血清胃蛋白酶原对胃癌的诊断价值

目的探讨血清胃蛋白酶原对胃癌的诊断价值。方法收集我院2011年6月-2011年11月经胃镜活检病理诊断浅表性胃炎27例,癌前状态51例,癌前病变8例,胃癌17例,晨起空腹采静脉血3 mL,收集血清,以酶联免疫吸附测定(ELISA)定量检测血清胃蛋白酶原Ⅰ(PGⅠ)、PGⅡ水平,计算PGⅠ/PGⅡ(PGR)值。结果在浅表性胃炎、癌前状态、癌前病变、胃癌中血清PGⅠ水平及PGR逐渐降低,而血清PGⅡ水平逐渐升高;血清PGⅠ、PGR在胃癌与浅表性胃炎、癌前状态比较差异有统计学意义,与癌前病变比较差异无统计学意义;血清PGⅡ在胃癌与浅表性胃炎、癌前状态、癌前病变比较差异均有统计学意义;胃癌与癌前疾病ROC曲线下面积PGⅠAUCROC=0.782,PGⅡAUCROC=0.919,PGR AUCROC=0.989,PGⅠ为93.53 g/L时诊断胃癌的敏感性76.47%,特异性76.27%;PGⅡ为58.85 g/L时诊断胃癌的敏感性82.35%,特异性89.83%;PGR为1.88时诊断胃癌的敏感性94.12%,特异性89.83%。结论血清PGⅠ、PGⅡ水平及PGR值对诊断胃癌有较高的敏感性和特异性,可用于胃癌筛查和早期诊断。

Value of serum pepsinogen for the diagnosis of gastric cancer

Objective To investigate the value of serum pepsinogen for the diagnosis of gastric cancer.Methods The records of 27 cases of superficial gastritis,51cases of precancerous condition,8 cases precancerous lesions,17 cases of gastric cancer were evaluated during the period from June to November 2011 in our hospital.All the patients were diagnosed by endoscopic biopsy.All patients were fasting venous blood 3 mL in the morning and serum was collected.Serum pepsinogenⅠ(PGⅠ),PGⅡ levels,PGⅠ/PGⅡ(PGR),value were detected by enzyme-linked immunosorbent assay(ELISA) quantitative.Results The serum levels of PGⅠ and PGR decreased in superficial gastritis,precancerous condition,precancerous lesions and gastric cancer,while serum PGⅡlevels gradually increased.Serum PGI level and PGR value in gastric cancer,superficial gastritis and precancerous condition were compared,the differences were statistically significant;serum PGⅡ level in gastric cancer,superficial gastritis,precancerous condition,precancerous lesions were compared,the differences were statistically significant;area under ROC curve of gastric cancer and precancerous disease were PGⅠ AUCROC=0.782,PGⅡ AUCROC=0.919,PGⅠ AUCROC=0.989.When the serum PGⅠ level was 93.53g/L,the sensitivity and specificity were 76.47% and 76.27% respectively for gastric cancer.When the serum PGⅡ level was 58.85 μg/L,the sensitivity and specificity were 82.35% and 89.83%,when the PGR value was 1.88,the sensitivity and specificity were 94.12% and 89.83%.Conclusion Serum PGⅠ,PGⅡ levels and PGR value have higher sensitivity and specificity for the diagnosis of gastric cancer,which can be used for screening and early diagnosis of gastric cancer.