胃蛋白酶原检测对消化性溃疡和胃癌的筛查作用  

Screening effect of pepsinogen detection on peptic ulcer and gastric cancer

作　　者：孙克玉 刘梅 程德山 凌美蓉 赵缜 

机构地区：[1]上海市闵行区中心医院急诊科,201199 [2]上海市闵行区中心医院检验科,201199

出　　处：《临床内科杂志》2017年第9期613-615,共3页Journal of Clinical Internal Medicine

基　　金：上海市重点专科建设项目（ZK2015815）;上海市闵行区科学技术委员会基金资助项目（2015MHZ039）

摘　　要：目的探讨胃蛋白酶原（PG）I和PGII检测对消化性溃疡和胃癌的筛查作用。方法将1534例体检者作为体检组、401例慢性胃炎患者作为慢性胃炎组、149例胃溃疡患者作为胃溃疡组、358例十二指肠溃疡患者作为十二指肠溃疡组、57例胃癌患者作为胃癌组（溃疡型39例月}溃疡型18例），分别检测其PGI和PGII，并计算PGI／PG11（PGR），比较3个指标在各组之间的差异；根据体检人群90％可信区间设定参考值，观察PGI、PGⅡ、PGR对消化性溃疡和胃癌的筛查作用。结果慢性胃炎组、胃溃疡组、十二指肠溃疡组和胃癌组血清PG1分别为（234．5±106．6）ng／ml、（259．0±125．9）ng／ml、（265．9±114．2）ng／ml和（204．2±151．6）ng／ml，均高于体检组[（183．7±56．7）ng／ml，P〈0．05]；PG11分别为（31．2±26．8）ng／ml、（44．3±41．8）ng／ml、（40．9±39．6）rig／m1和（23．7±16．6）ng／ml，均高于体检组[（15．8±9．8）ng／mJ，P〈0．05]；PGR分别为（10．6±5．9）、（9．5±6．1）、（9．7±5．2）和（9．7±5．3），均低于体检组（14．3±6．4，P〈0．05）。胃溃疡组与十二指肠溃疡组血清PGI和PG1／均高于慢性胃炎组（P〈0．05）；胃癌组血清PGI和PGⅡ均低于慢性胃炎组（P〈0．05），且非溃疡型胃癌组PGI和PGII均低于溃疡型胃癌组（P〈0．05）；慢性胃炎组、胃溃疡组、十二指肠溃疡组和胃癌组间PGR比较差异均无统计学意义（P〉0．05）；PGI和PGII联合检测对消化性溃疡诊断的阳性率为60．4％，而PGI、PRG在非溃疡型胃癌组的阳性率分别为66．7％和55．6％。结论血清PG检测将来可能用于消化性溃疡或非溃疡型胃癌的筛查。Objective To evaluate the screening effect of pepsinogen detection（PG） I and II on peptic ulcer and gastric cancer. Methods A total of 1 534 physical examinees were selected as physical examine group,401 chronic gastritis patients as chronic gastritis group, 149 gastric ulcer patients as gastric ulcer group,358 duodenal ulcer patients as duodenal ulcer group and 57 gastric cancer patients as gatric cancer group（ ulcerative type with 39 cases and non-ulcerative type with 18 cases）. PG I , II and PGR were detected and compared. The 90% confidence interval of physical examinees was set up as reference values that were used to explore the screening effect of peptic ulcer and gastric cancer. Results PG I in chronic gastritis, gastric ulcer, duodenal ulcer and gastric cancer group were （234. 5± 106. 6 ）ng/ml, （259. 0 ± 125.9）ng/ml, （265.9 ± 114. 2） ng/ml and （204.2 ± 151.6） ng/ml respectively, which were higher than that in physical examine group[ （ 183.7 ±56.7 ） ng/ml ,P 〈 0.05 ]. PG II in chronic gastritis, gastric ulcer, duodenal ulcer, and gastric cancer group were （31.2 ± 26.8 ）ng/ml, （44.3 ± 41. 8 ）ng/ml, （40.9 ± 39.6） ng/ml, and （ 23.7 ±16.6） ng/ml respectively, which were also higher than that in physical examinees [ （ 15.8 ± 9.8） ng/ml,P 〈 0. 05 ]. PGR of abored four groups were 10.6 ± 5.9,9.5 ± 6. 1,9.7 ±5.2 and 9. 7 ± 5.3 respectively, which were lower than that of physical examinees （ 14.3 ± 6.4, P 〈 0.05 ）. PG I and PG II in gastric ulcer and duodenal ulcer group were significantly higher than those in chronic gastritis group（ P 〈 0.05 ）. However, PG I and PG II in gastric cancer groups were significantly lower than those in chronic gastritis （ P 〈 0.05 ）. Moreover, PG I and PG II in non-ulcerative gastric cancer group were significantly lower than those in ulcerative gastric cancer group （ P 〈 0.05 ）. There was no significant difference of PGR among chronic gastritis, gastric ulcer, duodenal ulcer and gastric cancer

关 键 词：胃蛋白酶原 慢性胃炎 消化性溃疡 溃疡型胃癌 非溃疡型胃癌 

分 类 号：R573.1[医药卫生—消化系统]