血清胃蛋白酶原含量与胃粘膜病变关系的流行病学研究

Epidemiological Study of Serum Pepsinogens and Its Relationship to Histopathology of Gastric Mucosa

本文首次报告了胃癌高发区山东省临朐县一组随机人群共3252人的胃粘膜病变与血清胃蛋白酶原(PG)含量的关系。当地居民血清PGⅠ含量较高,当胃粘膜萎缩范围较广,特别是累及胃体时才有较显著的下降。PGⅡ含量与胃粘膜萎缩肠化的程度和范围呈正相关,是影响PGⅠ/Ⅱ比值的主要因紊。PGⅠ/Ⅱ比值随病变进展呈梯度下降趋势,由浅表性胃炎的9.1下降到异型性增生的5.4和胃癌的3.8。即使在相同病变条件下,PGⅠ/Ⅱ比值与病变范围呈负相关。因此,PGⅠ/Ⅱ比值可做为胃镜检查的辅助诊断和对当地人群不同胃粘膜病变随访观察的指标。

Concentrations of serum pepsinogens (PG) Ⅰand Ⅱ determined in 3252 randomly selected adults who took part in a population-based gastroscopic screening project in an area of China where stomach cancer preevailed. PG Ⅰ and Ⅱ concentrations in both sexes tended to be higher than those reported in other countries, with levels generally higher among males than females. PG Ⅰ tended to decrease and PG Ⅱ to increase with age, but the most pronounced as- socations were between PG Ⅰ/Ⅱ ratios and gastric histo-pathology. Median PG Ⅰ/Ⅱ ratios monotonously declined from 9. 1 to 7. 2 to 5. 7 to 5. 4 to 3. 8 among those with superficial gastritis, chronic atrophic gastritis, intestinal metaplasia, dysplasia,and stomach cancer respectively. Within the same histological category, the PG Ⅰ/Ⅱ ratio was negatively as- sociated with extensive lesions of gastric mucosa. Therefore, it is suggested that low PG Ⅰ/Ⅱ ratio can be used as a marker of more advanced or extensive gastric lesions in the population studied.