血清胃泌素17、胃蛋白酶原、γ-突触核蛋白检测在老年消化道早癌、癌前病变诊断中的应用

Application of serum G-17,PG and SNCG in the diagnosis of early gastrointestinal cancer and precancerous lesions in elderly patients

目的分析血清胃泌素17(G-17)、胃蛋白酶原I(PG I)、胃蛋白酶原II(PG II)、γ-突触核蛋白(SNCG)检测在老年消化道早癌、癌前病变诊断中的应用价值。方法选取我院198例老年早期胃癌及癌前病变患者,均经内窥镜检查与病理证实,分为早癌组与癌前病变组,并取同期50例老年胃镜良性病变者为胃镜良性病变组,检测其血清G-17、PG I、PG II及SNCG水平,进行相关性分析,并采用受试者工作特征(ROC)曲线分析G-17、PG I/PG II联合SNCG对早期胃癌及癌前病变诊断效能。结果早癌组血清G-17、SNCG水平显著高于其余两组,且癌前病变组高于胃镜良性病变组(P<0.05);早癌组血清PG I水平、PG I/PG II显著低于其余两组,且癌前病变组显著低于胃镜良性病变组(P<0.05);PG I与G-17、SNCG呈负相关(P<0.05),G-17与SNCG呈正相关(P<0.05);ROC曲线分析显示,四项联合诊断敏感度为93.4%、特异度为96.0%,曲线下面积(AUC)为0.987,大于G-17、PG I、PG I/PG II及SNCG单独诊断(0.960、0.824、0.810、0.961)。结论血清G-17、PG I、PG I/PG II联合SNCG检测对老年早期胃癌及癌前病变具有较高诊断效能。

Objective To analyze the application value of serum gastrin 17(G-17),pepsinogen I(PG I),pepsinogen II(PG II)and gamma-synuclein(SNCG)in the diagnosis of elderly patients with early gastrointestinal cancer and precancerous lesions.Methods A total of 198 elderly patients with early gastric cancer and precancerous lesions confirmed by endoscopy and pathology were selected.They were divided into an early cancer group and a precancerous lesion group.Meanwhile,50 patients with benign gastric lesions were selected as a benign lesion group.Serum G-17,PG I,PG II and SNCG levels were detected,and correlation analysis was performed.The receiver operating characteristic(ROC)curve analysis was used to analyze the diagnostic efficiency of joint detection of above indicators for early gastric cancer and precancerous lesions.Results Serum levels of G-17,PG II and SNCG in the early cancer group were significantly higher than those in the other two groups(P<0.05),and the levels in the precancerous lesion group were significantly higher than those in the benign lesion group(P<0.05).Serum PG I level and PG I/PG II in the early cancer group were significantly lower than those in the other two groups(P<0.05),and the two indicators in the precancerous lesion group were significantly lower than those in the benign lesion group(P<0.05).PG I was negatively correlated with G-17 and SNCG(P<0.05),and G-17 was positively correlated with SNCG(P<0.05).ROC curve analysis showed that the sensitivity,specificity and area under the curve(AUC)of joint detection of the four indicators were 93.4%,96.0%and 0.987,respectively.The AUC was larger than that of G-17,PG I,PG I/PG II or SNCG alone(0.960,0.824,0.810 and 0.961).Conclusions The joint detection of serum G-17,PG I,PG I/PG II and SNCG can achieve high diagnostic efficiency for elderly patients with early gastric cancer and precancerous lesions.