血清胃蛋白酶原和胃泌素-17与萎缩性胃炎关系的研究

Relationship between Serum Pepsinogen and Gastrin-17 and Atrophic Gastritis

目的:应用血清胃蛋白酶原(pepsinogens,PG)Ⅰ、PGⅠ/PGⅡ比值(PGR)和胃泌素-17(gastrin-17,G-17),评价其能否作为筛查萎缩性胃炎(AG)的指标,探讨胃癌高危人群的非侵袭性血清学筛查方法。方法:选取2017年1-12月于本院就诊的患者和健康体检者200例。通过内镜和病理诊断确诊将其分为胃癌组9例、慢性非AG组38例、慢性AG组42例(根据病变分布分为胃窦萎缩组13例、胃体萎缩组15例、全胃多灶萎缩组14例)、正常对照组111例,均采用ELISA法检测血清PGⅠ和PGⅡ及G-17水平,比较四组PGⅠ、PGⅡ、PGR及G-17水平,慢性AG组不同萎缩部位血清PGⅠ、PGⅡ、PGR及G-17水平。结果:慢性AG组和胃癌组血清PGⅠ、PGR水平均低于正常对照组(P<0.01),慢性AG组G-17水平高于正常对照组,胃癌组与慢性非AG组G-17水平低于对照组,且胃癌组G-17水平低于慢性非AG组(P<0.01);胃体萎缩组和全胃多灶萎缩组PGⅠ、PGR水平均低于胃窦萎缩组(P<0.01),全胃多灶萎缩组和胃窦萎缩组G-17水平均低于胃体萎缩组(P<0.01)。结论:血清PGⅠ、PGR和G-17水平可用于AG的筛查,血清PGⅠ、PGR水平降低同时G-17水平显著降低对胃癌早期筛查具有重要的临床意义。

Objective:To evaluate whether serum pepsinogens(PG)Ⅰ,PGⅠ/PGⅡ(PGR)and gastrin-17(G-17)can be used as screening indicators for atrophic gastritis(AG),and to explore non-invasive serological screening methods for high-risk groups of gastric cancer.Method:A total of 200 patients and healthy persons in our hospital from January to December 2017 were selected.According to endoscopy and pathological diagnosis,they were divided into 9 cases of gastric cancer group,38 cases of chronic non-AG group,42 cases of chronic AG group(according to the distribution of lesions were divided into 13 cases of gastric antral atrophy group,15 cases of gastric body atrophy group,14 cases of total gastric multifocal atrophy group),111 cases of normal control group.The serum levels of PGⅠand PGⅡand G-17 were measured by ELISA.The levels of PGⅠ,PGⅡ,PGR and G-17 in four groups were compared,and the levels of PGⅠ,PGⅡ,PGR and G-17 in different atrophic sites of chronic AG group were compared.Result:The levels of serum PGI and PGR in chronic AG group and gastric cancer group were lower than those in normal control group(P<0.01),the level of G-17 in chronic AG group was higher than that of normal control group,the level of G-17 in gastric cancer group and chronic non-AG group was lower than that of control group,the level of G-17 in gastric cancer group was lower than that of chronic non AG group(P<0.01).The levels of PGⅠand PGR in gastric body atrophy group and total gastric multifocal atrophy group were lower than those of gastric antral atrophy group(P<0.01),the level of G-17 in total gastric multifocal atrophy group and gastric antral atrophy group were lower than those of gastric body atrophy group(P<0.01).Conclusion:The level of serum PGⅠ,PGR and G-17 can be used for screening of AG,and the decrease of serum PGⅠand PGR levels and the decrease of G-17 levels have important clinical significance for early screening of gastric cancer.