幽门螺杆菌、血清PG及CEA水平在胃癌诊断中的预测价值

Predictive value of Helicobacter pylori, serum PG and CEA levels in the diagnosis of gastric cancer

目的探究幽门螺杆菌(Hp)、血清胃蛋白酶原(PG)及癌胚抗原(CEA)在非胃癌患者与胃癌患者中表达水平的差异,并分析以上指标在胃癌诊断中的预测价值。方法选取2016年1月至2018年12月在我院胃肠外科经病理检查确诊的胃癌患者78例为胃癌组,另选取经过同法检查的非胃癌患者78例为非胃癌组。检测各组受试者的Hp、血清PG及CEA水平,分析其在胃癌诊断中的灵敏度及特异度。结果胃癌组的Hp-IgG抗体阳性率显著高于非胃癌组,且进展期胃癌组显著高于早期胃癌组(P<0.001)。进展期胃癌组的PGⅠ、PGR低于早期胃癌组(P<0.05);进展期胃癌组的PGⅡ、CEA水平显著高于早期胃癌组(P<0.05)。胃癌组的血清PG及CEA阳性表达率高于非胃癌组,且进展期胃癌组高于早期胃癌组(P<0.05)。PG、CEA、Hp联合检测胃癌的灵敏度和特异度高于各项指标单独检测。萎缩性胃炎组同胃溃疡组的上述各指标均无显著差异(P>0.05)。结论 Hp、血清CEA及PG在胃癌患者中表达较非胃癌患者有所差异,且联合检测应用于胃癌检测中具有较高的预测价值,值得临床推广。

Objective To investigate the differences of expression levels of Helicobacter pylori(Hp), serum pepsinogen(PG) and carcinoembryonic antigen(CEA) in non-gastric cancer patients and gastric cancer patients, and analyze the predictive value of the above indexes in the diagnosis of gastric cancer. Methods From January 2016 to December 2018, 78 gastric cancer patients confirmed by pathological examination in gastrointestinal surgery department of our hospital were selected as gastric cancer group, and 78 non-gastric cancer patients confirmed by the same method were selected as nongastric cancer group. The levels of Hp, serum PG and CEA were measured, and the sensitivity and specificity in the diagnosis of gastric cancer were analyzed. Results The positive rate of Hp-IgG antibody in the gastric cancer group was significantly higher than that in the non-gastric cancer group, and that in the advanced gastric cancer group was significantly higher than the early gastric cancer group(P<0.001). PGI and PGR in the advanced gastric cancer group were lower than those in the early gastric cancer group(P<0.05);PGⅡ and CEA level in the advanced gastric cancer group were significantly higher than those in the early gastric cancer group(P<0.05). The positive expression rate of serum PG and CEA in the gastric cancer group were higher than those in the non-gastric cancer group, and those in the advanced gastric cancer group were higher than the early gastric cancer group(P<0.05). The sensitivity and specificity of combined detection of PG, CEA and Hp in the diagnosis of gastric cancer were higher than those of single detection of each index. There were no significant differences in the above indexes between the atrophic gastritis group and gastric ulcer group(P>0.05). Conclusion The expression of Hp, serum CEA and PG in gastric cancer patients is different from that in non-gastric cancer patients. And the combined detection has a high predictive value in gastric cancer detection, which is worthy of clinical promotion.