胃蛋白酶原、胃泌素17与胃癌前病变进展风险的纵向研究

Longitudinal Study on the Relationship between Pepsinogen, Gastrin-17 and the Risk of Gastric Precancerous Lesions

目的:探讨血清胃蛋白酶原I、II (pepsinogen, PGI、II)与胃泌素-17 (gatrin-17, G-17)在胃癌前病变中的诊断价值。方法:选择2018年1月~10月有消化道症状患者98例,根据胃镜检查及病理结果分为胃溃疡组(32例)、萎缩性胃炎组(21例)、肠上皮化生组(25例)、低级别上皮内瘤变组(20例),选取同期30例非萎缩性胃炎者作为对照组。应用ELISA法检测比较五组血清PGI、PGII、胃蛋白酶原比值(PGR即PGI/PGII比值)、G-17水平。结果:胃溃疡组PGI、PGII水平明显高于萎缩性胃炎组、肠上皮化生组、低级别上皮内瘤变组及对照组,差异有统计学意义(P 0.05)。萎缩性胃炎组、肠上皮化生组、低级别上皮内瘤变组中PGI、PGR值低于对照组,差异有统计学意义(P 0.05)。萎缩性胃炎组、肠上皮化生组、低级别上皮内瘤变组与对照组PGII比较无统计学意义(P 】0.05)。萎缩性胃炎组血清G-17水平与对照组比较,差异无统计学意义(P 】0.05);胃溃疡组、肠上皮化生组、低级别内瘤变组血清G-17均显著高于对照组与萎缩性胃炎组,差异有统计学意义(P 0.05)。结论:血清PGI、PGII、PGR以及G-17的变化对胃癌前病变进展风险有一定的临床价值,值得我们深入研究。

Objective: To explore the diagnostic value of serum pepsinogen and gastrin-17 in precancerous lesions of gastric cancer. Methods: From January to October 2018, 98 patients with digestive tract symptoms were divided into three groups according to gastroscopy and pathology: gastric ulcer group (n = 32), atrophic gastritis group (n = 21), intestinal metaplastic group (n = 25) and low grade intraepithelial neoplastic group (n = 20). In the same period, 30 healthy subjects were selected as the control group. ELISA method was used to detect and compare the levels of serum PGI, PGII and PGR, G-17 in the five groups. Results: The level of PGI, PGII in gastric ulcer group was significantly higher than that in atrophic gastritis group, intestinal metaplastic group, low grade intraepithelial neoplastic group and control group (P 0.05). PGI and PGR values in atrophic gastritis group, intestinal epithelial metaplasia group and low-grade intraepithelial neoplasia group were lower than those in control group (P 0.05). There was no significant difference in PGII between atrophic gastritis group, intestinal metaplastic group and low grade intraepithelial neoplastic group compared with the control group (P >0.05). There was no significant difference in serum G-17 level between atrophic gastritis group and control group (P >0.05), but the serum G-17 level in gastric ulcer group, intestinal metaplastic group and low grade intratumor group was significantly higher than that in control group and atrophic gastritis group (P 0.05). Conclusions: The changes of serum PGI, PGII, PGR and G-17 have certain clinical value in the diagnosis of precancerous lesions of gastric cancer, which is worthy of further study.