血清PG、SLPI及TK1联合胃镜表现在胃癌前病变筛查中的应用价值分析  

Application Value of Serum PG,SLPI and TK1 combined with Gastroscopy in the Screening of Gastric Precancerous Lesions

作　　者：韩晓亮 HAN Xiaoliang(Department of Gastroenterology,the Fifth People’s Hospital of Anyang City,He’nan Province 455000)

机构地区：[1]河南省安阳市第五人民医院消化内科,455000

出　　处：《医学理论与实践》2021年第21期3692-3695,3698,共5页The Journal of Medical Theory and Practice

摘　　要：目的:分析血清胃蛋白酶原(PG)、分泌性白细胞蛋白酶抑制因子(SLPI)及胸苷激酶1(TK1)联合胃镜表现在胃癌前病变筛查中的应用价值。方法:回顾性分析2017年6月—2019年6月350例于本院接受早期胃癌筛查且未经治疗者临床资料,收集所有研究对象临床资料,统计病理结果中各癌前病变情况。记录不同病理诊断患者相关血清指标[PG(PGⅠ和PGⅡ)、SLPI及TK1水平]水平差异,比较胃镜表现与病理诊断的关系;计算胃镜检查表现、单一和联合血清指标及血清联合胃镜表现在诊断癌前病变的灵敏度和特异性。结果:350例研究对象经病理学诊断,发现萎缩性胃炎共154例(44.00%),低级别上皮内瘤变共95例(27.14%),未检出高级别上皮内瘤变者,非萎缩性胃炎者共101例(28.86%)。在萎缩性胃炎患者中:轻度萎缩62例,中度萎缩60例,重度萎缩32例。胃镜表现:黏膜红斑204例,出血18例,糜烂75例,白相为主53例,低级别上皮内瘤变组、非萎缩性胃炎组、重度萎缩组、中度萎缩组及轻度萎缩组间血清PG(PGⅠ和PGⅡ)、SLPI及TK1水平比较有差异(P<0.05);低级别上皮内瘤变组血清TK1、PGⅡ、SLPI水平高于非萎缩性胃炎组、重度萎缩组、中度萎缩组及轻度萎缩组,PGⅠ低于上述各组(P<0.05);白相为主诊联合糜烂或出血胃镜表现后诊断灵敏度和特异度较单一胃镜表现高(P<0.05);胃镜表现联合血清学三联检测对萎缩性胃炎、非萎缩性胃炎及低级别上皮内瘤变诊断的灵敏度和特异性高于血清学三联检测(P<0.05)。结论:胃镜表现可提示萎缩性胃炎、非萎缩性胃炎及低级别上皮内瘤变等胃癌前病变的存在,血清PG、SIPL及TK1水平与癌前病变的发生和发展关系密切,血清水平联合胃镜表现可提高胃癌前病变筛查的准确率,值得临床推广。Objective:To analyze the application value of serum PG,SLPI and TK1 combined with gastroscopy in the screening of gastric precancerous lesions.Methods:The clinical data of 350 patients who received early screening of gastric cancer but were not treated still in our hospital from June 2017 to June 2019 were retrospectively analyzed.The clinical data of all subjects were collected,and the precancerous lesions in the pathological results were counted.The difference in serum index[PG(PGⅠand PGⅡ),SLPI and TK1 level]levels of patients with different pathological diagnoses was recorded,and the relationship between gastroscopic performance and pathological diagnosis was compared.The sensitivity and specificity of gastroscopy,single and combined serum indicators and serum indicators combined with gastroscopy in the diagnosis of precancerous lesions were calculated.Results:350 subjects were diagnosed by pathology,and 154 cases(44.00%)with atrophic gastritis were found,95 cases(27.14%)with low-grade intraepithelial neoplasias were detected,and there was no one with high-grade intraepithelial neoplasia,101 cases(28.86%)with non-atrophic gastritis.Among patients with atrophic gastritis,there were 62 cases with mild atrophy,60 cases with moderate atrophy,and 32 cases with severe atrophy.Gastroscopy showed there were 204 cases with erythroplakia,18 cases with bleeding,75 cases with erosion,53 cases with white phase.There were differences in the levels of serum PG(PGⅠand PGⅡ),SLPI and TK1 in low-grade intraepithelial neoplasia group,non-atrophic gastritis group,severe atrophy group,moderate atrophy group and mild atrophy group(P<0.05).The levels of serum TK1,PGⅡ,and SLPI in the low-grade intraepithelial neoplasia group were higher than those in the non-atrophic gastritis group,severe atrophy group,moderate atrophy group,and mild atrophy group,and PGⅠwas lower(P<0.05).The diagnostic sensitivity and specificity of the white phase,as the main diagnosis,combined with performance of gastroscopy like erosion or hemorrhage

关 键 词：胃癌前病变 PG SLPI TK1 胃镜 

分 类 号：R730.4[医药卫生—肿瘤] R735.2[医药卫生—临床医学]