血清胃蛋白酶原、胃泌素17、幽门螺旋杆菌感染联合检测诊断早期胃癌的价值

The value of combined detection of serum pepsinogen,gastrin 17,and Helicobacter pylori infection in the diagnosis of early gastric cancer

[目的]探究血清胃蛋白酶原(PG)、胃泌素17(G-17)以及幽门螺旋杆菌(Hp)感染联合检测在诊断早期胃癌中的价值。[方法]选取确诊为早期胃癌的15例患者(早期胃癌组)、慢性浅表性胃炎组患者(30例)和萎缩性胃炎组患者(30例)作为研究对象;对比分析所有患者血清中PGⅠ、PGⅡ、PG(PGⅠ/PGⅡ)以及G-17水平差异及Hp阳性情况,分析上述指标差异变化与早期胃癌的相关性。[结果]萎缩性胃炎组血清中PGⅠ、PG水平明显低于且PGⅡ、G-17水平明显高于慢性浅表性胃炎组(P<0.05);早期胃癌组血清中PGⅠ、PG水平明显低于且PGⅡ、G-17水平明显高于慢性浅表性胃炎组和萎缩性胃炎组(均P<0.05)。萎缩性胃炎组Hp阳性率明显高于慢性浅表性胃炎组患者(P<0.05),但低于早期胃癌组患者(P<0.05);早期胃癌组患者Hp阳性率明显高于慢性浅表性胃炎组患者(P<0.05);采用Logistic多元回归方法分析,最终进入回归的变量示喜食腌制食品、胃溃疡个人史、Hp阳性率、PG、G-17为胃癌发生的危险因素。PGⅠ、PGⅡ、PG、G-17、Hp诊断早期胃癌的AUC分别为0.701、0.682、0.728、0.627、0.681,联合检测诊断早期胃癌的AUC为0.898。[结论]PG、G-17以及Hp感染的联合检测在早期胃癌筛查具有一定价值,可作为临床筛查早期胃癌的方法之一。

[Objective]To explore the value of combined detection of serum pepsinogen(PG),gastrin 17(G-17)and Helicobacter pylori(Hp)infection in the diagnosis of early gastric cancer.[Methods]Total 15 patients diagnosed with early gastric cancer in the Gastroenterology Department of our hospital from August 2018 to August 2021 were recruited as the research objects.The patients with chronic superficial gastritis group(30 cases)and atrophic gastritis group(30 cases)were recruited as control group.The PGⅠ,PGⅡ,PG(PGⅠ/PGⅡ),G-17 levels in serum of and Hp infection status were detected,and the correlation between the changes of the above indicators and early gastric cancer were analyzed.[Results]The serum levels of PGⅠ and PG in the atrophic gastritis group were significantly lower than those in the chronic superficial gastritis group(P<0.05),and the levels of PGⅡ and G-17 were significantly higher than those in the chronic superficial gastritis group(P<0.05).The serum levels of PGⅠ and PG in the gastric cancer group were significantly lower than those in the other two groups(P<0.05),and the levels of PGⅡ and G-17 were significantly higher than those in the other two groups(P<0.05).Comparing theHppositive rates among the three groups,the difference was statistically significant(P<0.05).The positive rate of Hp in the atrophic gastritis group was significantly higher than that of patients in the chronic superficial gastritis group(P<0.05),but lower than that of patients in the early gastric cancer group(P<0.05).The positive rate of Hp in the early gastric cancer group was significantly higher than that in the chronic superficial gastritis group(P<0.05).The logistic multiple regression method was used to analyze,and finally entered the regression variable.Preference for pickled foods,personal history of gastric ulcers,Hp positive rate,PG,and G-17 were the risk factors for gastric cancer.The AUC of PGⅠ for diagnosis of early gastric cancer was 0.701.The AUC of PGⅡ for diagnosis of early gastric cancer was 0.682.The AUC of PG for diagnosis of early gastric cancer was 0.728.The AUC of G-17 for diagnosis of early gastric cancer was 0.627,and the AUC of Hp for diagnosis of early gastric cancer was 0.681.The AUC of combined detection for early gastric cancer diagnosis was 0.898.[Conclusion]The combined detection of PG,G-17 and Hp infection has certain value in the screening of early gastric cancer,and can be used as one of the methods for clinical screening of early gastric cancer.