早期胃癌患者内镜黏膜下剥离术前后血清胃泌素-17、糖类抗原-125及胃蛋白酶原水平的变化和意义  

Clinical changes and significance of level of serum gastrin-17, carbohydrate Antigen-125 and pepsinogen in patients with early gastric cancer before and after endoscopic gastrointestinal mucosa dissection

作　　者：董曲文 陈晓[2] 丁纪元[3] Qu-wen Dong;Xiao Chen;Ji-yuan Ding(Department of Medical Administration,Wuyun Mountain Sanatorium,Hangzhou,Zhejiang 310008,China;Department of Clinical Laboratory,Wuyun Mountain Sanatorium,Hangzhou,Zhejiang 310008,China;Department of Comprehensive Oncology of Traditional Chinese Medicine,Hangzhou Cancer Hospital,Hangzhou,Zhejiang 310000,China)

机构地区：[1]杭州市五云山疗养院(杭州市第一人民医院集团五云山院区)医务科,浙江杭州310008 [2]杭州市五云山疗养院(杭州市第一人民医院集团五云山院区)检验科,浙江杭州310008 [3]杭州市肿瘤医院中医综合肿瘤科,浙江杭州310000

出　　处：《中国内镜杂志》2020年第2期37-42,共6页China Journal of Endoscopy

摘　　要：目的探讨早期胃癌患者内镜黏膜下剥离术(ESD)前后血清胃泌素-17(G-17)、糖类抗原-125(CA125)及胃蛋白酶原(PG)水平的变化和意义。方法选取2015年1月-2018年1月杭州市肿瘤医院接受ESD手术治疗的68例早期胃癌患者为手术组,同期选取40例体检健康者为健康组,测定所有受试者血清G-17、CA125及PG水平,观察手术治疗前后早期胃癌患者血清G-17、CA125及PG水平的变化,同时比较治疗前手术组与健康组上述指标,分析其与预后关系。结果手术组手术前血清PGⅠ水平及胃蛋白原比值(PGR)明显低于健康组,血清PGⅡ、G-17及CA125水平明显高于健康组,差异均有统计学意义(P<0.05)。术后30和90 d早期胃癌患者血清PGⅠ水平及PGR明显上升,血清PGⅡ、G-17、CA125明显下降,差异均有统计学意义(P<0.05)。术后随访1年,经胃镜及病理结果确认,8例患者复发转移(复发组),60例患者未复发转移(未复发组),复发组患者血清PGⅠ水平及PGR明显低于未复发组,血清PGⅡ、G-17、CA125水平均明显高于未复发组,差异均有统计学意义(P<0.05)。结论血清PGⅠ、PGR、G-17及CA125水平可作为早期胃癌人群的筛查指标,早期胃癌患者ESD后血清PG、PGR、G-17及CA125水平的数值随访可发挥预防和监测胃癌是否复发的作用,且术后血清PG、PGR、G-17及CA125水平可间接评价ESD治疗早期胃癌的有效性。Objective To investigate the clinical changes and significance of level of serum gastrin-17,carbohydrate antigen-125 and pepsinogen in patients with early gastric cancer before and after endoscopic gastrointestinal mucosa dissection.Methods From January 2015 to January 2018,68 patients with early gastric cancer who underwent ESD operation were selected as the operation group,and 40 healthy persons were selected as the healthy group.The levels of serum G-17,CA125,and PG were measured in all the subjects.The changes of the level of serum G-17,CA125 and PG in patients with early gastric cancer before and after operation were observed.The above indexes between the operation group and the healthy group before treatment was compared and the relationship between it and the prognosis was analyzed.Results The level of serum PGⅠand PGR in the operation group were significantly lower than those in the healthy group before operation.The level of serum PGⅡ,G-17 and CA 125 were significantly higher than those of healthy controls(P<0.05).The level of serum PGⅠand PGR value of patients with early gastric cancer increased significantly at 30 and 90 days after operation.Postoperative followup for 1 year,confirmed by gastroscopy and pathology.There were 8 cases of recurrence and metastasis(recurrence group),60 cases of recurrence and metastasis(no recurrence group).The levels of serum PGⅠand PGR in patients with recurrence were significantly lower than those in patients without recurrence.The level of serum PGⅡand G-17,CA125 were significantly higher than those of non-recurrence group(P<0.05).Conclusion The level of serum PGⅠ,PGR,G-17 and CA125 can be used as screening markers for early gastric cancer.The follow-up of levels of serum PG,PGR,G-17 and CA125 after endoscopic mucosal resection may play a role in preventing and monitoring the recurrence of gastric cancer.The level of serum PG,PGR,G-17 and CA 125 can be used to evaluate the efficacy of endoscopic mucosal resection in the treatment of early gastric cancer.

关 键 词：早期胃癌 内镜黏膜下剥离术 血清胃泌素-17 糖类抗原-125 胃蛋白酶原 

分 类 号：R735.2[医药卫生—肿瘤]