血清PGR、G-17、TK1、RHBDD1联合幽门螺杆菌抗体对萎缩性胃炎与早期胃癌的鉴别价值研究

Differential Value Study of Serum PGR,G-17,TK1,RHBDD1 Combined with Helicobacter Pylori Antibody in Atrophic Gastritis and Early Gastric Cancer

目的:研究血清胃蛋白酶原比值(PGR)、胃泌素-17(G-17)、胸苷激酶1(TK1)、菱形结构域蛋白1(RHBDD1)联合幽门螺杆菌抗体(HP-IgG)对萎缩性胃炎与早期胃癌的鉴别价值。方法:选取2018年1月~2021年12月我院收治的202例早期胃癌患者,记作胃癌组。另选取同期萎缩性胃炎和健康体检志愿者各200例,记作萎缩性胃炎组及对照组。检测并比较三组血清胃蛋白酶原(PG)Ⅰ、PGⅡ、PGR、G-17、TK1、RHBDD1水平以及HP-IgG阳性率。比较早期胃癌HP-IgG阳性及阴性患者血清PGⅠ、PGⅡ、PGR、G-17、TK1、RHBDD1水平。采用受试者工作特征(ROC)曲线分析血清PGR、G-17、TK1、RHBDD1水平联合HP-IgG鉴别早期胃癌与萎缩性胃炎的效能。结果:胃癌组血清PGⅠ、PGR水平均低于萎缩性胃炎组及对照组,且萎缩性胃炎组上述指标水平均低于对照组(均P<0.05);胃癌组血清PGⅡ、G-17、TK1、RHBDD1水平以及HP-IgG阳性率均高于萎缩性胃炎组及对照组,且萎缩性胃炎组上述指标水平均高于对照组(均P<0.05)。早期胃癌HP-IgG阳性患者血清PGⅠ、PGR均低于HP-IgG阴性患者,而血清PGⅡ、G-17、TK1、RHBDD1水平均高于HP-IgG阴性患者(均P<0.05)。经ROC曲线分析发现,血清PGR、G-17、TK1、RHBDD1水平以及HP-IgG抗体联合鉴别早期胃癌与萎缩性胃炎的效能优于上述五项指标单独鉴别。结论:早期胃癌患者血清PGR存在异常低表达,而血清G-17、TK1、RHBDD1以及HP-IgG抗体存在异常高表达,联合上述五项指标鉴别早期胃癌与萎缩性胃炎的价值较高。

Objective:To study the differential value of serum pepsinogen ratio(PGR),gastrin-17(G-17),thymidine kinase 1(TK1),rhomboid domain protein 1(RHBDD1)combined with Helicobacter pylori antibody(HP-IgG)in atrophic gastritis and early gastric cancer.Methods:A total of 202 patients with early gastric cancer who were admitted to our hospital from January 2018 to December 2021 were selected and classified as gastric cancer group.In addition,200 cases of chronic atrophic gastritis and 200 cases of healthy volunteers in the same period were selected and recorded as atrophic gastritis group and control group.The levels of serum pepsinogen(PG)I,PG II,PGR,G-17,TK1,RHBDD1 and the positive rate of HP-IgG were detected and compared among the three groups.The levels of serum PG I,PG II,PGR,G-17,TK1 and RHBDD1 between HP-IgG positive and negative patients with early gastric cancer were compared.Receiver operating characteristic(ROC)curve was used to analyze the efficacy of the levels of serum PGR,G-17,TK1,RHBDDI combined with HP-IgG in the differential diagnosis of early gastric cancer and atrophic gastritis.Results:The levels of serum PG I and PGR in gastric cancer group were lower than those in atrophic gastritis group and control group,and the above indexes in atrophic gastritis group were lower than those in control group(all P<0.05).The levels of serum PG II,G-17,TK1,RHBDD1 and the positive rate of HP-IgG in gastric cancer group were higher than those in atrophic gastritis group and control group,and the above indexes in atrophic gastritis group were higher than those in control group(all P<0.05).The serum PG I and PGR of HP-IgG positive patients with early gastric cancer were lower than those of HP-IgG negative patients,while the levels of serum PG II,G-17,TK1 and RHBDD1 were higher than those of HP-IgG negative patients(all P<0.05).ROC curve analysis showed that the combination of serum PGR,G-17,TK1,RHBDD1 and HP-IgG antibody was better than the above five indicators alone in differentiating early gastric cancer from atrophic gastritis.Conclusion:The serum PGR of patients with early gastric cancer is abnormally low,while the serum G-17,TK1,RHBDD1 and HP-IgG antibodies are abnormally high.The combination of the above five indicators has a high value in differentiating early gastric cancerfrom atrophicgastritis.