血清胃蛋白酶原和胃泌素-17对幽门螺杆菌阳性早期胃癌患者的诊断价值  

Diagnostic Value of Serum Pepsinogen and Gastrin-17 in Early Gastric Cancer Patients with Positive Helicobacter Pylori Infection

作　　者：孙树申 宋蕊[1] 华德芳 李雪[1] 吕洪敏[2] SUN Shushen;SONG Rui;HUA Defang;LI Xue;LYU Hongmin(Tianjin University Jinnan Hospital(Tianjin Jinnan Hospital),Tianjin 300350,China;Tianjin Third Central Hospital,Tianjin 300350,China)

机构地区：[1]天津大学津南医院(天津市津南医院),天津300350 [2]天津市第三中心医院,天津300350

出　　处：《肿瘤学杂志》2024年第8期652-656,共5页Journal of Chinese Oncology

基　　金：天津市教委科研计划项目(2022YGYB17)。

摘　　要：[目的]探讨胃蛋白酶原(pepsinogen,PG)Ⅰ、PGⅡ、PGⅠ/PGⅡ比值联合胃泌素-17(gastrin-17,G-17)检查在幽门螺杆菌(Helicobacter pylori,Hp)阳性患者胃癌早筛中应用价值。[方法]选取2023年1月至2024年4月期间就诊的121例Hp感染患者为研究对象,根据胃镜活检组织病理结果将Hp阳性患者分为对照组、癌前病变组和胃癌组,比较各组血清PGⅠ、PGⅡ、PGⅠ/PGⅡ比值和G-17水平变化,绘制受试者特征(receiver operating characteristic,ROC)曲线并分析血清PGⅠ、PGⅡ、PGⅠ/PGⅡ比值和G-17对Hp阳性患者胃癌的诊断价值。[结果]与对照组相比,胃癌组、癌前病变组患者的血清PGⅠ水平和PGⅠ/PGⅡ比值降低,血清PGⅡ、G-17水平升高(P均<0.05);与癌前病变组相比,胃癌组患者的血清PGⅠ水平和PGⅠ/PGⅡ比值降低,血清G-17水平升高(P均<0.05)。ROC分析结果显示,血清PGⅠ、PGⅡ、PGⅠ/PGⅡ比值、G-17及4项指标联合检测对Hp感染患者胃癌诊断的曲线下面积分别为0.866(95%CI:0.802~0.930)、0.693(95%CI:0.582~0.804)、0.847(95%CI:0.779~0.916)、0.749(95%CI:0.654~0.845)和0.955(95%CI:0.920~0.990),4项指标联合检测时的AUC高于各指标单独检测(P<0.05)。[结论]Hp阳性胃癌患者血清PGⅠ水平和PGⅠ/PGⅡ比值降低,而血清PGⅡ、G-17水平升高,4项指标联合检测对Hp感染胃癌有较高的辅助诊断价值。[Objective]To explore the value of pepsinogen(PG)Ⅰ,PGⅡ,PGⅠ/PGⅡratio(PGR)and gastrin-17(G-17)in early diagnosis of gastric cancer in patients with Helicobacter pylori(Hp)infection.[Methods]One hundred and twenty-one patients with Hp infection were enrolled between January 2023 and April 2024.According to pathological results of gastroscopic biopsy,patients were divided into control group,precancerous lesion group and gastric cancer group.The changes of serum PGⅠ,PGⅡ,PGR and G-17 were compared among three groups,and their diagnostic value for gastric cancer was analyzed by receiver operating characteristic(ROC)curve.[Results]Compared with control group,serum PGⅠand PGR levels were decreased,while PGⅡand G-17 levels were increased in gastric cancer group and precancerous lesion group(all P<0.05).Compared with precancerous lesion group,serum PGⅠand PGR levels were decreased,while G-17 level was increased in gastric cancer group(all P<0.05).The area under ROC curve(AUC)of serum PGⅠ,PGⅡ,PGR,G-17 and the combination of 4 indicators in the diagnosis of gastric cancer were 0.866(95%CI:0.802~0.930),0.693(95%CI:0.582~0.804),0.847(95%CI:0.779~0.916),0.749(95%CI:0.654~0.845)and 0.955(95%CI:0.920~0.990),respectively.The AUC of combination of 4 indicators was greater than that of single index(P<0.05).[Conclusion]Serum PGⅠand PGR levels are decreased,while PGⅡand G-17 levels are increased in Hp-positive patients with gastric cancer;the combined detection of 4 indicators has high value in early diagnosis of gastric cancer.

关 键 词：幽门螺杆菌 胃肿瘤 胃蛋白酶原Ⅰ 胃蛋白酶原Ⅱ 胃泌素-17 诊断 

分 类 号：R735.2[医药卫生—肿瘤]