早期胃癌胃镜筛查中联合应用血清PG、G-17、CA72-4及Hp检测的价值研究

Serum PG,G-17,CA72-4 and HP for screening of early gastric cancer

目的探究早期胃癌胃镜筛查中联合应用血清胃蛋白酶原(PG)、胃泌素17(G-17)、糖类抗原72-4(CA72-4)及幽门螺旋杆菌(Hp)13C尿素呼气试验检测的价值。方法选取2018年1月至2019年12月中国人民武装警察部队海警总队医院收治的胃部疾病患者200例作为研究对象,同时选取同期体检健康者65例为对照组。全部患者入院前均行组织活检,并以病理检查结果为依据将200例胃部疾病患者分为早期胃癌组67例、胃溃疡组68例、萎缩性胃炎组65例。全部患者均行胃镜诊断,同时检测血清PG、G-17、CA72-4、Hp,将病理结果视为金标准,分析胃镜诊断早期胃癌的病理特点,比较各组PG、G-17、CA72-4水平以及Hp阳性率,对比各单项指标检测与联合检测的准确度、灵敏度和特异度。结果病灶主要位于胃窦,胃镜分型凹陷型占比较高,病理分型中以管状腺癌居多。血清PGⅠ、PGⅡ、G-17、CA72-4、Hp阳性率4组间比较及4组间两两比较差异均有统计学意义(均P<0.05)。胃镜联合各指标检测准确度、灵敏感度和特异度分别为0.89、0.87、0.90,均明显高于各单项指标检测(均P<0.05)。结论早期胃癌胃镜筛查时,联合各血清肿瘤标志物和Hp检查效果明显,能够及早提醒进行胃镜筛查早期胃癌,值得推广。

Objective To explore the value of combined detection of serum pepsinogen(PG),gastrin 17(G-17),carbohydrate antigen 72-4(CA72-4)and Helicobacter pylori(HP)in screening of early gastric cancer.Methods Two hundred patients with gastric diseases admitted to China Coast Guard Hospital of Chinese People’s Armed Police Force from January 2018 to December 2019 were selected as the study subjects,and 65 healthy subjects served as control group.All subjects underwent gastroscopy,serum levels of PG,G-17,CA72-4 were measured,and Hp were detected by 13 C breath test.The pathological results were used as the gold standard,and the diagnostic values of PG,G-17,CA72-4 and Hp infection for gastric cancer were analyzed.Results The lesions were mainly located in the antrum of the stomach,the gastroscope classification predominantly was concave type,and the pathological classification was mostly tubular adenocarcinoma.There were significant differences in serum PGⅠ,PGⅡ,G-17,CA72-4 levels and HP positive rate among patients with early gastric cancer,atrophic gastritis,gastric ulcer and control group(all P<0.05).The accuracy,sensitivity and specificity of gastroscopy combined with each index were 0.89,0.87 and 0.90,respectively,which were significantly higher than those indicators of each individual test(all P<0.05).Conclusion The combination of serum tumor markers and HP infection can be used as an early warning for gastroscope screening of gastric cancer.