安徽医科大学学报2017，Vol.52Issue(8)：1227-1231,5.DOI:10.19405/j.cnki.issn1000-1492.2017.08.028
血清胃蛋白酶原、胃泌素17和幽门螺杆菌检测在胃癌前病变诊断中的价值
Diagnostic value of serum pepsinogen, gastrin 17 andHelicobacter pylori detection in gastric precancerous lesions
摘要
Abstract
Objective To study the diagnostic value of serum pepsinogen(PG), gastrin17 (G17) and Helicobacterpylori (H.pylori) detection in gastric precancerous lesions.Methods The levels of serum PGI, PGII and G17 were detected by ELISA in 424 patients of gastric precancerous lesions (case group) and 646 patients of non-precancerous lesions (control group).13C urea breath test was used to detect H.pylori infection.The levels of PG and G17 between the two groups were compared, and the changes of PG and G17 in different degrees of atrophy, intestinal metaplasia and intraepithelial neoplasia in the case group were compared.Receiver operating characteristic (ROC) curve was used to calculate the optimal cut-off value of sensitive indicator in the diagnosis of precancerous lesions.Results The levels of serum PG and G17 were associated with gender, age and H.pylori infection.The level of serum PGII in the case group was higher than that in the control group (P=0.005), and the level of PGI/PGII ratio (PGR) was lower than that in the control group (P=0.015).The level of serum PGI of severe atrophy group was lower than that in the control group (P=0.013) and the levels of PGII and G17 in the low-grade intraepithelial neoplasia group and the high-grade intraepithelial neoplasia group increased significantly(P<0.05).The levels of PGR decreased significantly in atrophy group, intestinal metaplasia group and intraepithelial neoplasia group (Pall<0.05).The optimal cut-off value of PGR in the diagnosis of gastric precancerous lesions was 8.75 (sensitivity 70.0%, specificity 58.0%);when H.pylori positive, the optimal cut-off valuewas 7.70(sensitivity 75.6%, specificity 73.7%);when H.pylori negative, the optimal cut-off value was 9.50 (sensitivity 57.5%, specificity 58.2%).Conclusion Low serum PGR combined with H.pylori detection has an important clinical value in the diagnosis of gastric precancerous lesions.The levels of serum PGII and G17 increase significantly in the intraepithelial neoplasia group, which could become important indicators of gastric precancerous lesions.关键词
胃蛋白酶原/胃泌素/幽门螺杆菌/癌前病变Key words
pepsinogen/gastrin/Helicobacter pylori/precancerous lesions分类
医药卫生引用本文复制引用
刘应玲,陈思,洪海鸥,王业涛,王巧民,张开光..血清胃蛋白酶原、胃泌素17和幽门螺杆菌检测在胃癌前病变诊断中的价值[J].安徽医科大学学报,2017,52(8):1227-1231,5.基金项目
安徽省科技攻关项目资助(编号:1604a0802075) （编号:1604a0802075）
