【摘要】 目的研究不同胃疾病患者的血清中胃蛋白酶原Ⅰ(PGⅠ)、PGⅡ、胃泌素-17(G-17)水平变化,探讨血清PG和G-17检测对胃癌的诊断价值。方法选取胃癌患者158例(胃癌组)、慢性萎缩性胃炎患者56例(慢性萎缩性胃炎组)、慢性浅表性胃炎患者53例(慢性浅表性胃炎组)、健康体检者85例(对照组)。采用化学发光免疫法测定所有研究对象血清中的PGⅠ、PGⅡ、G-17水平,并计算PGⅠ/PGⅡ(PGR)值。结果慢性萎缩性胃炎组、胃癌组的PGI和PGR水平明显低于对照组和慢性浅表性胃炎组,差异有统计学意义(P<0.05);血清PGⅠ和PGR水平与胃癌的分期和病变部位有关,差异有统计学意义(P<0.05);受试者工作特征曲线(ROC曲线)显示筛选和诊断胃癌PGⅠ和PGR的最佳临界值PGⅠ为69.6ng/mL,PGR为2.9,而慢性萎缩性胃炎组或胃癌组患者中,多灶性病变时血清G-17的水平明显低于胃体和胃窦病变,差异有统计学意义(P<0.05)。结论血清PG和G-17的水平变化与胃黏膜病变密切相关,低水平的血清PGⅠ、PGR可作为筛查和早期诊断胃癌的重要手段。更多还原

【Abstract】 Objective To investigate the changes of serum pepsinogenⅠ(PGⅠ),pepsinogenⅡ(PGⅡ)and gastrin-17(G-17)in the patients with different gastric disease,and to study the value of serum PG and G-17 detection in diagnosing gastric cancer.Methods One hundred and fifty-eight patients with gastric cancer(gastric cancer group),56 patients with chronic atrophic gastritis(chronic atrophic gastritis),53 cases of chronic superficial gastritis(chronic superficial gastritis group)and 85 individuals undergoing healthy physical examination were selected in this study.The levels of serum PGⅠ,PGⅡ,and G-17 were measured by chemiluminescent immunoassay,and the PGⅠ/PGⅡratio(PGR)was calculated.Results The levels of PGⅠand PGR in the chronic atrophic gastritis group and gastric cancer group were significantly lower than those in the chronic superficial gastritis group and control group,the difference was statistically significant(P<0.05).The serum PGⅠ and PGR were related to the tumor stage and tumor site,the difference was statistically significant(P<0.05).The receiver operating characteristic(ROC)curve showed that the optimal cut off values of PGⅠand PGR for screening and diagnosing gastric cancer were 69.6ng/mL for PGⅠand 2.9for PGR.The G-17 level in multifocal lesions of the chronic atrophic gastritis group or gastric cancer group was significantly lower than that in the gastric body and gastric antrum,difference was statistically significant(P<0.05).Conclusion The change of serum PG and G-17 level is related to gastric mucosal lesion.Low level of serum PGⅠand PGR could be used as an important means of screening and early diagnosis of gastric cancer.更多还原