血清胃蛋白酶原及幽门螺杆菌抗体在胃癌早期诊断中的意义

Clinical value of pepsinogen levels and Helicobacter pylori antibody detection in the early diagnosis of gastric cancer

目的探讨血清胃蛋白酶原(PG)、幽门螺杆菌(Hp)抗体联合检测在胃癌早期诊断中的临床意义。方法选取2013年6月-2015年7月经胃镜检查并病理确诊的实验组及健康体检者为对照组,采用化学发光微粒子免疫检测法检测血清PGⅠ、PGⅡ水平;采用胶体金法检测血清Hp-IG抗体,并进行统计学分析。结果与对照组比较,浅表性胃炎组PGⅠ、PGⅡ和PGR水平差异无统计学意义(P>0.05);胃溃疡组PGⅠ、PGⅡ水平显著升高,差异有统计学意义(P<0.05),PGR差异无统计学意义(P>0.05);萎缩性胃炎组和胃癌组PGⅠ、PGR水平显著降低,差异有统计学意义(P<0.05),PGⅡ差异无统计学意义(P>0.05)。血清Hp-IG抗体阳性检出率以胃溃疡组为最高(68.1%);血清HpIG抗体阳性组的PGR显著低于Hp-IG抗体阴性组,差异有统计学意义(P<0.05)。结论 PGⅠ、PGR下降可作为萎缩性胃炎和胃癌人群早期筛查的血清学指标,Hp感染可影响PGR水平。

Objective To investigate the significance of serum pepsinogen（ PG） and Helicobacter pylori（ Hp） antibody joint detection in the diagnosis of gastric cancer. Methods Cases were selected randomly as the experiment group based on endoscope inspection and pathologic confirmation from June 2013 to July 2015,and healthy subjects from health examination were selected as the control group. Levels of serum PGⅠ,PGⅡ were detected via chemiluminescence microparticle immunoassays; Hp-IG antibody was detected by gold immunochromatographic assay for statistical analysis. Results Compared with the control group,there was no statistical significance on the diferences of PGⅠ,PGⅡ and PGR in the superficial gastritis group（ P〈0. 05）.PGⅠ and PG Ⅱ levels in the gastric ulcer group increased significantly,and the difference was statistically significant（ P〈0. 05）. While,there was no statistical significance on the difference in PGR（ P〈0. 05）. PGⅠ and PGR levels in atrophic gastritis and gastric cancer group decreased significantly,compared with the control,and the difference was statistically significant（ P〈0. 05）,but there was no statistical significance on the difference in PGⅡ（ P〈0. 05）. Positive rate of serum Hp-IG antibody in the gastric ulcer group was the highest（ 68. 1%）. The PGR level in the Hp-IG antibody positive group was significant higher than the Hp-IG antibody negative group,and the difference had statistical significance（ P〈0. 05）. Conclusion Decrease in PGⅠand PGR can be a serum biological marker for screening of atrophic gastritis and gastric cancer. PGR level could be affected by Hp infection.