【摘要】 目的探讨血清胃蛋白酶原Ⅰ(PGⅠ)、胃蛋白酶原Ⅱ(PGⅡ)水平结合超声内镜(EUS)术前诊断胃癌分期的价值。方法选取2019年1月至2021年1月于新乡医学院第一附属医院确诊的胃癌和胃炎患者各75例,分别作为胃癌组和胃炎组,治疗前均行EUS检查和血清PGⅠ、PGⅡ水平检测,分析PGⅠ、PGⅡ水平与TNM分期的关系。结果 EUS检查对胃癌术前T、N、M分期诊断的符合率分别为81.33%、82.67%、76.00%。胃癌组血清PGⅠ水平低于胃炎组,PGⅡ水平高于胃炎组,差异有统计学意义(P<0.05)。不同TNM分期患者血清PGⅠ、PGⅡ水平比较差异有统计学意义(P<0.05)。血清PGⅠ水平与TNM分期呈负相关(r=-0.715,P<0.05),PGⅡ水平与TNM分期呈正相关(r=0.623,P<0.05)。PGⅠ、PGⅡ诊断Ⅰ+Ⅱ期胃癌的敏感度、特异度为81.33%和61.33、69.33%和56.67%,PGⅠ、PGⅡ诊断截断值结合EUS诊断Ⅰ+Ⅱ期胃癌的敏感度为90.67%,灵敏度为85.33%。结论 EUS检查可判断胃癌TNM分期,而胃癌患者血清PGⅠ、PGⅡ表达均与TNM分期有关,血清PGⅠ、PGⅡ水平结合EUS诊断胃癌分期效能较高。更多还原

【Abstract】 Objective To investigate the value of serum pepsinogen Ⅰ(PGⅠ) and pepsinogen Ⅱ(PGⅡ) levels combined with endoscopic ultrasonography(EUS) in the preoperative diagnosis of gastric cancer staging.Methods 75 patients with gastric cancer and 75 patients with gastritis diagnosed in the hospital between January 2019 and January 2021 were selected as the gastric cancer group and the gastritis group.EUS examination and detection of serum PGⅠ and PGⅡ were performed before treatment.The relationship between levels of PGⅠ and PGⅡ and TNM staging was analyzed.Results The coincidence rates of preoperative T,N and M stages of gastric cancer by EUS examination were 81.33%,82.67% and 76.00%,respectively.The level of serum PGⅠ in the gastric cancer group was lower than that in the gastritis group while the level of PGⅡ was higher than that in the gastritis group(P<0.05).The differences in levels of serum PGⅠ and PGⅡ were statistically significant among patients with different TNM stages(P<0.05).Serum PGⅠ level was negatively correlated with TNM staging(r=-0.715,P<0.05),and PGⅡ level was positively correlated with TNM staging(r=0.623,P<0.05).The sensitivity and specificity of PGⅠ and PGⅡ in the diagnosis of stage Ⅰ+Ⅱ stage gastric cancer were 81.33% and 61.33%,and 69.33% and 56.67%.The sensitivity and specificity of cut-off values of PGⅠ and PGⅡ combined with EUS were 90.67% and 85.33% in the diagnosis of stage Ⅰ+Ⅱ stage gastric cancer.Conclusion EUS examination can determine the TNM staging of gastric cancer,and the expressions of serum PGⅠ and PGⅡ in patients with gastric cancer are related to TNM staging.The combination of serum PGI and PGⅡ levels and EUS has a higher diagnostic efficacy in the diagnosis of gastric cancer staging.更多还原