血清胃蛋白酶原检测在胃部疾病诊断中的意义

Clinical significance of serum pepsinogen levels in gastric diseases

目的:探讨血清胃蛋白酶原(Pesinogen,PG)PGⅠ、PGⅡ含量变化与不同胃黏膜病变的关系,为胃癌的早期诊断提供线索。方法:采用放射免疫分析方法测定197例正常人、273例各种胃病患者的血清PGⅠ、PGⅡ含量,并进行统计学分析。结果:与对照组相比,慢性萎缩性胃炎患者PGⅠ水平有所下降(P<0.05);十二指肠溃疡患者PGⅠ明显升高(P<0.01);胃溃疡患者PGⅠ略有升高而PGⅡ明显升高(P<0.01);慢性浅表性胃炎患者PGⅠ、PGⅡ变化不明显;胃癌患者PGⅠ、PGⅠ/PGⅡ明显下降(P<0.01)。以PGⅠ<35μg/L或PGⅠ/PGⅡ<1.5为临界值,联合诊断胃癌,其灵敏度为72.4%,特异性为84.0%。结论:血清PGⅠ、PGⅡ含量的变化与胃黏膜病变密切相关,对癌前病变及胃癌的早期筛查具有重要的临床意义。

Objective： To evaluate the relationship between serum pepsinogen level and gastric diseases. Methods： Serum pepsinogen Ⅰ and Ⅱ levels were measured by radioimmunoassay in 197 healthy controls, and 273 patients with gastric diseases. The resuhs were analyzed by statistics. Results： Compared with healthy controls, the serum PG I levels of duodenal ulcer patients and serum PG Ⅱ levels of gastric ulcer were significantly higher. The serum PG Ⅰ levels of gastritis patients were significantly lower and the serum PG [ levels and PG Ⅰ/PG Ⅱ ratio of gastric cancer patients were much more lower. Using the cutoff value of 35 μg/L for PG Ⅰ and 1.5 for PG Ⅰ/PG Ⅱ ratio, the sensitivity and specificity of the combined tests for gastric cancer were 72.4.6% and 84.0%, respectively. Conclusion： The changes of serum PG Ⅰ and PG Ⅱ levels are valuable for diagnosis of gastric cancer and gastric pathological changes.