【摘要】 目的评价联合胃泌素17、胃蛋白酶原、14C呼气试验在健康体检人群中胃癌筛查的效果,为健康体检项目的制定提供理论依据。方法选取2016年7—10月河北医科大学第四医院参与胃癌筛查项目的 40岁及以上职工1 186例为研究对象,检测胃泌素17、胃蛋白酶原水平,并行14C呼气试验及无痛胃镜检查。结果胃泌素17、胃蛋白酶原、14C呼气试验及联合筛查的阳性率分别为46.5%(219/471)、42.0%(198/471)、46.8%(206/440)、63.7%(242/380),其中联合筛查的阳性率高于胃泌素17、胃蛋白酶原、14C呼气试验(P<0.008 3)。共130例受试者参与无痛胃镜检查,检出萎缩性胃炎、胃溃疡、胃息肉、癌前病变分别有5、30、29、4例。联合筛查的胃溃疡、胃息肉阳性检出率高于胃泌素17、胃蛋白酶原、14C呼气试验,差异有统计学意义(P<0.008 3)。各筛查项目萎缩性胃炎、胃溃疡、胃息肉、癌前病变的阳性预测值比较,差异无统计学意义(P>0.05)。结论联合胃泌素17、胃蛋白酶原、14C呼气试验能提高胃黏膜病变的阳性检出率,可作为胃癌高危人群的筛查项目。更多还原

【Abstract】 Objective To evaluate the effect of a combination test of gastrin-17(GAS-17) and pepsinogen measurement and 14 C-UBT for gastric cancer screening in physical examination,providing a theoretical basis for the enaction of physical examination items.Methods The enrolled 1 186 participants were employees aged 40 or over from Fourth Hospital of Hebei Medical University.They underwent a physical examination from July to October,2017.The number of participants undergoing GAS-17 measurement,pepsinogen measurement,14 C-UBT,combination test(GAS-17 and pepsinogen measurement combined with 14 C-UBT) and painless gastroscopy for gastric cancer screening was 471,471,440,380,130,respectively.Results The overall positive prevalence detected by GAS-17 measurement,pepsinogen measurement,14 C-UBT,combination test was 46.5%(219 cases),42.0%(198 cases),46.8%(206 cases),63.7%(242 cases),respectively,demonstrating that the combination test had higher positive rate than the other 3 methods(P<0.008 3).Moreover,the prevalence of gastric ulcer or gastric polyps detected by combination test was still higher compared with the other 3 methods(P<0.008 3).However,these 4 methods showed similar positive predictive value for atrophic gastritis,gastric ulcer,gastric polyps or gastric precancerous lesions(P>0.05).By painless gastrosopy,5 were found with atrophic gastritis,30 with gastric ulcer,29 with gastric polyps,and 4 with gastric precancerous lesions.Conclusion The combination test demonstrated higher detection rate of gastric diseases than each of its components alone,so it can be used as a screening item for high risk population for gastric cancer.更多还原