胃蛋白酶原及幽门螺杆菌抗体检测在早期胃癌筛查中的价值

The value of pepsin and helicobacter pylori detection in early gastric cancer screening

目的 :探讨胃蛋白酶原(PG)水平及幽门螺杆菌免疫球蛋白抗体G(HP IgG)在早期胃癌筛查中的应用价值,以期为临床诊疗提供科学参考。方法 :选取我院2016年01月~2017年12月63例于我院接受治疗的早期胃癌患者作为观察组,另选取71例同期于我院体检的健康人群作为对照组;观察并比较两组患者血清PGⅠ、PGⅡ和PGⅠ/PGⅡ(PGR)水平和HP IgG抗体阳性率;采用受试者工作曲线(ROC)曲线分析血清PGⅠ、PGⅡ和PGR在早期胃癌中的诊断价值;比较HP IgG抗体阳性组和HP IgG抗体阴性组血清PGⅠ、PGⅡ和PGR水平。结果 :观察组患者血清PGⅠ和PGR水平显著低于对照组,观察组患者血清PGⅡ水平显著高于对照组,观察组患者HP IgG抗体阳性率(82.54%52/63 VS 28.17%20/71)显著高于对照组,差异具有统计学意义;ROC曲线分析显示:血清PGⅠ在诊断早期胃癌的最佳阈值为66.32μg/L,其敏感性为83.10%,特异性为76.19%;血清PGⅡ在诊断早期胃癌的最佳阈值为21.53μg/L,其敏感性为77.46%,特异性为73.02%;PGR在诊断早期胃癌的最佳阈值为4.137,其敏感性为87.32%,特异性为79.37%;HP IgG抗体阳性组患者血清PGⅠ和PGR水平显著低于HP IgG抗体阴性组,HP IgG抗体阳性组患者血清PGⅡ水平显著高于HP IgG抗体阴性组,差异具有统计学意义。结论 :血清PGⅠ、PGⅡ、PGR和HP IgG抗体检测对早期胃癌筛查具有较好的应用价值,可为临床早期胃癌诊断提供参考。

Objective Our study was aimed toanalyze the application value of pepsin(PG)level and helicobacter pylori immunoglobulin antibody in early gastric cancer screening in order to provide reference for clinical treatment.Methods Clinical data of 63 patients with early gastric carcinoma received treatment at our hospitalfrom January 2016 to December 2017 were analyzed as observation group and 71 healthy cases were enrolled as control group.Observe and compare the serum PGⅠ,PGⅡand PGⅠ/PGⅡ(PGR)levels and HP IgG antibody positive rate in the two groups.Analyze the diagnosis value of the serum PGⅠ,PGⅡand PGR by ROC cure.Compare the serum PGⅠ,PGⅡand PGR levels in the HP IgG antibody positive group and HP IgG antibody negative group.Results The serum PGⅠand PGR of the observation group were significantly lower than the control group.And the serum PGⅡof the observation group were significantly higher than the control group,The positive rate of HP IgG antibody in the observation group(82.54%52/63 VS 28.17%20/71)was significantly higher than that in the control group,The difference was statistically significant.ROC curve analysis showed that the PGⅠcut-off point value of 66.32μg/L,as used for the diagnosis of the early gastric carcinoma,provided a sensitivity of 77.46%,a specificity of 73.02%;PGR cut-off point value of4.137,as used for the diagnosis of the early gastric carcinoma,provided a sensitivity of 87.32%,a specificity of 79.37%;the serum PGⅠand PGR in the HP IgG antibody positive groups were significantly lower than the HP Ig G antibody negative groups,serum PGⅡin the HP IgG antibody positive patients were significantly higher than HP IgG antibody negative groups,statistically significant difference.Conclusion Serum PGⅠ,PGⅡ,PGR,and HP IgG antibody detection has good application value in early gastric cancer screening and can provide reference for early clinical diagnosis of gastric cancer.