血清胃蛋白酶原、胃泌素17和幽门螺杆菌检测在胃癌前病变诊断中的价值

发布时间：2019-02-24 19:01

【摘要】：目的研究血清胃蛋白酶原(PG)、胃泌素17(G17)和幽门螺杆菌(H.pylori)检测在胃癌前病变诊断中的价值。方法 ELISA法检测424例胃癌前病变患者(病例组)和646例非癌前病变患者(对照组)PG和G17水平,13C尿素呼气试验检测H.pylori,比较两组中PG和G17水平及病例组中不同萎缩程度和黏膜肠化、上皮内瘤变PG和G17变化,采用ROC曲线得出敏感指标诊断胃癌前病变的最佳临界值。结果 PG和G17水平与性别、年龄、H.pylori感染相关。病例组PGII高于对照组(P=0.005),PGI/PGII比值(PGR)低于对照组(P=0.015)。重度萎缩组PGI较对照组明显降低(P=0.013),PGII和G17在低级别瘤变组和高级别瘤变组较对照组明显升高,差异有统计学意义(P0.05),PGR在萎缩、肠化、上皮内瘤变组降低差异有统计学意义(P0.05)。PGR诊断胃癌前病变的最佳临界值为8.75(灵敏度70.0%,特异度58.0%);当H.pylori阳性时,最佳临界值为7.70(灵敏度75.6%,特异度73.7%);当H.pylori阴性时,最佳临界值为9.50(灵敏度57.5%,特异度58.2%)。结论低水平PGR结合H.pylori检测在胃癌前病变诊断中有重要的临床价值,PGII和G17在上皮内瘤变组升高明显,提示可作为胃癌前病变的观察指标。
[Abstract]:Objective to study the diagnostic value of serum pepsinogen (PG), gastrin 17 (G17) and Helicobacter pylori (H.pylori) in precancerous lesions. Methods the levels of PG and G17 were detected by ELISA in 424patients with precancerous lesions (case group) and 646 patients with non-precancerous lesions (control group), and H.pylorius was detected by 13C urea breath test. The levels of PG and G17 in the two groups and the changes of PG and G17 in different atrophy, mucosal intestinal metaplasia, intraepithelial neoplasia and intraepithelial neoplasia were compared between the two groups. The best critical value for the diagnosis of gastric precancerous lesions was obtained by ROC curve. Results PG and G 17 levels were correlated with sex, age and H.pylori infection. The PGII of the case group was higher than that of the control group (P0. 005), and the (PGR) ratio of PGI/PGII was lower than that of the control group (P0. 015). The PGI of severe atrophy group was significantly lower than that of control group (P0. 013), PGII and G17 were significantly higher in low grade tumor degeneration group and high grade tumor degeneration group than in control group (P0.05), PGR in atrophy and intestinal metaplasia. The decrease of intraepithelial neoplasia group was statistically significant (P0.05). The best critical value of). PGR for diagnosis of gastric precancerous lesions was 8.75 (sensitivity 70.0%, specificity 58.0%). When H.pylori is positive, the best critical value is 7.70 (sensitivity 75.6%, specificity 73.7%), and when H.pylori is negative, the best critical value is 9.50 (sensitivity 57.5%, specificity 58.2%). Conclusion low level PGR combined with H.pylori has important clinical value in the diagnosis of gastric precancerous lesion. PGII and G17 are significantly increased in intraepithelial neoplasia group, which suggests that they can be used as an index of gastric precancerous lesion.
【作者单位】：安徽医科大学附属省立医院消化内科;安徽医科大学附属省立医院健康管理中心;
【基金】：安徽省科技攻关项目资助(编号:1604a0802075)
【分类号】：R735.2

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