胃蛋白酶原比值联合胃泌素诊断慢性萎缩性胃炎的价值研究

Value of serum pepsinogen antigen ratio combined with gastrin in diagnosing chronic atrophic gastritis

目的:探讨血清胃蛋白酶原比值(PGR)联合胃泌素-17(GAS-17)诊断慢性萎缩性胃炎的临床价值。方法:筛选2017年6月至2019年6月至我院住院的慢性胃炎患者的临床资料,选取121例慢性萎缩性胃炎患者,同时选取98例慢性非萎缩性胃炎患者作为对照组;收集两组的一般情况及胃蛋白酶原-Ⅰ(PG-Ⅰ)、胃蛋白酶原-Ⅱ(PG-Ⅱ)、GAS-17等资料,计算PGR。应用Pearson相关性分析PG-Ⅰ、PG-Ⅱ、PGR和GAS-17的相关性;利用工作者受试特征(ROC)曲线比较胃蛋白酶原相关指标、GAS-17及两者联合对慢性萎缩性胃炎的诊断效能。结果:与对照组比较,慢性萎缩性胃炎组患者的PG-Ⅰ、PGR及GAS-17水平降低,差异有统计学意义(P<0.05);Pearson相关性分析结果显示慢性萎缩性胃炎组患者PG-Ⅰ、PGR与GAS-17水平之间呈正相关(r1=0.468,P1<0.001;r2=0.405,P2<0.001);ROC曲线显示,PG-Ⅰ、PGR、GAS-17单独诊断慢性萎缩性胃炎患者的曲线下面积(AUC)分别为0.817、0.838、0.794,最佳诊断临界点分别为102.62μg·L-1、8.95、8.52 pmol·L-1,PG-Ⅰ和GAS-17联合诊断时AUC为0.849,PGR和GAS-17联合诊断时AUC为0.896。结论:单一指标诊断慢性萎缩性胃炎时,PGR的诊断效能最高,联合GAS-17后诊断效能进一步提升,两者联合诊断对慢性萎缩性胃炎高危人群筛选有较高的临床价值。

Objective:To investigate the diagnostic value of serum pepsinogen ratio(PGR)combined with gastrin-17(GAS-17)in chronic atrophic gastritis patients.Methods:The clinical data of patients with gastritis in our hospital from June 2017 to June 2019 were screened retrospectively.121 patients with chronic atrophic gastritis were included and 98 patients with chronic non-atrophic gastritis were also included as the control group.We collected demographic characteristics data of these patients and detected pepsinogen-I(PG-Ⅰ),pepsinogen-Ⅱ(PG-Ⅱ),GAS-17,and calculated PGR as well.Pearson correlation was used to analyze the correlation between PGR and GAS-17.Receiver operating characteristic(ROC)curve of PGR,GAS-17 and their combined diagnosis were plotted respectively to compare the diagnostic efficacy of chronic atrophic gastritis patients.Results:Compared to the control group,levels of PG-Ⅰ,PGR and GAS-17 in the chronic atrophic gastritis group were decreased(P<0.05).Pearson correlation analysis showed that there were positive correlation between PG-Ⅰor PGR and GAS-17 in chronic atrophic gastritis group(r1=0.468,P1<0.001;r2=0.405,P2<0.001).ROC curve showed that the areas under curve(AUC)of PG-Ⅰ,PGR,GAS-17 in the diagnosis of chronic atrophic gastritis were 0.817,0.838 and 0.794,respectively.The best diagnostic critical points were 102.62μg·L-1,8.9,and 8.52 pmol·L-1,respectively.The AUC of PG-Ⅰ+GAS-17 and PGR+GAS-17 was 0.849 and 0.896,respectively.Conclusion:The diagnostic efficacy of PGR was shown to be the highest in chronic atrophic gastritis,and it could be further improved when combined with GAS-17.PGR combined with GAS-17 are helpful to screen high risk population of chronic atrophic gastritis.