胃黏膜“血清学活检”在胃癌前疾病筛查中的临床应用  

Clinical application of serological gastric biopsy in the screening of gastric precancerous disease

作　　者：董文珠 梁越 赵琦 于海涛 李栋 陈燕 王群英 DONG Wen-zhu;LIANG Yue;ZHAO Qi;YU Hai-tao;LI Dong;CHEN Yan;WANG Qun-ying(Department of Gastroenterology,the 971st Hospital of PLA Navy,Qingdao,Shandong 266071,China)

机构地区：[1]中国人民解放军海军第九七一医院消化科,山东青岛266071 [2]海军军医大学附属长海医院消化科,上海200433

出　　处：《中国临床研究》2023年第2期186-190,共5页Chinese Journal of Clinical Research

基　　金：青岛市医药科研指导计划(2020-WJZD200);青岛市市南区科技计划项目(2020-2-009-YY)。

摘　　要：目的分析胃黏膜“血清学活检”,即血清胃蛋白酶原Ⅰ(PGⅠ)、胃蛋白酶原Ⅱ(PGⅡ)、PGⅠ/PGⅡ比值(PGR)、胃泌素-17(G-17)和幽门螺杆菌抗体(HP-IgG),与组织学慢性胃炎分级评估系统(OLGA/OLGIM)的相关性,评价其对胃癌前疾病筛查的效力。方法选取2019年1月至2021年12月中国人民解放军海军第971医院因消化不良症状行胃镜检查的417例患者,根据OLGA/OLGIM胃炎评估系统对其进行分组评估,对各组患者血清PG及G-17、HP-IgG进行检测及比较。结果在OLGA/OLGIM分组中,PGⅠ和PGR随分组等级升高呈降低趋势(P<0.01),而G-17和HP感染率随分组等级升高呈升高趋势(P<0.01)。Kendall相关性分析显示联合评分法与OLGA分期、OLGIM分期之间均呈正相关(r=0.44、0.43,P<0.01)。此外,HP-IgG阳性组PGⅡ、G-17水平显著高于阴性组,PGⅠ、PGR水平显著低于阴性组,差异有统计学意义(P<0.01)。结论胃黏膜“血清学活检”与组织学OLGA/OLGIM胃炎评价标准密切相关,在胃癌前疾病的筛查评估展现出极大的潜力。Objective To analyze the correlation between gastric mucosa serological biopsy[serum pepsinogenⅠ(PGⅠ),pepsinogenⅡ(PGⅡ),ratio of PGⅠ/PGⅡ(PGR),gastrin-17 and helicobacter pylori antibody(HP-IgG)]and histological gastritis evaluation criteria(OLGA/OLGIM),and to evaluate the efficacy of these indicators in the screening of gastric precancerous disease.Methods A total of 417 patients underwent gastroscopy for dyspepsia were selected in the 971st Hospital of the PLA Navy from January 2019 to December 2021 were selected.They were evaluated in groups according to the OLGA/OLGIM staging system,and the serum PGⅠ,PGⅡ,PGR,G-17 and HP-IgG were detected and analyzed.Results In OLGA/OLGIM group,PGⅠand PGR decreased with the increase of group grade(P<0.01),while the infection rates of G-17 and HP increased with the increase of group grade(P<0.01).Kendall correlation analysis showed that there was a positive correlation between the combined scoring method and OLGA stage and OLGIM stage(r=0.44,0.43,P<0.01).In addition,the levels of PGⅡand G-17 in HP-IgG positive group were significantly higher than those in the negative group,and the levels of PGⅠand PGR were significantly lower than those in the negative group(P<0.01).Conclusion Serological gastric biopsy is closely related to OLGA/OLGIM stage,which shows great potential in the screening and evaluation of gastric precancerous disease.

关 键 词：胃蛋白酶原 胃泌素 幽门螺杆菌抗体 胃癌前疾病 筛查 血清学活检 

分 类 号：R735[医药卫生—肿瘤]