胃黏膜癌变过程中血清胃泌素水平的变化及其影响因素的研究

The study on changes of serum gastrin level and its influencing factors in carcinogenesis of gastric mucosa

目的探讨常见因素对血清胃泌素水平的影响,揭示血清胃泌素在胃癌及其癌前疾病诊断中的价值。方法利用ELISA方法检测2002年6月至2004年7月收集的3906份血清样品的血清胃泌素水平。结果≥60岁组的血清胃泌素水平显著高于其他年龄组。患有胃窦疾病患者的血清胃泌素水平显著高于患有胃体疾病患者。HP阳性组的血清胃泌素水平显著高于HP阴性组。由正常者经浅表性胃炎至胃糜烂或溃疡,血清胃泌素水平进行性升高,由胃糜烂或溃疡至萎缩性胃炎有所下降;由萎缩性胃炎至不典型增生,血清胃泌素水平明显升高;由不典型增生至胃癌,血清胃泌素水平明显降低。胃癌的血清胃泌素水平显著低于其他胃疾病组。结论60岁以后,老年人的血清胃泌素水平已开始倾向于升高。胃部疾病的发生部位是影响血清胃泌素水平的一个重要因素。HP可使感染者的血清胃泌素水平升高。在胃癌前期,血清胃泌素水平可随疾病的发展而呈波动性递增,至胃癌形成时明显降低;血清胃泌素是鉴别胃良恶性疾病的一个较好的标志物。

Objective To explore the common factors＇ influence on serum gastrin level, and reveal the value of serum gastrin in the diagnosis of gastric precancerous lesions and gastric cancers, Methods Serum gastrin level of 3 906 serum samples was detected by ELISA. Results Serum gastrin level of patients over 60 years old was distinctively higher than that of other age groups. Serum gastrin level in antral diseases was higher than that in diseases of the body. HP positive group was higher than the negative one. The level progressingly increased from normal group to superficial gastritis and to gastric erosion or ulcer; and it decreased from gastric erosion or ulcer to atrophic gastritis, while it increased from atrophic gastritis to dysplasia, and it decreased from dysplasia to gastric cancer. Serum gastrin level was distinctively lower in gastric cancer than in other groups. Conclusion For people over 60 years old, their serum gastrin level has the tendence to increase. The location of gastric disease is an important factor affecting serum gastfin level, HP can increase the serum gastrin level. During gastric precancerous stage, the serum gastrin level may gradually increase with the diseases＇ progression, and decrease when gastric cancer is formed. Serum gastrin is a good marker to differentiate benign and malignant gastric diseases.