血清胃蛋白酶原Ⅰ、Ⅱ和幽门螺杆菌IgG抗体对胃癌的诊断价值探讨  

The diagnosis value of serum PGⅠ, PGⅡ and IgG anti-Hp in patients with gastric cancer

作　　者：林德谦 

机构地区：[1]浙江省苍南县中医院检验科,325800

出　　处：《中国基层医药》2017年第11期1654-1657,共4页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的 探讨血清胃蛋白酶原Ⅰ（PGⅠ）、胃蛋白酶原Ⅱ（PGⅡ）、PGⅠ/PGⅡ比值（PGR）和幽门螺杆菌IgG抗体（IgG anti-Hp）水平在胃癌早期诊断中的价值.方法 选择胃癌患者30例（胃癌组）,采用胶乳免疫比浊法检测血清PGⅠ、PGⅡ水平,ELISA法检测IgG anti-Hp浓度,并以30例健康人（对照组）作为对照,分析PGⅠ、PGⅡ和IgG anti-Hp筛查胃癌的最佳界值.结果 胃癌组血清PGⅠ、PGⅡ、PGR、IgG anti-Hp水平分别为（33.72±6.49）ng/L、（8.36±1.26）ng/L、（3.67±0.72）、（69.74±15.86）IU,对照组分别为（111.36±15.86）ng/L、（10.57±1.71）ng/L、（10.53±1.34）、（34.62±8.94）IU,胃癌组与对照组相比,血清PGⅠ、PGⅡ、PGR水平降低（t=25.58、5.60、24.67,均P＜0.01）,而IgG anti-Hp水平升高（t=10.55,P＜0.01）;胃癌组IgG anti-Hp阳性者PGⅠ、PGⅡ、PGR和IgG anti-Hp水平与IgG anti-Hp阴性者比较,差异均有统计学意义（t=5.77、4.02、3.76,均P＜0.01）;根据ROC曲线,PGⅠ、PGⅡ、PGR和IgG anti-Hp的最佳界值分别为32.54ng/L[敏感度80.7%,特异度75.0%,曲线下面积（0.775±0.075）]、7.73 ng/L[敏感度75.4%,特异度70.5%,曲线下面积（0.742±0.071）],3.48[敏感度86.4%,特异度72.5%,曲线下面积（0.859±0.067）]和69.11 IU[敏感度59.1%,特异度75.0%,曲线下面积（0.667±0.089）].结论 检测血清PGⅠ、PGR和IgG anti-Hp水平可用于胃癌早期筛查,PGR是筛查胃癌的最佳单一指标.Objective To explore the relationship between the serum PGⅠ,PGⅡ,PGⅠ/PGⅡ ratio（PGR）,IgG anti-HP and gastric cancer and the diagnostic value.Methods The levels of serum PGⅠ,PGⅡ,PGⅠ/PGⅡ ratio（PGR） and IgG anti-HP were detected by emulsio immunoturbidimetry and ELISA in 30 patients with gastric cancer and 30 healthy subjects as controls.Then, the best cut-off value was established to screen gastric cancer.Results The levels of serum PGⅠ,PGⅡ,PGR and IgG anti-HP in the gastric cancer group were （33.72±6.49）ng/L, （8.36±1.26）ng/L, （3.67±0.72）, （69.74±15.86）IU,respectively,which in the control group were （111.36±15.86）ng/L, （10.57±1.71）ng/L, （10.53±1.34）, （34.62±8.94）IU,respectively.The levels of serum PGⅠ,PGⅡ and PGR in the gastric cancer group were significantly lower than those in the control group（t=25.58,5.60,24.67,all P〈0.01）,while the level of serum IgG anti-HP was significantly higher than that in the control group（t=10.55,P〈0.01）.Compare the serum PGⅠ, PGR between IgG anti-HP positive group and IgG anti-HP negative group, there was statistically significant differences（t=5.77,4.02,3.76,all P〈0.01）.According to the ROC curves, the best cut-off points of PGⅠ, PGⅡ, PGR, IgG anti-HP were 32.54 ng/L[sensitivity 80.7%,specificity 75.0%,area under curve （0.775±0.075）], 7.73 ng/L[sensitivity 75.4%,specificity 70.5%,area under curve （0.742±0.071）],3.48[sensitivity 86.4%,specificity 72.5%,area under curve （0.859±0.067）] and 69.11 IU[sensitivity 59.1%,specificity 75.0%,area under curve （0.667±0.089）].Conclusion Detection of serum PGⅠ, PGR, and IgG anti-HP levels can be useful as a way to screen gastric cancer, the PGR may the best single measure to diagnosis of gastric cancer.

关 键 词：胃肿瘤 胃蛋白酶原A 胃蛋白酶原C 螺杆菌 幽门 

分 类 号：R735.2[医药卫生—肿瘤]