胃泌素17和胃蛋白酶原血清学联合检测对胃癌高危人群筛查的临床价值  

The Clinical Value of the Combined Detection of Gastrin 17 and Pepsinogen Serology in Screening High-risk Groups of Gastric Cancer

作　　者：谈春晓[1] TAN Chun-xiao(Digestive Endoscopy Room,Department of Gastroenterology,Wuxi Second People's Hospital,Wuxi 214002,Jiangsu,China)

机构地区：[1]无锡市第二人民医院消化内科消化内镜室,江苏无锡214002

出　　处：《医学信息》2020年第24期71-73,共3页Journal of Medical Information

摘　　要：目的探讨应用胃泌素17和胃蛋白酶原血清学联合检测对于胃癌高危人群进行胃癌筛查的临床价值。方法选取2017年9月~2019年1月我院接受胃癌筛查的457例胃癌高危人群病例作为研究对象,采用ELISA检测血清胃泌素17(G-17)、胃蛋白酶原PGⅠ、PGⅡ水平,根据其结果将G-17(-)PG(-)设为A组,G-17(+)PG(-)设为B组、G-17(-)PG(+)设为C组、G-17(+)PG(+)设为D组,以胃镜及病理活检结果作为金标准,比较各组胃癌检出率,分析G-17和PG诊断胃癌的临床价值。结果457例患者共检出胃癌12例,其中早期胃癌8例,进展期胃癌4例,胃癌检出率2.63%。A、B、C、D组胃癌检出率分别为0.42%(1/236)、4.63%(5/108)、2.41%(2/83)、13.33%(4/30),A组胃癌检出率低于其他三组,差异有统计学意义(P<0.05)。血清学联合检测结果中与胃镜检查一致率为92.56%,阳性预测值为13.33%,阴性预测值为98.13%。ROC曲线分析显示,G-17、PGR、PGⅠ的ROC曲线下面积分别为0.769、0.742、0.708,最佳诊断临界值分别为14.63 pmol/L、7.08、56.69μg/ml。结论胃泌素17和胃蛋白酶原血清学联合检测方法具有无创有效且简单易行的特点,能为胃癌诊断提供良好的依据,适宜作为胃癌初筛的检查手段。Objective To investigate the clinical value of combined detection of gastrin 17 and pepsinogen serology for gastric cancer screening in high risk population of gastric cancer.Methods Selected 457 cases of high-risk gastric cancer patients who were screened for gastric cancer in our hospital from September 2017 to January 2019 as the research objects.ELISA was used to detect the levels of serum gastrin 17(G-17),pepsinogen PGⅠ,and PGⅡ.As a result,G-17(-)PG(-)was set to group A,G-17(+)PG(-)was set to group B,G-17(-)PG(+)was set to group C,G-17(+)PG(+)was set as group D,and gastroscopy and pathological biopsy results were used as the gold standard to compare the detection rates of gastric cancer in each group,and analyzed the clinical value of G-17 and PG in the diagnosis of gastric cancer.Results A total of 12 cases of gastric cancer were detected in 457 patients,including 8 cases of early gastric cancer and 4 cases of advanced gastric cancer.The detection rate of gastric cancer was 2.63%.The detection rates of gastric cancer in groups A,B,C,and D were 0.42%(1/236),4.63%(5/108),2.41%(2/83),13.33%(4/30),respectively.The detection rate of gastric cancer in group A was lower than the other three groups,the difference was statistically significant(P<0.05).The concordance rate of the combined serological test with gastroscopy was 92.56%,the positive predictive value was 13.33%,and the negative predictive value was 98.13%.ROC curve analysis showed that the area under the ROC curve of G-17,PGR,and PGI were 0.769,0.742,and 0.708,respectively,and the best diagnostic cutoff values were 14.63 pmol/L,7.08,and 56.69μg/ml,respectively.Conclusion The combined detection of gastrin 17 and pepsinogen serology is noninvasive,effective and simple.It can provide a good basis for the diagnosis of gastric cancer.It is suitable for gastric cancer screening.

关 键 词：胃泌素17 胃蛋白酶原 胃癌 

分 类 号：R735.2[医药卫生—肿瘤]