血清胃泌素-17、胃蛋白酶原联合放大色素内镜诊断早期胃癌的效果分析  

Effect of serum gastrin-17 and pepsinogen combined with magnifying chromoendoscopy in the diagnosis of early gastric carcinoma

作　　者：索日娜[1] 赵丽萍[1] 李凤 范华[1] 郭德煊 SUO Ri-na;ZHAO Li-ping;LI Feng;FAN Hua;GUO De-xuan(Department of Gastroenterology,Hohhot First Hospital,Hohhot Inner Mongolia 010030,China)

机构地区：[1]呼和浩特市第一医院消化内科,内蒙古呼和浩特010030

出　　处：《局解手术学杂志》2022年第2期155-159,共5页Journal of Regional Anatomy and Operative Surgery

基　　金：呼和浩特市科技计划项目(2018-社-7-2)。

摘　　要：目的探讨血清胃泌素-17(G-17)、胃蛋白酶原(PG)联合放大色素内镜对早期胃癌(EGC)的诊断价值。方法选取行EGC筛查的405例患者为研究对象,所有患者均行病理活检,根据是否患EGC将其分为观察组(n=88)和对照组(n=317)。记录所有患者一般资料(年龄、性别、BMI)、血清检测结果(G-17、PGⅠ、PGⅡ)和放大色素内镜检查结果。Kappa系数检验评估放大色素内镜对EGC的诊断效能。采用Logistic回归分析判定G-17、PGⅠ、PGⅡ、放大色素内镜与EGC的关联情况,构建列线图模型,绘制受试者工作特征(ROC)曲线评估PGⅠ、G-17、放大色素内镜及联合3种因素构建的列线图模型的诊断能力。结果共有88例(21.73%)患者病理检查诊断为EGC,2组G-17、PGⅠ比较,差异具有统计学意义(P<0.05);放大色素内镜单独诊断EGC的灵敏度为93.22%,特异度为91.80%,诊断效果较好;多因素Logistic回归分析显示,PGⅠ<70μg·L^(-1)、G-17≥12 pmoL·L^(-1)和放大色素内镜诊断为阳性与EGC密切相关;基于3个因素构建的列线图模型拟合效果良好,ROC曲线下面积(AUC)为0.990(95%CI0.988~0.993),诊断能力显著较高。结论放大色素内镜对EGC具有更高的诊断能力,联合G-17、PGⅠ构建的列线图模型对EGC具有更高的诊断能力,可有效提高EGC的检出率。Objective To investigate the diagnostic value of serum gastrin-17(G-17)and pepsinogen(PG)combined with magnifying chromoendoscopy for early gastric carcinoma(EGC).Methods A total of 405 patients who underwent EGC screening were selected,and all of them conducted the pathological biopsy.Patients were divided into the observation group(n=88)and the control group(n=317)according to whether they had EGC.The general information(age,gender,BMI),results of the serum test(G-17,PGⅠ,PGⅡ)and the examination results of magnifying chromoendoscopy of all the patients were recorded.Kappa coefficient test was used to evaluate the diagnostic efficacy of magnifying chromoendoscopy for EGC.Logistic regression analysis was used to assess the correlation between G-17,PGⅠ,PGⅡ,magnifying chromoendoscopy and EGC.A nomogram model was established and a receiver operating characteristic(ROC)curve was drawn to evaluate the diagnostic ability of the nomogram model established by PGⅠ,G-17,magnifying chromoendoscopy and the combination of the three factors.Results A total of 88 patients(21.73%)were diagnosed as EGC by pathological examination.There were statistically significant differences in G-17 and PGⅠbetween the two groups(P<0.05).The sensitivity and specificity of magnifying chromoendoscopy in the diagnosis of EGC alone were 93.22%and 91.80%,respectively,which showed a good diagnostic effect.Multivariable Logistic regression analysis showed that PGⅠ<70μg·L^(-1),G-17≥12 pmol·L^(-1) and positive results of magnifying chromoendoscopy were closely related to EGC,and the fitting effect of the nomogram model established based on the three factors was good,with an area under the ROC curve(AUC)of 0.990(95%CI:0.988 to 0.993),which showed a high diagnostic ability.Conclusion The magnifying chromoendoscopy has high diagnostic ability in the diagnosis of EGC,and the nomogram model based on magnifying chromoendoscopy combined with G-17 and PGⅠhas higher diagnostic ability for EGC,which can effectively increase the detection rate

关 键 词：早期胃癌 胃泌素-17 血清胃蛋白酶原 放大色素内镜 列线图模型 

分 类 号：R735.2[医药卫生—肿瘤]