血清胃蛋白酶原检测联合FICE染色内镜在萎缩性胃炎及胃癌诊断中的应用

The clinical value of combined determination of serum PG and FICE in diagnosis of chronic atrophic gastritis and gastric carcinoma

目的:探讨胃蛋白酶原Ⅰ(PepsinogenⅠ,PGⅠ)、胃蛋白酶原Ⅱ(PepsinogenⅡ,PGⅡ)、PGⅠ/PGⅡ(PGR)水平变化结合FICE内镜(FujiIntelligent ChromoEndoscope,FICE)对提高萎缩性胃炎及胃癌诊断的价值。方法:将856例疾病组患者随机分为两组——白光内镜组和FICE组,以PGI≤70μg/L和PGI/II≤3为筛查指标,应用ELASA法测定了856例患者的血清胃蛋白酶原,其中血清胃蛋白酶原(Pepsinogen,PG)降低的患者,白光内镜组不作染色按肉眼判断常规取活检,FICE组内镜组在FICE染色后在可疑病灶处取活检。以400例未检测PG的患者作为对照组(仅作白光内镜检查,按肉眼判断常规取活检)。结果:FICE组中检出萎缩性胃炎及胃癌的检出率为5.43%;白光组阳性率为3.56%,对照组阳性率为2.5%,三组检出率差异有统计学意义(P<0.05)。结论:血清PGⅠ、PGⅡ、PGR检测结合FICE染色内镜可显著提高萎缩性胃炎及胃癌的检出率。两项技术联合应用,有助于胃癌筛查。

Objective： To ewduate the clinical value of measuring the serum levels of pepsinogen I （ PG I ）, pepsinogen Ⅱ （ PG Ⅱ ）, PC. I/PC. 11 （PGR） and FICE in 556 patients. Metheds： These 856 patients were randomized into two groups. All of them were measured with the two- siteUsandwich technique of enzyme - linked immunosorbent assay（ ELISA） with the standard of PGI≤ 70μg/L和PGI/Ⅱ≤ 3, PC： I , PGⅡ and PG Ⅰ/PGⅡ ratio （ PGR ）. The patients whose PG were under that level were pefformeded with FICE gastroseopy in the FICE group , while the patients in another group just be inspected with normol endoscopy. 400 patientsin the control group were only inspected with hemal endoscopy without PG test and staining. At last, all of them were eorutinned with pathology. Results： The positive ratio of chronic atrophic gastritis（CAG）and gastric carcinoma（GC） in the FICE was 21.94%, 17.63 % in the normol endoscopy group and 13 % in the control group. Conclusion： Feasibility and the necessity of combined determination were evaluated. Compared with solo determination, for patients with gastric lesions,it was more sensitive to determine and analyze the serum levels ofPG I ,PG /I and F/CE.So it is recommended to popularize the combined deten＇nination of serum PG I .PG[I and FICE in clinical distinetive diamaosis of CAG and GC.