胃癌高危人群血清胃蛋白酶原筛查的临床意义

Clinical significance of serum pepsinogen screening among high risk gastric cancer populations

目的探讨血清胃蛋白酶原（PG）用于徐州地区胃癌高危人群筛查的界定值及临床意义。方法采用酶联免疫吸附测定法（ELISA）检测人群血清PGI、PGⅡ水平,计算PGI/PGⅡ,并行胃镜及病理检查;运用ROC曲线法确定适合徐州地区居民胃癌高危人群的血清PG异常界定值。结果共筛查142人,年龄35~70岁,胃癌高危组45人、非高危组97人。高危组血清PGI水平低于非高危组,差异有统计学意义（t=5.117,P=0.000）;高危组血清PGⅡ水平与非高危组差异无统计学意义（t=1.117,P=0.266）;高危组血清PGI/PGⅡ水平低于非高危组,差异有统计学意义（t=2.086,P=0.039）。以胃镜及病理检查作为金标准,根据ROC曲线法确定筛查的临界值：当PGI〈119.52μg/L,筛查灵敏度为95.80%,特异度为42.42%;当PGI/PGⅡ〈11.32,筛查灵敏度为69.80%,特异度为82.21%。结论血清PGI〈119.52μg/L或PGI/PGⅡ〈11.32,可以作为筛查胃癌高危人群的指标。

Objective To study cutoff value and clinical significance of serum pepsinogen（PG）screening among high risk gastric cancer populations in Xuzhou.Methods Serum PGI and PGⅡlevels were analyzed by Enzyme Linked Immunosorbent Assay（ELISA）,PGI/PGⅡ value was calculated,endoscopy and pathological examination were performed.The cutoff values of abnormal serum PG levels among high risk gastric cancer populations were determined by ROC curve.Results A total of 142 cases aged 35 to 70years old were screened,among which 45 were in high risk gastric cancer group and 97 cases were in nonhigh risk group.The serum PGI level of high risk group was lower than non-high risk group,with statistical difference（t=5.117,P=0.000）.The level of serum PG II between 2groups had no statistical difference（t=1.117,P=0.266）.The serum PGI/PGⅡvalue of high risk group was lower than non-high-risk group,with statistical significance（t=2.086,P=0.039）.Using endoscopy and pathological examination as golden standard,the cutoff values were determined by ROC curve：screening sensitivity and specificity was 95.80%and 42.42%,respectively,under the condition of PGI〈119.52μg/L;screening sensitivity and specificity was 69.80%and 82.21%,respectively under the condition of PGI/PGⅡ〈11.32.Conclusion Serum PG can be used as an indicator of high risk gastric cancer population screening under the condition of PGI〈119.52μg/L or PGI/PGⅡ〈11.32.