血清胃蛋白酶原和胃泌素-17检测在胃癌筛查中的应用  

Application of serum pepsinogen and gastrin-17 detection in the screening of gastric cancer

作　　者：李林[1] 张立新[1] 艾冬琴[1] 李嘉伟[1] 

机构地区：[1]泰州市人民医院检验科,江苏泰州225300

出　　处：《海南医学》2015年第22期3335-3337,共3页Hainan Medical Journal

摘　　要：目的探讨血清胃蛋白酶原Ⅰ、Ⅱ(PGⅠ、PGⅡ)、胃泌素-17(G-17)联合检测在胃癌早期诊断中的临床价值。方法选择我院经胃镜检查确诊的104例胃疾病患者为研究对象,以组织病理学检查结果将受检者分为4组,即胃癌组29例、萎缩性胃炎组30例、胃溃疡组24例、浅表性胃炎组21例。同时从我院体检中心选择经胃镜检查无任何异常的20例作为对照组。各组均在胃镜检查前抽取空腹静脉血3 ml,分离血清,-20℃冰箱保存。采用ELISA法检测PGⅠ、PGII、G-17。结果 (1)胃癌组和萎缩性胃炎组血清PGⅠ水平显著低于健康对照组,胃癌组血清PGⅠ水平又明显低于萎缩性胃炎组;而胃溃疡组与其他各组相比血清PGⅠ水平明显增高;以上差异均有统计学意义(P<0.05)。浅表性胃炎组与健康对照组的血清PGⅠ水平比较差异无统计学意义(P>0.05)。胃癌组血清G-17水平明显高于其他各组,而萎缩性胃炎组明显低于其他各组,差异均有统计学意义(P<0.05);各组血清PGⅡ水平差异均无统计学意义(P>0.05)。(2)PGⅠ、G-17单独或联合检测结果作胃癌诊断的ROC分析,线下面积分别为0.895、0.918、0.976。(3)Logistic回归方程为P=1/[1+e-(-5.421-0.079 PGⅠ+0.845 G-17)]。诊断点P=0.1271,敏感性为0.966,特异性为0.900。结论血清PGⅠ及G-17联合检测可提高胃癌诊断率,对胃癌早期诊断具有重要的临床意义。Objective To study the clinical value of combined detection of serum pepsinogenⅠ, Ⅱ（PGⅠ,PGⅡ） and gastrin-17（G-17） in the diagnosis of gastric cancer. Methods One hundred and four patients with gastric disease checked in our hospital were selected as study objects. The patients were divided into four groups： gastric cancer group（29 cases）, atrophic gastritis group（30 cases）, gastrohelcosis group（24 cases）, and superficial gastritis group（21 cases）. Moreover, 20 healthy individuals were enrolled as control group. A fixed volume（3 ml） of blood sample was obtained from each patient, then separated for serum and kept in-20℃ refrigerator. The serum levels of PGⅠ, PGⅡ, G-17 were detected by using ELISA. Results（1） The serum level of PGⅠwere significantly lower in gastric cancer group and atrophic gastritis group than the control group（P〈0.05）, and also lower in gastric cancer group than atrophic gastritis group. The level in gastrohelcosis group was significantly higher than all the other groups. The differences above were all statistically significant（P〈0.05）. There was no significant difference in the PGⅠlevel between superficial gastritis group and the control group（P〉0.05）. G-17 level in the gastric cancer group was significantly higher than all the other groups, and the level in atrophic gastritis group was significantly lower than all the other groups（P〈0.05）. There was no statistically significant difference in the level of PG Ⅱ between the five groups（P〉0.05）.（2） The area under the receiver operating characteristic curve of combined detection of PG Ⅰ and G-17 in gastric cancer group was 0.976, higher than single detection of PG Ⅰ（0.895） and G-17（0.918）.（3） Logistic regression equation was P=1/[1＋e^-（-5.421-0.079 PGI＋0.845 G-17）]. Diagnosis of point was P=0.1271. Diagnostic sensitivity and specificity of combined detection of PGⅠ and G-17 were 0.966 and 0.900. Conclusion Combined detection of PG Ⅰ a

关 键 词：胃蛋白酶原 胃泌素 胃癌 筛查 

分 类 号：R735.2[医药卫生—肿瘤]