胃蛋白酶原亚群与胃部疾病的相关性研究

Studies on Relationship of the Pepsinogen Subtypes and Stomach Disease

为测定胃蛋白酶原亚群(pepsinogenI PGI,pepsinogenⅡPGⅡ)在健康体检者及胃部疾病患者的血清含量,探讨血清中PG亚群检测对萎缩性胃炎和胃癌早期诊断的临床意义,利用放射免疫法(radioimmunoassay RIA)检测35例健康体检者、18例胃溃疡、30例萎缩性胃炎和30例胃癌患者血清中PGⅠ、PGⅡ及PGⅠ/PGⅡ比值的变化,比较正常组与各疾病组的胃蛋白酶原含量。结果:(1)与正常组相比,胃溃疡组PGⅠ、PGⅡ升高,以PGⅡ增高明显,而PGⅠ/PGⅡ比值降低;萎缩性胃炎和胃癌组PGⅠ水平均呈下降趋势,而PGⅡ水平变化不明显,PGⅠ/PGⅡ比值下降。(2)与溃疡组相比,萎缩性胃炎和胃癌组PGⅠ、PGⅡ及PGⅠ/PGⅡ比值均明显降低。(3)与萎缩性胃炎组相比,胃癌组PGⅠ、PGⅡ及PGⅠ/PGⅡ比值虽略低于萎缩性胃炎,但差异无统计学意义。(4)当PGⅠ≤80 ng/mL和PGⅠ/PGⅡ≤6时,检出萎缩性胃炎的特异度和灵敏度分别为94.3%和53.3%。说明血清PGⅠ和PGⅠ/PGⅡ比值的降低,是萎缩性胃炎及胃癌人群筛查和辅助诊断的一项血清学指标。血清PGI≤80 ng/mL且PGⅠ/PGⅡ≤6时检测萎缩性胃炎具有较好的特异度和灵敏度。测定血清PG亚群的方法简单易行,适于初筛萎缩性胃炎及胃癌人群及胃镜检查禁忌者。

To determined variation of Serum pepsinogen subgroups（pepsinogen,PGⅠ,PGⅡ） content in healthy persons and the patients with stomach diseases,and investgate serum pepsinogen subgroups（PepsinogenI PGI,PepsinogenII PGⅡ） content for significant of early diagnosis of atrophic gastritis and gastric cancer,the changes of PGⅠ,PGⅡ and the PGI/PGⅡ with radioimmunoassay（RIA） were measured in 35 healthy persons,the patients of 18 gastric ulcer,30 chronicatrophic gastritis and 30 gastric cancer.The normal group and every disease group were statistically compared.It is resulted：（1） Compared with the normal control group,the content of serum PGⅠand PGII in the gastric ulcer were go up（P=0.029）,the atrophic gastritis and the gastric cancer were decreasing（P 0.05）,respectively and the ratio of PGⅠ/ PGⅡ was also decreasing,but the content of serum PGⅡ did not change significantly of the atrophic gastritis and the gastric cancer.（2） Compared with the peptic ulcer,the content of serum PGI、PGⅡ and the ratio of PGⅠ/ PGⅡ in the atrophic gastritis and the gastric patients cancer decreased significantly（P 0.05）.（3） Compared with the atrophic gastritis,the content of PGⅠ,PGⅡ and the ratio of PGI / PGⅡ in the gastric cancer was slightly lower,but the difference was not statistically significant.（4） When PGⅠ≤80 ng/mL and the PGI/PGⅡ ≤6,the sensitivity and specificity for detection of the atrophic gastritis were 53.3% and 94.3%.It is conclused that decreasing of PGⅠ and the ratio of PGI/ PGⅡ are a serum markers for screening and supplementary diagnosis of the atrophic gastritis and the gastric cancer.There are better specificity and sensitivity for measuring the atrophic gastritis,when PGⅠ≤80ng/mL and PGI/ PGⅡ≤6.This method is simple and easy to operate and suitable for screening of the atrophic gastritis,the gastric cancer and the individual of endoscopey contraindication.