实用临床医药杂志2025，Vol.29Issue(13)：1-6,12,7.DOI:10.7619/jcmp.20246039
基于尿素呼气试验、血清胃蛋白酶原及促胃液素-17的胃癌前病变预测模型构建与验证
Construction and validation of predictive model for gastric precancerous lesions based on urea breath test,serum pepsinogen and gastrin-17
摘要
Abstract
Objective To construct and validate a predictive model for gastric precancerous le-sions based on urea breath test,serum pepsinogen(PG)and gastrin-17(G-17).Methods Partici-pants who underwent endoscopic screening for upper gastrointestinal tumors were retrospectively en-rolled as study subjects.Using random function,all participants were divided into training cohort of 2,788 cases(comprising 1,290 cases in precancerous lesion group and 1,498 cases in control group)and validation cohort of 1,194 cases(comprising 581 cases in precancerous lesion group and 613 cases in control group)at a ratio of 7 to 3.A simple model was established based on urea breath test,PG and G-17.Clinical data between the precancerous lesion group and the control group in the training cohort were compared.A predictive model for gastric precancerous lesions was constructed u-sing multifactorial Logistic regression analysis,and a scoring model for gastric precancerous lesions(the complete model)was developed based on this predictive model.The complete model,the simple model,the new ABC method,and the Li's score were all included in the validation cohort to compare the predictive performance of the four models.Results Multifactorial Logistic regression analysis indicated that male,smoking,positive Helicobacter pylori(Hp)infection,PG Ⅱ ≥10.19 μg/L,the ratio of PG Ⅰ to PG Ⅱ(PGR)≤11.87,and G-17 ≥3.82 pmol/L were independent risk factors for gastric precancerous lesions(P＜0.05).A predictive model for gastric precancerous lesions was constructed based on these risk factors,and the complete model was established based on the predic-tive model.The total score ranged from 0 to 12(with 6 to 12 indicating a high-risk population for gastric precancerous lesions and 0 to 5 indicating a low-risk population).When the complete model,the simple model,the new ABC method,and the Li's score were included in the validation cohort for comparison,the predictive values of the complete model and the simple model were similar.Both models demonstrated higher sensitivity,specificity,positive predictive value,negative predictive value,and accuracy compared to the new ABC method and the Li's score.Furthermore,the diag-nostic value of the simple model in the high-sensitivity region was slightly superior to that of the com-plete model.Conclusion The simple model constructed based on the urea breath test,PG and G-17 exhibits favorable predictive efficacy,calibration,and clinical utility,and is of positive signifi-cance for the early identification of patients with gastric precancerous lesions.关键词
胃癌前病变/幽门螺杆菌/胃蛋白酶原/促胃液素-17/危险因素/预测模型/早癌筛查/新ABC法Key words
gastric precancerous lesions/Helicobacter pylori/pepsinogen/gastrin-17/risk factors/predictive model/early cancer screening/new ABC method分类
医药卫生引用本文复制引用
洪娟,姜鑫,侯思聪,丁岩冰,高雪峰..基于尿素呼气试验、血清胃蛋白酶原及促胃液素-17的胃癌前病变预测模型构建与验证[J].实用临床医药杂志,2025,29(13):1-6,12,7.基金项目
国家自然科学基金项目(82273084) （82273084）
江苏省科技厅项目(BE2019698) （BE2019698）
江苏省扬州医学重点学科项目(YZYXZDXK-12) （YZYXZDXK-12）
