血清胃蛋白酶原联合胃镜检查在高危Hp相关性胃癌中的诊断分析

Diagnostic analysis of serum pepsinogen combined with gastroscopy in the diagnosis of high risk Helicobacter pylori(Hp) associated gastric cancer

目的探讨高危幽门螺旋杆菌相关性胃癌诊断中血清胃蛋白酶原联合胃镜检查的应用价值。方法所选162例上消化道疾病患者按照组织病理活检结果,分为A组(萎缩性胃炎,n=60)、B组(浅表性胃炎,n=54)、C组(胃癌,n=48)。D组为同期到本院体检的健康人,共38例。结果 C组PGⅠ、PGR水平均低于A组、B组、D组,差异有统计学意义(P<0.05),但C组PGⅡ高于A组、B组、D组,差异有统计学意义(P<0.05);胃镜检查显示A组、B组、C组患者幽门螺旋杆菌阳性发生率分别为71.7%、66.7%、79.2%,组间比较差异无统计学意义(P>0.05);血清胃蛋白酶原阳性的胃癌患者Hp感染率明显高于血清胃蛋白酶原阴性的胃癌患者,差异有统计学意义(P<0.05)。结论临床上可将血清胃蛋白酶原联合胃镜检查作为筛查高危幽门螺旋杆菌相关性胃癌的重要手段,以提升早期胃癌诊断准确性。

Objective To investigate the value of serum pepsinogen combined with gastroscopy in the diagnosis of high risk Helicobaeter pylori （Hp） associated gastric cancer. Methods 162 patients with upper gastrointestinal diseases were selected and divided into A group （atrophic gastritis,n=60）,B group （superficial gastritis,n=54） and C group （gastric cancer,n=48） according to the results of the pathological biopsy.At the same period,a total of 38 cases of healthy person carried on hospital physical examination were as D group. Results PG Ⅰ,PGR levels of C group were lower than those of A group,B group and D group （P 〈 0.05）,but the PG Ⅱ of C group was higher than that of A group, B group and D group （P 〈0.05）.Gastroscopy showed that the helicobacter pylori positive rates in the A group,B group,C group of patients were 71.7%,66.7%,79.2% respectively,without a significant difference among the groups （P〉0.05）.The infection rate of Hp in serum positive gastric cancer patients was significantly higher than that in patients with serum negative pepsinogen （P 〈 0.05）. Conclusion Serum pepsinogen combined with gastroscopy can be used as an important means of screening high-risk Helicobacter pylori associated gastric cancer to improve the diagnostic accuracy of early gastric cancer.