原发性胃癌患者血清中胃蛋白酶原、胃泌素-17水平及其与肿瘤恶性程度的相关性

Correlation of serum pepsinogen and gastrin levels and tumor malignancy in patients with primary gastric cancer

目的测定原发性胃癌患者血清内胃蛋白酶原(PG)、胃泌素-17(G17)水平,并分析其与肿瘤恶性程度的相关性,为临床诊治提供可靠依据。方法将2019年1月至2020年1月北大医疗鲁中医院诊治的155例原发性胃癌患者作为研究组,并以同期到本院体检的100例健康志愿者作为对照组,所有研究对象均取晨起外周静脉血检测,对比分析血清PGⅠ、PGⅡ、G17水平,并计算PGⅠ/PGⅡ(PGR),并分析不同阶段、不同TNM分期胃癌患者的指标水平,绘制受试者工作特征(ROC)曲线,分析上述指标在胃癌诊断中效能。结果研究组PGⅠ、PGR显著低于对照组(P<0.05),血清G17水平显著高于对照组,PGⅡ水平差异无统计学意义(P>0.05)。基于肿瘤灶进展情况,进展期患者血清PGⅠ、PGR显著低于早期胃癌患者(P<0.05),而血清G17水平高于早期胃癌患者(P<0.05)。基于肿瘤TNM分期,血清PGⅠ水平随分期增高而显著降低(P<0.05),血清G17则显著增高(P<0.05)。通过绘制ROC曲线,表明血清PGⅠ、PGⅡ、PGR、G17联合检测诊断胃癌效能优于单一指标,联合检测曲线下面积(AUC)最高,灵敏度和特异度分别是83.87%、76.77%。结论血清PGⅠ、PGR及G17表达水平和原发性胃癌恶性程度存在相关性,且联合检测诊断原发性胃癌具有良好效能,有着重要临床价值。

Objective The serum levels of pepsinogen(PG)and gastrin 17(G17)in patients with primary gastric cancer were determined,and the correlation between them and the degree of tumor malignancy was analyzed to provide a reliable basis for clinical diagnosis and treatment.Methods The study group included 155 patients with primary gastric cancer treated in Peking University(PKU)Care Luzhong Hospital from January 2019 to January 2020,and with the same period to the hospital physical examination of 100 cases of healthy volunteers as control group.Peripheral venous blood samples were taken from all subjects for detection,and serum PGⅠ,PGⅡ,G17 level were compared and analyzed,and PGⅠ/PGⅡ(PGR)was calculated.The indexes of gastric cancer patients in different stages and tumor node metastasis(TNM)stages were analyzed,and the receiver operating characteristic(ROC)curve was drawn to analyze the efficacy of the above indicators in the diagnosis of gastric cancer.Results The levels of PGⅠand PGR in the study group were significantly lower than those in the control group(P<0.05),and the serum level of G17 was significantly higher than that of the control group,while the difference of PGⅡlevel was not statistically significant(P>0.05).Based on the progress of tumor focus,serum PGⅠand PGR in patients with advanced gastric cancer were significantly lower than those in patients with early gastric cancer(P<0.05),while serum G17 level were higher in patients with early gastric cancer(P<0.05).Based on TNM stage,serum PGⅠlevel decreased significantly with the increase of tumor stage(P<0.05),while serum G17 level increased significantly(P<0.05).The ROC curve showed that the combined detection of serum PGⅠ,PGⅡ,PGR and G17 was superior to single index in the diagnosis of gastric cancer.The area under curve(AUC)of combined detection was the highest,with sensitivity and specificity of 83.87%and 76.77%,respectively.Conclusions The expression levels of serum PGⅠ,PGR and G17 are correlated with the degree of malignancy of primary gastric cancer.Moreover,combined detection and diagnosis of primary gastric cancer has good efficacy and important clinical value.