血清胃蛋白酶原、胃泌素-17联合检测筛查社区人群HP现症感染的临床价值

The clinical value of combined detection of serum pepsinogen and gastrin-17 in the screening of current HP infection in community population

目的 :探讨血清胃蛋白酶原(pepsinogen, PG)、胃泌素-17(gastrin-17, G-17)联合筛查对预测幽门螺杆菌(helicobacter pylori, HP)现症感染的临床价值。方法 :选取社区人群1 820人,将^(13)C呼气试验阳性判定为HP阳性组,阴性为HP阴性组。检测所有患者的血清PGⅠ、PGⅡ及G-17水平,并计算PGⅠ与PGⅡ比值(PGⅠ/PGⅡratio, PGR)。采用受试者工作特征(receiver operating characteristic, ROC)曲线评估各项指标判断HP现症感染的价值。结果:PGⅠ、PGⅡ、PGR、G-17、PGⅠ+PGⅡ、PGⅠ+PGⅡ+G-17判断HP感染的曲线下面积(area under the curve, AUC)分别为0.679、0.852、0.747、0.628、0.858和0.858,PGⅠ、PGⅡ、PGR和G-17的最佳临界值分别为88.85 ng/mL、9.25 ng/mL、2.05和1.35 pmol/L。结论 :单项PGⅡ检测对判断HP现症感染有一定价值,PG(PGⅠ+PGⅡ)与PG联合G-17具有同等预测价值,从卫生经济学角度单独PG联合检测更占优势,更适宜在社区人群中推广。

Objective:To explore the clinical value of combined screening of serum pepsinogen(PG)and gastrin-17(G-17)in predicting current infections of helicobacter pylori(HP).Methods:A total of 1820 patients from the community were selected,and the result of^(13)C breath test was positive and judged as HP positive group,while negative was judged as HP negative group.The serum PGⅠ,PGⅡand G-17 levels of all patients were detected,and PGⅠ/PGⅡratio(PGR)was calculated.The receiver operating characteristic(ROC)curve was used to evaluate the value of various indicators to judge the current HP infection.Results:The area under the curve(AUC)of PGⅠ,PGⅡ,PGR,G-17,PGⅠ+PGⅡ,PGⅠ+PGⅡ+G-17 for judging HP infection were 0.679,0.852,0.747,0.628,0.858 and 0.858.The best cut-off values of PGⅠ,PGⅡ,PGR and G-17 are88.85 ng/mL,9.25 ng/mL,2.05 and 1.35 pmol/L.Conclusion:A single PGⅡtest has certain value in judging the current HP infection.PG(PGⅠ+PGⅡ)and PG combined with G-17 have the same predictive value.From the perspective of health economics,the single PG combined test has more advantages and is more suitable for promotion in the community.