空腹血清胃泌素-17对胃息肉的诊断价值

Diagnostic value of fasting serum gastrin-17 in patients with gastric polyps

目的评价空腹血清胃泌素-17(Fs G-17)对胃息肉的诊断价值。方法以经内镜或病理诊断的胃息肉患者86例设为观察组,将与观察组年龄、性别、幽门螺杆菌(Hp)感染情况相似的经内镜明确无活动性胃炎及其他胃部疾病者105例设为对照组。采用酶联免疫法对两组患者行Fs G-17检测和比较,并根据息肉数量分为单个和多个息肉两亚组,比较两亚组Fs G-17水平。根据结果选择有意义的指标做ROC曲线,确定最佳临界值及其所对应的敏感度和特异度。结果观察组Fs G-17水平为高于对照组[1.95(0.56,9.23)pmol/L vs 1.23(0.58,4.01)pmol/L,P=0.05],单个息肉亚组Fs G17水平低于多个息肉亚组[0.72(0.31,6.56)pmol/L vs 3.15(0.94,11.55)pmol/L,P=0.03]。根据观察组与对照组Fs G-17水平绘制ROC曲线,其曲线下面积(AUC)为0.582±0.083。依据约登指数确定其最佳临界值为2.18pmol/L,此时敏感度为47.7%,特异度为70.5%。结论胃息肉患者Fs G-17水平升高,其程度可能与息肉数量正相关,但Fs G-17对胃息肉诊断价值有限,尚不适合作为临床筛查。

Objective To evaluatethe value of fasting serum gastrin-17（ Fs G-17） to the diagnosis of gastric polyp.Methods Totally 86 patients with gastric polyps diagnosed via endoscopy or pathology were set as the observation group. Another 105 patients,with similar age,sex and Helicobacter Pylori（ Hp） infection condition to the observation group,confirmed by endoscopy with neither active gastritis nor other gastric organic disease,were set as the control group. The Fs G-17 of the two groups was detected via ELISA and compared with each other. Furthermore the subgroups on the basis of the number of the polyps were compared with their Fs G-17. The ROC curve was drawn according to the comparative result and the best cut-off point together with the corresponding sensitivity and specificity were calculated. Results The Fs G-17 level of the observation group was higher than that of the control group[1. 95（ 0. 56,9. 23） pmol/L vs 1. 23（ 0. 58,4. 01） pmol/L,P = 0. 05]. In the observation group,the Fs G-17 level of the subgroup with single polyp is lower than that of the multiple polyps subgroup[0. 72（ 0. 31,6. 56） pmol/L vs 3. 15（ 0. 94,11. 55） pmol/L,P = 0. 03]. According to the ROC curve of serum Fs G-17 level as well as the Youden index,the cut-off point should be 2. 18 pmol/L. At this point,the sensitivity and specificity of serum G-17 level in diagnosis of RE were 47. 7% and 70. 5% . Conclusion The Fs G-17 level was elevated in the patients with gastric polyps,and The extent may be positively related to the number of polyps. As to its limited diagnostic value,it was not yet appropriate to regard Fs G-17 as an screening method to diagnose the gastric polyp.