PG、MG7-Ag联合G-17检测对胃癌前病变、胃癌的诊断及鉴别诊断

Diagnosis and differential diagnosis of PG,MG7-Ag combined with G-17detection for gastric precancerous lesions and gastric cancer

目的分析胃蛋白酶原(PG)、胃癌单克隆抗体(MG7-Ag)联合胃泌素-17(G-17)检测对胃癌前病变、胃癌的诊断价值。方法收集2018年6月至2019年1月本院收治符合纳入标准的胃癌患者126例设为胃癌组,依据组织病理学肿瘤细胞不同分化程度将分为高分化组(n=38)、中分化组(n=52)及低分化组(n=36),同时选取同期本院正常健康体检者51例(健康对照组)、胃癌前病变患者112例(胃癌前病变组),胃癌前病变组再次分为浅表性胃炎组(n=38)、胃溃疡组(n=46)、慢性萎缩性胃炎组(n=28)。比较不同人群PG、MG7-Ag、G-17指标水平,计算HP阳性感染率,对比不同检测对胃癌前病变、胃癌的诊断效能。结果胃癌组MG7-Ag、G-17表达水平高于胃癌前病变组、健康对照组,差异具有统计学意义(P<0.05),胃癌前病变组PGⅠ、PGR表达水平显著高于健康对照组、胃癌组,胃癌组PGR水平显著低于胃癌前病变组、健康对照组,差异均具有统计学意义(P<0.05)。低分化组MG7-Ag高于高分化、中分化组,高分化组G-17水平显著低于中分化组、低分化组,差异均具有统计学意义(P<0.05);高、中、低分化胃癌患者PGⅠ、PGⅡ、PGR水平比较差异无统计学意义(P>0.05)。慢性萎缩性胃炎组G-17、PGR、PGⅠ水平显著低于浅表性胃炎组、胃溃疡组,浅表性胃炎组PGⅡ低于其余两组,差异均具有统计学意义(P<0.05)。胃癌组HP阳性率高于胃癌前病变组,差异具有统计学意义(P<0.05)。PG+G-17+MG7-Ag+HP检测胃癌、浅表性胃炎、胃溃疡、慢性萎缩性胃炎特异度、灵敏度显著高于单一检测(P<0.05)。结论 PG、MG7-Ag及G-17与胃癌疾病发生、进展存在一定联系,通过检测上述指标水平,可有效综合评估患者病情,联合检测可提高诊断灵敏度、特异度。

Objective To analyze the diagnostic value of pepsinogen(PG),MG-Antigen7-Ag(MG7-Ag)combined with gastrin-17(Gastrin-17,G-17)detection for gastric precancerous lesions and gastric cancer.Methods 126 patients with gastric cancer who met the inclusion criteria were collected from June 2018 to January 2019 and set as the gastric cancer group.According to the different differentiation levels of histopathological tumor cells,they will be divided into a highly differentiated group(n=38)and a moderately differentiated group(n=52)and poorly differentiated group(n=36).At the same time,51 cases with normal healthy physical examination in this hospital(healthy control group)and 112 cases with gastric precancerous lesions(superficial gastritis group)were selected.Patients in the gastric precancerous lesion group were again divided into superficial gastritis group(n=38),gastric ulcer group(n=46),and chronic atrophic gastritis group(n=28).The indicator levels of PG,MG7-Ag,and G-17 ih different populations were compared,the HP positive infection rate was calculated,and the diagnostic efficiency of different tests for gastric precancerous lesions and gastric cancer were compared.Results The expression levels of MG7-Ag and G-17 in the gastric cancer group were higher than those in the gastric precancerous lesion group and the healthy control group(P<0.05).The expression levels of PGⅠand PGR in the gastric precancerous lesion group were significantly higher than those in the healthy control group and gastric cancer group.The PGR level in the gastric cancer group was significantly lower than that in the gastric precancerous lesion group and the healthy control group.The difference between the groups was statistically significant(P<0.01).MG7-Ag in the low differentiation group was higher than that in the high differentiation group and moderate differentiation group.and the G-17 level in the high differentiation group was significantly lower than that in the moderate differentiation group and low differentiation group(P<0.05).There was no significant difference in the levels of PGⅠ,PGⅡand PGR among patients with high,medium and low differentiation of gastric cancer(P>0.05).The levels of G-17,PGR and PGⅠin the chronic atrophic gastritis group were significantly lower than those in the superficial gastritis group and gastric ulcer group.The PGⅡin the superficial gastritis group was low than that in the other two groups(P<0.05).The positive rate of HP in the gastric cancer group was higher than in the gastric precancerous lesion group(P<0.05).The specificity and sensitivity of PG+G-17+MG7-Ag+HP in detecting gastric cancer,superficial gastritis,gastric ulcer and chronic atrophic gastritis were significantly higher than those of single test(P<0.05).Conclusion PG,MG7-Ag and G-17 are related to the occurrence and progression of gastric cancer.The detection of the above indicators can effectively evaluate the patient s condition,and the combined detection can improve the sensitivity and specificity of diagnosis.