血清胃泌素17及胃蛋白酶原联合^(14)C呼气试验在健康体检人群胃癌筛查中的价值研究  

Serum Gastrin-17 and Pepsinogen Measurement Combined with ^(14)C-UBT for Gastric Cancer Screening in Physical Examination

作　　者：王书彩[1] 朱希燕[2] 李琛琮 刘庆利[1] 杜亚强[1] WANG Shu-cai1,ZHU Xi-yan2,LI Chen-cong1,LIU Qing-li1,DU Ya-qiang1(1.Physical Examination Center,Fourth Hospital of Hebei Medical University,Shijiazhuang 050012,China2 No.5 Department of Chest Surgery,Fourth Hospital of Hebei Medical University,Shijiazhuang 050012,Chin)

机构地区：[1]河北医科大学第四医院体检部,河北省石家庄市050012 [2]河北医科大学第四医院胸外五科,河北省石家庄市050012

出　　处：《中国全科医学》2018年第13期1585-1588,共4页Chinese General Practice

基　　金：河北省医学科学研究重点课题计划(20150811)

摘　　要：目的评价联合胃泌素17、胃蛋白酶原、14C呼气试验在健康体检人群中胃癌筛查的效果,为健康体检项目的制定提供理论依据。方法选取2016年7—10月河北医科大学第四医院参与胃癌筛查项目的 40岁及以上职工1 186例为研究对象,检测胃泌素17、胃蛋白酶原水平,并行14C呼气试验及无痛胃镜检查。结果胃泌素17、胃蛋白酶原、14C呼气试验及联合筛查的阳性率分别为46.5%(219/471)、42.0%(198/471)、46.8%(206/440)、63.7%(242/380),其中联合筛查的阳性率高于胃泌素17、胃蛋白酶原、14C呼气试验(P<0.008 3)。共130例受试者参与无痛胃镜检查,检出萎缩性胃炎、胃溃疡、胃息肉、癌前病变分别有5、30、29、4例。联合筛查的胃溃疡、胃息肉阳性检出率高于胃泌素17、胃蛋白酶原、14C呼气试验,差异有统计学意义(P<0.008 3)。各筛查项目萎缩性胃炎、胃溃疡、胃息肉、癌前病变的阳性预测值比较,差异无统计学意义(P>0.05)。结论联合胃泌素17、胃蛋白酶原、14C呼气试验能提高胃黏膜病变的阳性检出率,可作为胃癌高危人群的筛查项目。Objective To evaluate the effect of a combination test of gastrin-17（GAS-17） and pepsinogen measurement and 14 C-UBT for gastric cancer screening in physical examination,providing a theoretical basis for the enaction of physical examination items.Methods The enrolled 1 186 participants were employees aged 40 or over from Fourth Hospital of Hebei Medical University.They underwent a physical examination from July to October,2017.The number of participants undergoing GAS-17 measurement,pepsinogen measurement,14 C-UBT,combination test（GAS-17 and pepsinogen measurement combined with 14 C-UBT） and painless gastroscopy for gastric cancer screening was 471,471,440,380,130,respectively.Results The overall positive prevalence detected by GAS-17 measurement,pepsinogen measurement,14 C-UBT,combination test was 46.5%（219 cases）,42.0%（198 cases）,46.8%（206 cases）,63.7%（242 cases）,respectively,demonstrating that the combination test had higher positive rate than the other 3 methods（P0.008 3）.Moreover,the prevalence of gastric ulcer or gastric polyps detected by combination test was still higher compared with the other 3 methods（P0.008 3）.However,these 4 methods showed similar positive predictive value for atrophic gastritis,gastric ulcer,gastric polyps or gastric precancerous lesions（P〉0.05）.By painless gastrosopy,5 were found with atrophic gastritis,30 with gastric ulcer,29 with gastric polyps,and 4 with gastric precancerous lesions.Conclusion The combination test demonstrated higher detection rate of gastric diseases than each of its components alone,so it can be used as a screening item for high risk population for gastric cancer.

关 键 词：胃癌 胃泌素类 胃蛋白酶原类 幽门螺杆菌 筛查 健康体检 

分 类 号：R735.2[医药卫生—肿瘤]