胃蛋白酶原水平与胃癌及胃溃疡的相关性分析

Analysis of the relationship between pepsinogen and gastric cancer and gastric ulcer

探讨血清胃蛋白酶原Ⅰ(PG Ⅰ)、胃蛋白酶原Ⅱ(PG Ⅱ)含量及PGⅠ/PGⅡ值在胃癌和胃溃疡中的临床意义。方法 700例中对照组200例,胃癌组250例,胃溃疡组250例,采用酶联免疫吸附测定法检测血清PGⅠ、PGⅡ含量。结果方差分析显示:PGⅠ、PGⅡ及PGⅠ/PGⅡ在三组间差异均具有统计学意义(P<0.05);两两之间比较显示:胃溃疡组血清PGⅠ、PGⅡ含量分别为(234.38±53.42)μg/L、(31.69±8.37)μg/L,明显高于非萎缩性胃炎组(178.38±13.46)μg/L、(15.67±2.68)μg/L,差异有统计学意义(P<0.05),胃溃疡组PG Ⅰ/PG Ⅱ值(7.58±0.81),低于非萎缩性胃炎组(11.7±12.37),差异有统计学意义(P<0.05);胃癌组的血清PGⅠ、PGⅡ及PGⅠ/PGⅡ分别为(52.91±6.47)μg/L、(9.20±1.54)μg/L、(5.82±0.80),明显低于非萎缩性胃炎组(178.38±13.46)μg/L、(15.67±2.68)μg/L、(11.71±2.37)及胃溃疡组(234.38±53.42)μg/L、(31.69±8.37)μg/L、(7.58±0.81),差异均有统计学意义(P<0.05);通过对胃癌组与非萎缩性胃炎组PGⅠ、PGⅡ及PGⅠ/PGⅡ的Spearman等级分析发现,PGⅠ、PGⅠ/PGⅡ变化与胃癌的发生呈良好相关性(r=-0.575,P<0.01;r=-0.915,P<0.01)。结论血清PGⅠ、PGⅡ、PGⅠ/PGⅡ在非萎缩性胃炎、胃溃疡及胃癌患者中含量不同,血清PG含量变化与胃癌有一定的相关性,故可考虑作为常规项目对胃癌高危人群进行筛查。

Objective： To explore the clinical significance of serum pepsinogen Ⅰ（ PGⅠ）,pepsinogen Ⅱ（ PG Ⅱ） concentration and PG Ⅰ/PG Ⅱ ratio in gastric cancer and gastriculcer. Methods： The serum concentafions of PG Ⅰ and PG Ⅱ were detected with enzyme-linked immunosorbent assay（ ELⅠSA）,and PG Ⅰ/PG Ⅱ ratio was subsequently calculated from 700 subjects,including 200 normal controls,250 patients with gastric cancers and 250 patients with gastriculcers. Results： The variance analysis showed that PG Ⅰ,PG Ⅱ and PG Ⅰ/PG Ⅱ were statistically significant（ P〈0. 05）. The serum PG Ⅰ,PG Ⅱ levels in gastriculcer group were（ 234. 38 ± 53. 42） μg/L,（ 31. 69 ± 8. 37） μg/L,significantly higher than that in non-atrophic gastritis group,which were（ 178. 38 ± 13. 46） μg/L,（ 15. 67 ± 2. 68） μg/L（ P〈0. 05）. The level of PG Ⅰ/PG Ⅱ（ 7. 58 ± 0. 81） in gastric ulcer group was lower than that in non-atrophic gastritis group（ 11. 7 ± 12. 37）,the difference was statistically significant（ P〈0. 05）. The levels of PG Ⅰ,PG Ⅱ and PG Ⅰ/PG Ⅱ in gastric cancer group were（ 52. 91± 6. 47） μg/L,（ 9. 20 ± 1. 54） μg/L and（ 5. 82 ± 0. 80）,respectively,which were significantly lower than those in nonatrophic gastritis group（ 11. 61 ± 3. 37） μg/L,（ 7. 58 ± 0. 81）,μg/L,（ 15. 67 ± 2. 68） μg/L,（ 11. 71 ± 2. 37） and gastric ulcer group（ 234. 38 ± 53. 42） μg/L. The difference was statistically significant（ P〈0. 05）. Spearman analysis of PGⅠ,PG Ⅱ and PGⅠ/PGⅡ in gastric cancer group and non-atrophic gastritis group showed that PG Ⅰ,PG Ⅰ/PG Ⅱ had a good correlation with gastric cancer（ r =-0. 575,P〈0. 01; r =-0. 915,P〈0. 01）. Conclusion： Serum PGⅠ,PGⅡ,PGⅠ/PGⅡ in different non-atrophic gastritis,gastric ulcer and gastric cancer in patients with different levels of serum PG levels and gastric cancer have a certain relevance,it can be considered as a conventional project for high-risk groups of gastric cancer Screening.