新型胃癌筛查评分系统在早期胃癌及癌前病变中的筛查价值

The value of new scoring system for gastric cancer screening in screening early gastric cancer and precancerous lesions

目的探讨早期胃癌及癌前病变运用新型胃癌筛查评分系统的价值。方法832例由于如腹胀、腹痛、黑便、早饱、恶心、呕吐、嗳气等各类胃肠道症状在本院完成胃蛋白酶原(PG)、血清胃泌素-17(G-17)、幽门螺杆菌(Hp)抗体检查等及完成内镜检查并在内镜检查中钳取组织标本行病理检查的患者,根据新型胃癌筛查评分系统的评分结果分为高危组(82例)、中危组(224例)、低危组(526例)。对三组患者进行内镜下精查。比较三组胃癌、癌前病变、癌前疾病的检出情况。结果高危组筛查出阳性67例(81.7%),其中早期胃癌8例(9.8%),进展期胃癌4例(4.9%),癌前病变15例(18.3%),癌前疾病40例(48.8%);中危组筛查出阳性143例(63.8%),其中早期胃癌3例(1.3%),进展期胃癌14例(6.3%),癌前病变20例(8.9%),癌前疾病106例(47.3%);低危组筛查出阳性233例(44.3%),其中早期胃癌1例(0.2%),进展期胃癌8例(1.5%),癌前病变44例(8.4%),癌前疾病180例(34.2%)。三组早期胃癌、进展期胃癌、癌前病变、癌前疾病检出率比较,差异均具有统计学意义(P<0.05)。结论应用新型胃癌筛查评分系统能够提升就医患者的早期胃癌和癌前病变的检出率,值得应用推广。

Objective To discuss the value of new scoring system for gastric cancer screening in screening early gastric cancer and precancerous lesions.Methods Due to various gastrointestinal symptoms such as abdominal distension,abdominal pain,black stool,early satiety,nausea,vomiting,belching,832 patients who completed the antibody examination of pepsinogen(PG),serum gastrin-17(G-17),and Helicobacter pylori(Hp),as well as the endoscopic examination,during which tissue specimens were collected for pathological examination.They were divided into high-risk group(82 cases),medium-risk group(224 cases)and low-risk group(526 cases)according to the scoring results of new gastric cancer screening scoring system.Patients in the three groups were examined under endoscopy to compare the detection of gastric cancer,precancerous lesions and precancerous diseases among the three groups.Results In high-risk group,67 cases(81.7%)were positive,including 8 cases(9.8%)of early gastric cancer,4 cases(4.9%)of advanced gastric cancer,15 cases(18.3%)of precancerous lesions and 40 cases(48.8%)of precancerous diseases.In the medium-risk group,143 cases(63.8%)were positive,including 3 cases(1.3%)of early gastric cancer,14 cases(6.3%)of advanced gastric cancer,20 cases(8.9%)of precancerous lesions,and 106 cases(47.3%)of precancerous diseases.In the low-risk group,233 cases(44.3%)were positive,including 1 case(0.2%)of early gastric cancer,8 cases(1.5%)of advanced gastric cancer,44 cases(8.4%)of precancerous lesions,and 180 cases(34.2%)of precancerous diseases.There were statistically significant differences in the detection rates of early gastric cancer,advanced gastric cancer,precancerous lesion and precancerous disease among the three groups(P<0.05).Conclusion The application of the new scoring system for gastric cancer screening can improve the detection rate of early gastric cancer and precancerous lesions in patients,which is worthy of application and promotion.