胃蛋白酶原联合幽门螺杆菌在胃癌及癌前病变风险评估中的有效性及局限性研究  

Efficacy and limitations of pepsinogen combined with Helicobacter pylori in risk assessment of gastric cancer and precancerous lesions

作　　者：颜页 金尹[1] 吴建胜[1] YAN Ye;JIN Yin;WU Jian-sheng(Department of Gastroenterology,The First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325000,China)

机构地区：[1]温州医科大学附属第一医院消化内科,浙江温州325000

出　　处：《中国实用内科杂志》2021年第11期974-977,共4页Chinese Journal of Practical Internal Medicine

基　　金：温州市科技局基础性科研项目(Y20190160)。

摘　　要：目的评价胃蛋白酶原联合幽门螺杆菌(ABC法)在胃癌及胃癌前病变风险评估中的有效性及局限性。方法横断面研究选取2016年3月至2018年3月在温州医科大学附属第一医院同一天进行血清胃蛋白酶原(PG)和幽门螺杆菌(H.pylori)抗体检测和胃镜检查的5511名体检者。结果根据ABC法对体检者进行分组[A组:PG(-)并H. pylori(-),B组:PG(-)并H. pylori(+),C组:PG(+)并H. pylori(+),D组:PG(+)并H. pylori(-)]。A组中胃癌发生率最低(0.04%),癌前病变发生率最低(0.56%)。D组中胃癌的发生率最高(3.31%),发生胃癌的风险显著高于A组,校正后OR为49.766(95%CI 4.330~571.971,P=0.002)。C组中胃癌前病变的发生率最高(2.16%),发生胃癌前病变的风险显著高于A组,校正后OR为3.962(95%CI 1.398~11.228,P=0.010)。结论 ABC法作为一项有效的分层工具能够识别高风险的胃癌及癌前病变的人群,在体检人群中具有应用价值。但是该方法具有局限性,A组中存在胃癌及发生胃癌的高风险人群。Objective To evaluate the effectiveness and limitations of pepsinogen combined with Helicobacter pylori(ABC method)in assessing the risk of gastric cancer and precancerous lesions. Method This cross-sectional study involved 5511 asymptomatic individuals who underwent serum pepsinogen(PG) and H.pylori immunoglobulin antibody testing and gastroscopy on the same day from March 2016 to March 2018 in the First Affiliated Hospital of Wenzhou Medical Unirersity.Results According to the ABC method,risk stratification was carried out in the population undergoing physical examination. The incidence of gastric cancer was the highest in the D group(3.31%),with an adjusted OR of 49.766(95%CI: 4.330-571.971,P=0.002). The incidence of gastric precancerous lesions was the highest in the C group(2.16%),group A,with an adjusted OR of 3.962(95% CI 1.398-11.228,P=0.010). Conclusion ABC method,as on effective stratification method,is a useful tool for identifying patients at higher risk of developing gastric cancer and precancerous lesions,which has application value in the population receiving physical examination. However,this method has limitations,There are gastric cancer and high-risk groups of gastric cancer in group A.

关 键 词：ABC法 胃上皮内瘤变 胃癌 血清胃蛋白酶原 幽门螺杆菌 

分 类 号：R573[医药卫生—消化系统]