血清胃蛋白酶原在胃腺癌和胃溃疡中的表达及意义

Expression and significance of serum pepsinogen in gastric adenocarcinoma and gastric ulcer

目的:探讨血清胃蛋白酶原I(PG I)、胃蛋白酶原II(PG II)含量及PG I/PG II比值(PGR)在胃腺癌和胃溃疡中的临床意义。方法:91例中对照组20例,胃溃疡组28例,胃癌组43例,采用ELISA法检测血清PG I、PG II含量。结果:胃溃疡组患者血清PG I、PG II含量分别为(179.48±64.08)μg/L、(30.53±8.43)μg/L,明显高于对照的(134.02±22.82)μg/L、(20.07±6.51)μg/L及胃癌组的(80.50±24.33)μg/L、(18.36±6.31)μg/L,均P<0.01。胃癌组血清PG I、PGR均显著低于对照组(均P<0.01),PGⅡ水平与对照组差异无统计学意义(P>0.05)。受试者工作特征曲线(ROC曲线)分析,血清PGI及PGR对胃癌的诊断价值较高(曲线下面积分别为0.670和0.805)。结论:血清PG I、PG II显著升高是良性溃疡的危险因素,而血清PG I、PGR明显降低应高度警惕胃癌可能。检测血清PG有助于胃癌与胃溃疡的鉴别诊断。

Objective： To explore the clinical significance of serum pepsinogen I （PGI）, pepsinogen Ⅱ （PG Ⅱ） concentration and PG I/PG Ⅱ ratio （PGR） in gastric adenocarcinoma and gastriculcer. Methods： The serum concentations of PG I and PG Ⅱ were detected with enzyme-linked immunosorbent assay （ELISA）, and PGR ratio was subsequently calculated from 91 subjects, including 20 normal controls, 28 patients with gastric ulcers and 43 patients with gastric cancers. Results： The serum PG I, PG Ⅱ levels in gastriculcer group was （179.48 土 64.08） lag/L and （30.53 土 8.43） μg/L, significantly higher than that in normal control and gastric cancer group, which were （134.02 土 22.82） μg/L, （20.07 土 6.51） μg/L and （80.50 土 24.33）μg/L, （18.36 土 6.31） μg/L, all P 〈 0.01. The PG I level and PGR decreased significantly in gastric cancer compared to normal control （P 〈 0.01）. But for PG II, there was no statistical difference （P 〉 0.05）. ROC curves analysis revealed that PG I and PGR were valuable for diagnosis of the gastric cancer with an area under curve （AUC） of 0.670 and 0.805 respectively. Conclusion： Increased serum PG I and PG 1I indicates gastric ulcer, while decreased serum PG I and PGR should be highly vigilant gastric cancer. The serum PGs concentration contributes to the differential diagnosis of gastric cancer and gastric ulcer.