血清胃蛋白酶原与尿素^(14)C呼气试验检测在胃癌及其癌前病变筛查中的价值  

Value of serum pepsinogen and ^(14)C urea breath test in screening gastric cancer and precancerous lesions

作　　者：龙丹[1] 章杰[1] 钟冬水 王富华[1] 

机构地区：[1]福建省龙岩市第二医院消化内科,福建龙岩364000

出　　处：《中国医药科学》2017年第17期9-11,25,共4页China Medicine And Pharmacy

基　　金：福建省引进重大研发机构资助项目(2014I2003)

摘　　要：目的通过对血清胃蛋白酶原和尿素^(14)C呼气试验幽门螺杆菌的检测,探索其在胃癌和癌前病变筛查中的应用价值。方法选2015年1月~2016年6月在本院接受体检或治疗的胃部疾病患者,胃癌49例,肠上皮化生35例,慢性萎缩性胃炎39例,胃溃疡37例,慢性非萎缩性胃炎40例,选53例体检为健康的正常人作为对照组。用ELISA法检测血中PG Ⅰ、PG Ⅱ和PGR(胃蛋白酶原比值),用尿素^(14)C呼气试验测定幽门螺杆菌。结果慢性非萎缩性胃炎组与对照组差异无统计学意义(P>0.05);胃溃疡组的PG Ⅰ,PG Ⅱ较对照组高,PGR则较低,差异有统计学意义(P<0.05);胃癌、肠上皮化生、萎缩性胃炎的PG Ⅰ,PGR较低,PG Ⅱ则较高,差异有统计学意义(P<0.05)。对照组的Hp感染率最低,胃溃疡患者Hp感染率最高(75.68%),但各组之间差异无统计学意义(P>0.05)。Hp阳性对象的PG Ⅰ、PG Ⅱ及PGR与阴性实验对象差异无统计学意义(P>0.05)。结论 PG Ⅰ、PG Ⅱ、PRG可作为临床上诊断胃癌和癌前病变的初筛方法。Objective To explore application value of serum pepsinogen and ^14C urea breath test in screening gastric cancer and precancerous lesions by detection of Helicobacter pylori. Methods 49 patients with gastric diseases who received physical examination or treatment in our hospital from January 2015 to June 2016 were selected. Among whom, 49 cases were with gastric cancer, 35 cases were with intestinal metaplasia, 39 cases were with chronic atrophic gastritis, 37 cases were with gastric ulcer and 40 cases were with non-atrophic gastritis. In addition, 53 normal human whose physical examination were healthy were selected as the control group. Levels of PGI, PG II and PGR（pepsinogen ratio） in the blood were tested by ELISA and Helicobacter pylori was measured by ^14C urea breath test. Results There was no significant difference between the chronic non-atrophic gastritis group and the control group（P 〉 0.05）. PG I and PG II of the gastric ulcer group were higher than those of control group while PGR was lower. Difference was statistically significant（P 〈 0.05）. PGI and PGR of gastric cancer, intestinal metaplasia and atrophic gastritis were lower while PG II was higher. Difference was statistically significant（P 〈 0.05）.The infection rate of Hp in the control group was the lowest while infection rate of Hp of patients with gastric ulcer was the highest（75.68%）. But there was no significant difference between two groups and the difference was not statistically significant（P 〉 0.05）. There was no significant difference in PG I, PG II and PGR between the Hp positive subjects and the negative experimental subjects. The difference was not statistically significant（P 〉 0.05）. Conclusion PG I, PG II and PRG can be regarded as a screening method for the clinical diagnosis of gastric cancer and precancerous lesions.

关 键 词：血清PG HP 胃癌 癌前病变 

分 类 号：R735.2[医药卫生—肿瘤]