血清胃蛋白酶原异常居民胃粘膜变化的随访观察  

Follow up Observation of Gastrc Mucosal Changes in Subjects with Abnormal PG Levels.

作　　者：张祥宏[1] 卜玉华[2] 王俊灵 严霞[1] 米建民 赵文元[1] 张振国 杨永滨[1] 三角顺一 青木一雄 

机构地区：[1]河北医科大学病理研究室,石家庄市050017 [2]河北省赞皇县医院 [3]日本大分医科大学

出　　处：《中国肿瘤临床》2000年第7期491-494,共4页Chinese Journal of Clinical Oncology

基　　金：河北省医学重点研究项目;日本文部省科研基金

摘　　要：目的 :探讨血清胃蛋白酶原 (PG)水平变化与我国胃癌高发区居民胃癌发生的关系及PG异常在人群胃癌筛查中的价值。方法 :在对赞皇县 15 0 4名农村居民进行血清PG和HP抗体检测的基础上 ,对受检居民进行了随访 ,并分析了受检后 16～ 30个月胃粘膜病理形态学变化。结果 :赞皇县居民血清PG水平具有明显的性别差异 ,男性居民PGⅠ、PGⅡ和PGⅠ /PGⅡ比值明显高于女性居民 ,但男女居民中血清PG异常者检出率无明显差异(11.7%∶9.6 % ,P >0 .0 5 )。随访期内PG异常居民胃癌死亡率 (0 .6 4% )高于正常居民 (0 .0 0 7% ) ,但统计学意义不明显。血清PG异常组居民胃粘膜腺体萎缩和腺上皮不典型增生的发生率均达到 70 %以上 ,肠上皮化生的发生率也超过 5 0 % ,明显高于血清PG正常居民 (P <0 .0 1)。血清PG异常伴HP抗体阳性者腺体萎缩、肠上皮化生及腺上皮不典型增生发生率均明显高于HP抗体阴性者。结论 :血清PG异常居民胃粘膜多有明显的癌前病变 ,是胃癌的高危人群。Objective:To elucidate the relationship between changes in serum pepsinogen levels and carcinogenesis of gastric cancer in high risk area of stomach cancer and the significance of serum PG abnormality in the screen of gastric cancer.Method:On the bases of serum PG and anti-HP antibody detection,1504 rural residents in Zanhuang County were follow-uped for 16 to 30 months and pathological changes in gastric mucosa were examined in 63 PG abnormal cases and 25 PG normal cases with endoscopic and pathological methods.Results:Sex differences were found in serum PG levels of residents in Zanhuang County.PGⅠ and PGⅡ levels in male were all higher than those of female.While no differences were found in PG abnormal rate(11.7% vs 9.6%, P <0.05).Gastric cancer death rate for PG abnormal residents (PG-AR) washigher than that of PG normal residents (PG-NR),yet no significant statistical significance was found.Glandular atrophy and dysplasia were found in over 70% and intistinal metaplasia over 50% cases in PG-AR group,which were dramtically higher than those in PG-NR group.Within PG-AR group,the incidences of glandular atrophy,dysplasia and intestinal metaplasia in serum anti-HP antibody positive subjects were significantly higher than those inserum anti-HP negative subjects.Conclusion:Most of the serum PG level abnormality adult residents were accompanied with precancerous lesions (intestinal metaplasia and epithelia dysplasia) in gastric mucosa.

关 键 词：胃蛋白酶原 胃粘膜 癌前病变 胃肿瘤 

分 类 号：R730.4[医药卫生—肿瘤]