血清胃蛋白酶原、幽门螺杆菌联合内镜下木村-竹本分类在早期胃癌诊断中的价值  

Application value of serum pepsinogen and Helicobacter pylori combined with endoscopic Kimura-Takemoto classification in the diagnosis of early gastric cancer

作　　者：朱晟易[1] 姚林华[1] 危贵君[1] Zhu Shengyi;Yao Linhua;Wei Guijun(Department of Gastroenterology,the First People's Hospital of Huzhou,Huzhou 313000,Zhejiang Province,China)

机构地区：[1]湖州市第一人民医院消化内科,湖州313000

出　　处：《中国基层医药》2023年第6期856-861,共6页Chinese Journal of Primary Medicine and Pharmacy

基　　金：浙江省湖州市科技计划(2021GY22)。

摘　　要：目的探讨血清胃蛋白酶原(PG)、幽门螺杆菌(Hp)联合内镜下木村-竹本分类在早期胃癌诊断中的应用价值。方法选取2022年1-6月在湖州市第一人民医院消化内科就诊的胃癌患者60例(胃癌组),另选取同期该院收治的胃良性病变患者60例(胃良性病变组)和胃癌前病变患者60例(胃癌前病变组),均进行血清PG检测、Hp检测及内镜下木村-竹本分类,评估其在早期胃癌诊断中的应用价值。结果与胃良性病变组和胃癌前病变组患者比较,胃癌组患者血清PGⅠ/PGⅡ比值(PGR)均明显降低,而PGⅡ水平和Hp感染率[71.67%(43/60)]均明显升高(F=108.14、71.75、38.43,χ^(2)=6.89,均P<0.05)。与胃良性病变组和胃癌前病变组比较,胃癌组的木村-竹本分型明显加重(H=38.91,P<0.05)。胃癌组血清PGⅠ和PGR随病理分期的增高而降低,而PGⅡ水平随病理分期的增高而上升(F=65.79、5.66、53.32,均P<0.01);但各期患者的Hp感染率差异无统计学意义(P>0.05)。胃癌组各期患者的木村-竹本分型差异均无统计学意义(均P>0.05)。受试者工作特征曲线分析显示,PGⅠ、PGⅡ、PGR诊断胃癌的曲线下面积分别为0.865、0.664、0.881。结论血清PG、Hp联合内镜下木村-竹本分类能够提高早期胃癌的诊断率,木村-竹本分类法有助于胃癌患者在内镜筛查中进行风险分层,并与血清PG水平存在一致性,具有较高的应用价值。Objective To investigate the application value of pepsinogen,Helicobacter pylori combined with endoscopic Kimura-Takemoto classification in the diagnosis of early gastric cancer.Methods Sixty patients with gastric cancer who received treatment in the Department of Gastroenterology,the First People's Hospital of Huzhou from January to June 2022 were included in the gastric cancer group.An additional 60 patients with benign gastric lesions(benign gastric lesion group)and 60 patients with precancerous lesions of the stomach(precancerous lesion group)were also included in this study.Serologic testing for pepsinogen and Helicobacter pylori antibody combined with endoscopic Kimura-Takemoto classification was performed to evaluate their application value in the diagnosis of early gastric cancer.Results Compared with the benign gastric lesion and precancerous lesion groups,the pepsinogen I/pepsinogen II ratio was significantly lower,and the pepsinogen II level and Helicobacter pylori infection rate[71.67%(43/60)]were significantly higher in the gastric cancer group(F=108.14,71.75,38.43,χ^(2)=6.89,all P<0.05).Compared with the benign gastric lesion and precancerous lesion groups,the Kimura-Takenmoto classification in the gastric cancer group was significantly higher(H=38.91,P<0.05).In the gastric cancer group,pepsinogen I level and pepsinogen I/pepsinogen II ratio decreased and pepsinogen II level increased with the increase of pathological stage(F=65.79,5.66,53.32,all P<0.01).There was no significant difference in Helicobacter pylori infection rate between different stages of gastric cancer(P<0.05)in the gastric cancer group.There was no significant difference in Kimura-Takenmoto classification between different stages of gastric cancer(all P>0.05)in the gastric cancer group.The area under the receiver operating characteristic curve plotted for evaluating pepsinogen I,pepsinogen II,and pepsinogen I/pepsinogen II ratio for diagnosis of gastric cancer was 0.865,0.664,and 0.881,respectively.Conclusion Serum pepsinogen,Heli

关 键 词：胃肿瘤 血清学试验 胃蛋白酶原A 胃蛋白酶原C 幽门螺杆菌 木村-竹本分类 ROC曲线 诊断 

分 类 号：R735.2[医药卫生—肿瘤]