血清胃蛋白酶原、胃泌素-17及幽门螺杆菌检测在胃癌及癌前病变诊断中的价值研究

The value of serum pepsinogen,gastrin-17 and Helicobacter pylori in the diagnosis of gastric cancer and precancerous lesions

目的探讨血清胃蛋白酶原(PG)、胃泌素-17(G-17)及幽门螺杆菌(Hp)检测在胃癌及癌前病变诊断中的应用价值。方法选取该院2017年1月～2018年1月治疗的168例胃部疾病患者为研究对象,分为浅表性胃炎45例、胃溃疡40例、萎缩性胃炎30例、非典型增生28例、胃癌25例,同时选取38例健康体检者为对照组。采用荧光免疫层析法检测各组血清PGⅠ、PGⅡ、PGⅠ/PGⅡ(PGR)及G-17水平。^(13)C尿素呼气试验检测各组Hp并比较Hp感染阳性率。对各组及Hp阳性组、Hp阴性组血清PGⅠ、PGⅡ、PGR及G-17水平进行分析比较。结果与其余各组相比,胃癌组PGⅠ明显降低,溃疡组PGⅠ明显升高(P<0.01)。胃癌组、溃疡组及非典型增生组PGⅡ明显高于对照组(P<0.01)。胃癌组PGR明显低于其余各组,非典型增生组及萎缩性胃炎组PGR明显低于对照组、浅表性胃炎组及溃疡组(P<0.01)。胃癌组G-17明显高于其余各组,萎缩性胃炎组G-17明显低于溃疡组、非典型增生组及胃癌组。溃疡组、萎缩性胃炎组、非典型增生组及胃癌组Hp阳性率明显高于对照组(P<0.05)。与Hp阴性组相比,Hp阳性组PGⅠ及PGR明显降低,G-17明显升高(P<0.01)。结论血清胃蛋白酶原、胃泌素-17及幽门螺杆菌检测在胃癌及癌前病变的诊断中具有重要价值。

Objective To investigate the application value of serum pepsinogen（PG）, gastrin-17（G-17） and Helicobacter pylori（Hp） in the diagnosis of gastric cancer and precancerous lesions. Methods A total of 168 patients with gastric diseases treated in the hospital from January to February 2018 were enrolled in the study. They were divided into 45 cases of superficial gastritis, 40 cases of gastric ulcer, 30 cases of atrophic gastritis, and 28 cases of atypical hyperplasia, and 25 cases of gastric cancer. And 38 healthy subjects were selected as the control group. Serum PGⅠ, PGⅡ, PGⅠ/PGⅡ（PGR） and G-17 levels in each group were measured by fluorescence immunochromatography. The 13C urea breath test was used to detect Hp in each group and the positive rate of Hp infection was compared. Serum PGⅠ, PGⅡ, PGR and G-17 levels were analyzed and compared in each group and Hp positive group and Hp negative group. Results Compared with that of the other groups, the PGⅠ of the gastric cancer group was significantly decreased, and the PGⅠ of the ulcer group was significantly increased（P〈0.01）. The PGⅡ of gastric cancer group, ulcer group and atypical hyperplasia group was significantly higher than that of the control group（P〈0.01）. The PGR of the gastric cancer group was significantly lower than that of the other groups. The PGR of the atypical hyperplasia group and the atrophic gastritis group was significantly lower than that of the control group, superficial gastritis group and ulcer group（P〈0.01）. G-17 in the gastric cancer group was significantly higher than the other groups. The G-17 in the atrophic gastritis group was significantly lower than that in the ulcer group, atypical hyperplasia group and gastric cancer group. The positive rate of Hp in ulcer group, atrophic gastritis group, atypical hyperplasia group and gastric cancer group was significantly higher than that in control group（P〈0.05）. Compared with those in Hp negative group, PGⅠ and PGR were significantly decreased and G-17 was significantly increased in Hp positive group（P〈0.01）. Conclusion Serum pepsinogen, gastrin-17 and Helicobacter pylori detection have important value in the diagnosis of gastric cancer and precancerous lesions.