【摘要】 目的探讨血清胃蛋白酶原(PG)与胃疾病的相关性,并评估其临床诊断价值。方法采用时间分辨荧光免疫分析法,双盲检测血清PG样本795例,其中慢性浅表性胃炎289例,慢性萎缩性胃炎123例,消化性溃疡156例,胃癌227例;胃癌前期病变(肠上皮化生、腺上皮异型增生)170例;采用stata 7.0软件logistic回归和接受者工作特征(ROC)曲线统计分析。结果血清PGⅠ/Ⅱ与胃癌、胃癌前期病变呈负相关(P<0.01),血清PGI与萎缩性胃炎呈负相关(P<0.01),但二者的鉴别诊断价值较低[曲线下面积(AUC)<0.05];血清PGI与消化性溃疡呈正相关(P<0.01),诊断消化性溃疡的价值一般(AUC=0.683)。结论血清PGI、PGⅠ/Ⅱ低水平人群的胃癌、萎缩性胃炎和癌前期病变发生率高于非低水平人群,但单独应用血清PG临床诊断价值不高;血清PGⅠ升高者有溃疡可能,具有一定的临床诊断价值。更多还原

【Abstract】 Objective To analyze the correlation between serumpepsinogen(PG) and peptic diseases,evaluate the clinical diagnostic value of serum-pepsinogen.Methods The subjects consisted of 795 individuals(289 chronic gastritis,123 atrophic gastritis,156 peptic ulcer and 227 gastric cancer,170 precancerous lesions).The serum levels of PGⅠ and PGⅡ were detected by two-site time-resolved fluoroimmunoassay(TRFIA).The levels of PG were compared with the diagnoses of gastroscopy and pathology by logistic regression analysis and receiver operating characteristic(ROC) curve.Results The ratio of PGⅠ/Ⅱ was negative correlated with gastric cancer and precancerous lesions(P<0.01),the level of PGⅠ was negative correlated with atrophic gastritis(P<0.01),but their clinical diagnostic values were lower [area under cure(AUC)<0.05].The level of PGⅠ was direct correlated with peptic ulcer(P<0.01),its clinical diagnostic value was nearly middling(AUC=0.6830).Conclusion The people with lower levels of PGⅠ,PGⅠ/Ⅱ have higher rate of gastric cancer,atrophic gastritis and precancerous lesions than the people with normal levels.But the single detection of serum PG is not so valuable in clinical diagnosis.The higher level of PGI indicates the possiblity of peptic ulcer.更多还原