胃蛋白酶原、胃泌素17联合^(13)C尿素呼气试验在早期胃癌筛查中的应用  

Pepsinogen,gastrin 17 combined with 13C urea breath test for Hp detection in early gastric cancer screening

作　　者：林洁 周晓黎[1] 林静[2] Lin Jie;Zhou Xiaoli;Lin Jing(Department of Gastroenterology,Wuhan No.1 Hospital,Wuhan 430000,China;Department of Nuclear Medicine,Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology,Wuhan 430022,China)

机构地区：[1]武汉市第一医院消化内科,武汉430000 [2]华中科技大学同济医学院附属协和医院核医学科,武汉430022

出　　处：《保健医学研究与实践》2023年第8期53-57,共5页Health Medicine Research and Practice

基　　金：湖北省自然科学基金项目(2018CFC1040);武汉市医学科研项目(WX19A06)。

摘　　要：目的探讨胃蛋白酶原Ⅰ(PGⅠ)、胃蛋白酶原Ⅱ(PGⅡ)、胃泌素17(G-17)联合^(13)C-尿素呼气试验(^(13)C-UBT)检测在早期胃癌筛查中的应用价值。方法选取2019年6月—2022年6月因消化道症状在武汉市第一医院接受胃镜和病理学检查的156例患者,根据组织病理学诊断结果分为非萎缩性胃炎组(37例)、萎缩性胃炎组(21例)、早期胃癌组(24例)、进展期胃癌组(37例)和胃溃疡组(37例)。采用酶联免疫吸附法检测各组患者的血清PGⅠ、PGⅡ、G-17水平,采用^(13)C-UBT试验检测幽门螺杆菌(Hp)感染情况。结果5组患者血清PGⅠ、G-17水平和Hp感染率比较,差异均有统计学意义(P<0.05);5组患者血清PGⅡ水平比较,差异无统计学意义(P>0.05)。受试者工作特征(ROC)曲线分析结果显示,血清PGⅡ诊断早期胃癌的曲线下面积(AUC)为0.405(95%CI:0.228~0.582,P>0.05);血清PGⅠ、G-17及Hp感染诊断早期胃癌的AUC分别为0.815、0.709、0.649(95%CI:0.669~0.961、0.538~0.880、0.481~0.817,均P<0.001);血清PGⅠ、G-17及Hp感染联合检测诊断早期胃癌的AUC为0.874(95%CI:0.731~0.982,P<0.001),敏感度为89.5%,特异度为60.31%。结论血清PGⅠ、G-17及^(13)C-UBT检测对早期胃癌筛查具有重要的预警作用,联合检测可提高早期胃癌诊断准确率。Objective This paper aims to investigate the value of pepsinogen Ⅰ(PGⅠ),pepsinogen Ⅱ(PGⅡ),and gastrin 17(G-17)combined with ^(13)C-urea breath test(^(13)C-UBT)in Helicobacter pylori(Hp)detection in early gastric cancer screening.Methods A total of 156 patients who received gastroscopy and pathological examination in Wuhan No.1 Hospital due to gastrointestinal symptoms from June 2019 to June 2022 were selected as study participants.They were allocated to the non-atrophic gastritis group(n=37),atrophic gastritis group(n=21),early gastric cancer group(n=24),advanced gastric cancer group(n=37),and gastric ulcer group(n=37)following the results of histopathological diagnosis.Serum PG Ⅰ,PGⅡ,and G-17 levels were measured by enzyme-linked immunosorbent assay.Hp infection was detected by the ^(13)C-UBT test.Results Significant differences were observed in serum PGⅠ,G-17 levels,and Hp infection rate among the five groups(P<0.05),but not in serum PGⅡ levels among the five groups(P>0.05).The results of receiver operating characteristic(ROC)curve analysis showed that the area under the curve(AUC)of serum PGⅡ in the diagnosis of early gastric cancer was 0.405(95%CI:0.228~0.582,P>0.05).The AUC values of serum PGⅠ,G-17,and Hp infection in the diagnosis of early gastric cancer were 0.815,0.709,and 0.649(95%CI:0.669~0.961,0.538~0.880 and 0.481~0.817,all P<0.001),respectively.The AUC values of combined detection of serum PGⅠ,G-17,and Hp infection in the diagnosis of early gastric cancer were 0.874(95%CI:0.731~0.982,P<0.001).The sensitivity and specificity were 89.52% and 60.31%,respectively.Conclusion Serum PGⅠ,G-17 detection,combined with ^(13)C-UBT for Hp infection detection plays an important part in early warning of early gastric cancer screening,and combined detection can improve its diagnostic accuracy.

关 键 词：胃蛋白酶原 胃泌素17 ^(13)C-尿素呼气试验 幽门螺杆菌 早期胃癌 

分 类 号：R735.2[医药卫生—肿瘤]