higher than that of single detection,and the difference was statistically significant(P<0.05).Conclusion Serum pepsinogen level and ratio,stool Helicobacter pylori antigen can be used for large-scale screening of gastric cancer and precancerous lesions of gastric cancer.Combined detection has certain value in the diagnosis of early gastric cancer.