血清胃蛋白酶原联合胃泌素测定在胃癌及萎缩性胃炎中的诊断价值  

The value of the detection of pepsinogen and gastrin levels in gastric cancer and atrophic gastritis

作　　者：王雪华[1] 曹燕[1] 张剑宏[2] 王琦[1] 武希润[1] 申慧琴[1] 

机构地区：[1]山西医科大学第二临床医学院消化科,太原030001 [2]山西医科大学第二临床医学院检验科,太原030001

出　　处：《中华临床医师杂志（电子版）》2015年第10期62-65,共4页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的探索血清学检测胃蛋白酶原、胃泌素在胃癌及萎缩性胃炎中的诊断价值。方法应用酶联免疫吸附试验检测44例慢性浅表性胃炎、42例胃癌、47例萎缩性胃炎患者血清胃蛋白酶原Ⅰ(PGⅠ)、胃蛋白酶原Ⅱ(PGⅡ)、胃泌素-17(G-17)的水平,计算PGⅠ/PGⅡ的比值(PGR),比较不同组各指标的差异,绘制各指标筛查胃癌及萎缩性胃炎的ROC曲线,评价各指标对胃癌及萎缩性胃炎的诊断价值。结果胃癌组及萎缩性胃炎组患者血清PGⅠ、PGR水平较浅表性胃炎组下降,胃癌组的G17水平较浅表性胃炎组升高,萎缩性胃炎组的G17水平较浅表性胃炎组水平下降,差异均具有统计学意义。PGⅠ筛查胃癌的最佳界值为PGⅠ<74 ng/ml,其灵敏度和特异度分别为85.7%和75.0%,PGR筛查胃癌的最佳界值为PGR<4,其灵敏度和特异度分别为89.0%和62.5%。PGⅠ筛查萎缩性胃炎的最佳界值为PGⅠ<91 ng/ml,其灵敏度和特异度分别为77.3%和50.0%,PGR筛查萎缩性胃炎的最佳界值为PGR<9,其灵敏度和特异度分别为72.7%和53.2%,G17筛查萎缩性胃炎的最佳界值为G17<6 pmol/L,其灵敏度和特异度分别为65.9%和63.8%。结论血清学检测胃蛋白酶原、胃泌素可以作为筛查胃癌及萎缩性胃炎的指标,筛查胃癌的最佳界值分别为PGⅠ<74 ng/ml,PGR<4,筛查萎缩性胃炎的最佳界值为PGⅠ<91 ng/ml,PGR<9。Objective The purpose of the study was to research the applicability of measuring serum pepsinogen （PG） and gastrin-17 （G-17） as screening tests for gastric cancer and atrophic gastritis. Methods A total of 133 gastric disease patients were enrolled, the patients included those with superficial gastritis, chronic atrophic gastritis and gastric cancer. Serum PG I, PGII and G-17 levels were detected by Biohit ELISA kit （Finland）, and PG FII ratio was calculated. Differences in patients with different gastric diseases were analyzed using One-Way ANOVA. Results The levels of PG I and PGR in gastric cancer and chronic atrophic gastritis groups were significantly decreased than that of superficial gastritis groups. The level of G-17 in gastric cancer were significantly increased, while that of chronic atrophic gastritis significantly decreased. For the best discrimination of gastric cancer, the cut-of values of PG I, PGR calculated by receiver operating characteristic （ROC） curve were PG I 〈74 ng/ml （sensitivity： 85.7%, specificity： 75%） and PGR〈4 （sensitivity： 89%, specificity： 62.5%）, while for chronic atrophic, the cut-of values of PG I, PGR and G-17 calculated by receiver operating characteristic （ROC） curve were at PG I 〈91 ng/ml （sensitivity： 77.3%, specificity： 50.0%）, PGR〈9 （sensitivity： 72.7%, specificity： 53.2%）, G17〈6.0 pmol/L （sensitivity： 65.9%, specificity： 63.8%）. Conclusion Serological methods can be use to screen gastric cancer and chronic atrophic gastritis.

关 键 词：胃肿瘤 胃炎 萎缩性 胃蛋白酶原类 胃泌素类 

分 类 号：R573.3[医药卫生—消化系统] R735.2[医药卫生—内科学]