慢性萎缩性胃炎向胃癌转化时血清胃泌素和幽门螺杆菌的变化及其作用

The changing and its interaction of determining serum gastrin levels and helicobacter pylori test during chronic atrophic gastritis into gastric cancer

目的探讨慢性萎缩性胃炎（CAG）向胃癌转化时血清胃泌素（Gs）和幽门螺杆菌（Hp）的变化及其作用。方法采用放射免疫分析和13C-尿素呼气试验（13C—UBT）检测了63例CAG（其中随访1年者48例、3年者35例和5年者30例）、90例胃癌和61例正常对照者血清Gs水平及Hp感染率，并做组间比较分析。结果63例首诊CAG、48例随访1年CAG、35例随访3年CAG、30例随访5年CAG和90例胃癌者血清Gs水平明显高于正常对照组t分别为4．716、5．218、5．624、6．179和6．572，均为P〈0．01），Hp感染率分别为65．1％、70．8％、82．9％、86．7％和88．8％。90例不同部位胃癌患者血清Gs的水平：胃窦癌患者与正常对照组比较无统计学意义（t=1．560，P〉0．05），胃体癌和胃底贲门癌患者正常对照组明显增加（t=4．221，P〈0．05；t=4．436，P〈0．01），以胃底贲门癌患者为最高。结论CAG患者血清Gs水平和Hp感染率的随访测定可达到胃癌患者早期诊断和治疗之目的。

Objective To study the changing and its interaction of determining serum gastrin levels and Helieobacter pylori test during chronic atrophic gastritis into gastric cancer. Methods RIA and 13C- urea breath test （13C-UBT） determined the Gs levels and Hp infection rate in 63 rate cases （first visit） patients, 48 cases （after one year return visit） patients, 35 cases （after three year return visit） patients and 30 cases （after five years return visit） patients with CAG 90 cases patients with gastric cancer （and different position） and 61 cases normal controls. They all were done study compared. Results Serum Gs levels in 63 cases （first visit） patients, 48 cases （after one year return visit） patients, 35 cases （after three year return visit） patients and 30 cases （after five years return visit） patient with CAG were significantly higher （t=4.716, 5.218, 5.624, 6.179, 6.572, all P〈0.01） than 61 cases normal controls, but Hp infection rate were 65.1%, 70.8%, 82.9%, 86.7% and 88.8%. There was no distinct difference between serum Gs in patients with sinuses ventriculi cancer and normal controls （t=1.560, P〉0.05）. Serum Gs levels in 90 cases with gastric cancer （and different position） was significantly higher （t=4.221, P〈0.05; t=4.436, P〈0.01） than 61 cases normal controls and the highest serum Gs level was found in cancer of cardia and fundus. And Hp infection rate was 88.8%. Conclusion The early diagnosis on gastric cancer was very important by determining serum Gs and Hp infection rate.