胃蛋白酶原、胃泌素-17、幽门螺旋杆菌IgG抗体及CA72-4检测在胃癌筛查中的临床意义

Clinical significance of Pepsinogen,gastrin-17,Helicobacter pylori IgG antibody and CA72-4 detection in gastric cancer screening

目的:分析血清中胃蛋白酶原、胃泌素-17、幽门螺旋杆菌Ig G抗体及CA72-4检测在胃癌筛查中的临床价值。方法:收集广东医科大学附属医院2017年3月~2018年3月门诊及住院因胃部不适就诊的病例共196例,经胃镜检查及病理确诊分为胃炎组87例、胃癌组67例和对照组(即正常人群组)42例。分析比较各组间血清胃蛋白酶原Ⅰ(PGⅠ)、胃蛋白酶原Ⅱ(PGⅡ)、PGR(PGⅠ/PGⅡ)、胃泌素-17(G-17)、CA72-4水平的差异及幽门螺旋杆菌Ig G抗体阳性率。结果:胃蛋白酶原Ⅰ、PGR的水平,从高到低依次是对照组、胃炎组、胃癌组。在对照组、胃炎组、胃癌组3组中胃蛋白酶原Ⅰ含量分别为(118.32±32.168)μg/L、(105.39±32.50)μg/L、(48.41±23.62)μg/L;PGR的水平分别为11.72±3.39、8.49±3.42、4.56±1.25。CA72-4表达水平从高到低依次是胃癌组、胃炎组、对照组;含量分别为(54.39±79.41)U/ml、(8.92±7.31)U/ml、(3.09±1.67)U/ml。按照幽门螺旋杆菌Ig G抗体阳性率排序,从高到低依次是胃癌组、胃炎组、对照组;阳性率依次为86.5%、31.1%、4.7%。各组间胃蛋白酶原Ⅰ、PGR、CA72-4及幽门螺旋杆菌Ig G抗体阳性率对比,差异均有统计学意义(P<0.05)。胃泌素-17结果显示对照组低于胃癌组,差异具有统计学意义(P<0.05)。在胃癌诊断中,PGⅠ、PGⅡ、PGR、G-17、CA72-4灵敏度分别是69.37%、57.35%、71.32%、70.45%、67.15%;特异度分别为73.22%、65.81%、68.67%、73.23%、80.37%。结论:血清胃蛋白酶原、G-17、幽门螺旋杆菌Ig G抗体及CA72-4的检测可以较好地区分胃癌患者、胃炎患者及正常人群。在胃癌诊断中PGR的高灵敏度与CA72-4的高特异度对胃癌的早期筛查有重要意义,结合胃镜及病理检查有利于提高胃癌患者的检出率。

Objective To observe and analyze the clinical value of serum propepsin,gastrin-17,Helicobacter pylori Ig G antibody and CA72-4 in the screening of gastric cancer.Method 196 cases of outpatients and hospitalization in Guangdong Medical University Affiliated Hospital from March 2017 to March 2018 were divided into 87 cases of gastritis group,67 cases of gastric cancer group and 42 cases of control group(normal group)by gastroscopy and pathological diagnosis.The differences in the levels of pepsinogen(PGⅠ),pepsinogenⅡ(PGⅡ),PGR(PGⅠ/PGⅡ),gastrin-17,CA72-4 and the positive rate of Ig G antibodyin Helicobacter pylori were analyzed and compared.Results The levels of pepsinogenⅠand PGR from high to low were in the control group,gastritis group,and gastric cancer group.In the three groups of the control group,gastritis group and gastric cancer group,the content of pepsinogenⅠwas(118.32±32.168)μg/L、(105.39±32.50)μg/L、(48.41±23.62)μg/L;and the levels of PGR were 11.72±3.39、8.49±3.42、4.56±1.25,respectively.The expression level of CA72-4 from high to low was gastric cancer group,gastritis group and control group.The contents were(54.39±79.41)U/ml,(8.92±7.31)U/ml,(3.09±1.67)U/ml,respectively.According to the positive rate of Ig G antibody of Helicobacter pylori,from high to low,it was gastric cancer group,gastritis group and control group.The positive rates were 86.5%,31.1%and4.7%,respectively.The positive rates of pepsinogenⅠ,PGR,CA72-4 and Helicobacter pylori Ig G antibody in each group were statistically different(P<0.05).In the gastric cancer,the sensitivity of PGⅠ,PGⅡ,PGR,G-17 and CA72-4 were69.37%,57.35%,71.32%,70.45%and 67.15%,respectively,and the specificity was 73.22%,65.81%,68.67%,73.23%and 80.37%,respectively.Conclusion The detection of serum pepsinogen,gastrin-17,Helicobacter pylori Ig G antibody and CA72-4 can be better divided into gastric cancer patients,gastritis patients and normal population.It is of great significance for early screening of gastric cancer.It can be used as an index for early screening,which is beneficial to improve the detection rate of gastric cancer patients.