血清G-17、PGⅠ、PGⅡ在Hp阳性体检者胃部病变筛查中的应用价值

Application value of serum gastrin 17,pepsinogenⅠ,and pepsinogenⅡin the screening of gastric lesions in Helicobacter pylori positive patients

目的研究血清胃泌素17(G-17)、胃蛋白酶原Ⅰ(PGⅠ)、胃蛋白酶原Ⅱ(PGⅡ)在幽门螺杆菌(Hp)阳性体检者胃部病变筛查中的应用价值。方法选择2019年1~12月在广东省第二中医院行胃镜检查的1026例受检者为研究对象。按照Hp血清抗体试验结果,将342例Hp阳性者设为研究组,684例Hp阴性者设为对照组;再按照检查结果,将研究组分为胃部疾病组101例和非胃部疾病组241例。采用酶联免疫吸附试验法和乳胶增强免疫比浊法检测所有受检者的血清G-17、PGⅠ、PGⅡ水平,比较研究组和对照组受检者的血清学检查指标;采用Spearmen秩相关性分析法分析Hp感染与血清学检查结果的相关性;比较胃部疾病组与非胃部疾病组受检者的上述血清学检查指标;采用受试者工作特征曲线(ROC)分析Hp感染联合G-17、PGⅠ、PGⅡ对胃部病变初筛的价值。结果研究组受检者的PGⅠ、PGⅡ、PGⅠ/PGⅡ指标分别为(58.17±16.19)μg/L、(18.62±3.16)μg/L、(7.03±1.76),明显低于对照组的(94.45±25.03)μg/L、(22.96±3.78)μg/L、(16.51±3.83),G-17为(18.63±4.74)pmol/L,明显高于对照组的(11.29±3.91)pmol/L,差异均有统计学意义(P<0.05);Hp阳性与G-17水平呈正相关(r=0.637,P<0.05),与PGⅠ、PGⅡ水平呈负相关(r=-0.501、-0.582,P<0.05);胃部疾病组受检者的G-17水平明显高于非胃部疾病组,PGⅠ、PGⅠ/PGⅡ水平明显低于非胃部疾病组,差异均有统计学意义(P<0.05);Hp感染联合G-17、PGⅠ、PGⅡ初筛胃部病变的灵敏度和特异度分别为80.30%、84.90%,明显高于Hp感染单独筛查的73.20%和41.50%,差异均有统计学意义(P<0.05)。结论血清G-17、PGⅠ、PGⅡ在Hp阳性体检者胃部病变筛查中具有临床应用价值。

Objective To study the application value of serum gastrin 17(G-17),pepsinogenⅠ(PGⅠ),and pepsinogenⅡ(PGⅡ)in the screening of gastric lesions in Helicobacter pylori(Hp)positive patients.Methods A total of 1026 subjects who underwent gastroscopy in Guangdong Second Traditional Chinese Medicine Hospital from January 2019 to December 2019 were selected as the research objects.According to the Hp serum antibody test results,the subjects were divided into the Hp positive study group(n=342),and the Hp negative control group(n=684).According to the examination results,the study group was divided into the gastric disease group(n=101)and the non-gastric disease group(n=241).The levels of serum G-17,PGⅠ,and PGⅡin all subjects were detected by enzyme-linked immunosorbent assay and latex enhanced immunoturbidimetry,and the serological examination results of the subjects in the study group and the control group were compared(PGⅠ,PGⅡ,G-17,PGⅠ/PGⅡ).Spearman rank correlation analysis was used to analyze the correlation between Hp infection and serological examination results.The serological examination results of gastric disease group and non-gastric disease group were compared and analyzed.Receiver operating characteristic curve(ROC)was used to analyze the value of Hp infection combined with G-17,PGⅠ,and PGⅡin screening gastric lesions.Results The indexes of PGⅠ,PGⅡ,and PGⅠ/PGⅡin the study group were(58.17±16.19)μg/L,(18.62±3.16)μg/L,7.03±1.76,which were significantly lower than(94.45±25.03)μg/L,(22.96±3.78)μg/L,16.51±3.83of the control group,while the level of G-17 was(18.63±4.74)pmol/L,significantly higher than(11.29±3.91)pmol/L of the control group(P<0.05).Hp positive was positively correlated with the level of G-17(r=0.637,P<0.05),and negatively correlated with the levels of PGⅠand PGⅡ(r=-0.501,-0.582,P<0.05).The levels of G-17 in gastric disease group were significantly higher than those in non-gastric disease group,and the levels of PGⅠand PGⅠ/PGⅡwere significantly lower than those in non-gastric disease group,with statistically significant differences(P<0.05).The sensitivity and specificity of Hp infection combined with G-17,PGⅠ,and PGⅡfor screening gastric lesions were80.30%and 84.90%,respectively,which were significantly higher than 73.20%and 41.50%of Hp infection alone(P<0.05).Conclusion Serum G-17,PGⅠ,and PGⅡhave high application value in the screening of gastric lesions in Hp positive patients,which is worthy of clinical application.