摘要
目的探讨胃蛋白酶原(PG)联合同型半胱氨酸(Hcy)检测对胃组织良恶性病变的诊断价值。方法收集2014年1月至2016年8月我院收治的100例胃癌患者为胃癌组,100例胃良性病变患者(41例胃炎、25例胃息肉、34例胃溃疡)为胃良性病变组,选取同期我院健康体检者200例为对照组。采用酶联免疫吸附法(ELISA)测定三组受检者的血清PG(PGⅠ、PGⅡ)水平并计算胃蛋白酶原率(PGR),循环酶法测定三组受检者的血清Hcy水平,并计算血清PG联合Hcy对胃良性病变及胃癌的诊断价值。结果胃癌组、胃良性病变组血清PGⅠ水平分别为(59.37±14.16)μg/L、(93.85±14.23)μg/L,PGR分别为(3.27±1.52)、(7.65±2.04),均低于对照组的(149.92±13.34)μg/L、(11.40±1.95),差异均有统计学意义(P<0.05);胃癌组、胃良性病变组血清PGⅡ水平分别为(20.18±4.59)μg/L、(16.06±5.87)μg/L,Hcy水平分别为(26.37±3.85)μmol/L、(12.16±3.91)μmol/L,均高于对照组的(10.71±5.15)μg/L、(9.83±3.24)μmol/L,差异均有统计学意义(P<0.05);胃癌组血清PGⅠ水平、PGR低于胃良性病变组,血清PGⅡ、Hcy水平高于胃良性病变组,差异均有统计学意义(P<0.05)。在TNM分期Ⅰ、Ⅱ、Ⅲ、Ⅳ时,血清Hcy水平分别为(19.64±4.98)μmol/L、(22.00±5.14)μmol/L、(24.38±5.97)μmol/L、(27.07±4.52)μmol/L,呈递增趋势,整体比较差异有统计学意义(P<0.05),PG I水平分别为(67.63±15.91)μg/L、(55.39±15.18)μg/L、(46.18±14.97)μg/L、(39.72±15.50)μg/L,PGⅡ水平分别为(18.02±3.97)μg/L、(17.25±4.25)μg/L、(16.34±4.50)μg/L、(15.38±4.12)μg/L,PGR分别为(3.87±2.28)、(3.38±2.56)、(2.76±3.31)、(2.02±3.54),均呈递减趋势,整体比较差异均有统计学意义(P<0.05)。PGⅠ+PGR+Hcy对胃癌诊断的灵敏度、特异性、阳性预测值、阴性预测值及准确率分别为89.00%、95.00%、94.68%、89.62%、92.00%,均高于PG I+PGR的76.00%、83.00%、81.72%、77.57%、79.50%以及Hcy的71.00%、86.00%、83.53%、74.78%、78.50%,差异均有统计学意义(P<0.05)。结论血清PG、Hcy可有效评估胃黏膜的疾病状态,两指标联合有助于早期鉴别诊断胃良性病变和胃癌,提高对胃癌的诊断价值。
Objective To explore the diagnostic value of pepsinogen（PG） combined with homocysteine（Hcy）detection on benign and malignant lesions of gastric tissue. Methods A total of 100 patients with gastric cancer, who admitted to our hospital from January 2014 to August 2016, were selected as the gastric cancer group, and 100 patients with benign lesions（41 cases of gastritis, 25 cases of gastric polyps, 34 cases of gastric ulcer） were selected as the benign lesions group. Besides, 200 healthy persons who were inspected in our hospital during the same period were selected as the control group. The serum PG（PG Ⅰ, PGⅡ） levels of three groups were detected by the enzyme-linked immunosorbent assay（ELISA）, and the rate of pepsinogen（PGR） was calculated. The serum levels of Hcy of the three groups were determined by cyclic enzyme assay, and the value of serum PG combined with Hcy in the diagnosis of benign and malignant gastric lesions was evaluated. Results The serum PGⅠ levels and PGR levels of the gastric cancer group and benign lesions group were（59.37±14.16） μg/L,（3.27±1.52）,（93.85±14.23） μg/L,（7.65±2.04）, respectively, which were significantly lower than（149.92±13.34） μg/L and（11.40±1.95） of the control group（P0.05）. The serum PGⅡ levels and Hcy levels in the gastric cancer group and benign lesion group were（20.18±4.59） μg/L,（26.37±3.85） μmol/L,（16.06±5.87） μg/L,（12.16±3.91） μmol/L, respectively, which were significantly higher than（10.71±5.15） μg/L and（9.83±3.24） μmol/L in the control group（P0.05）. The levels of serum PGⅠ and PGR in the gastric cancer group were significantly lower than those in the benign lesions group, and the levels of serum PGⅡ and Hcy in the gastric cancer group were significantly higher than those in the benign lesions group（all P0.05）. At Ⅰ, Ⅱ, Ⅲ, Ⅳ of tumor, nodes, metastasis（TNM） stage, the serum Hcy levels were（19.64±4.98） μmol/L,（22.00±5.14） μmol/L,（24.38±5.97） μmol/L,（27.07±4.52） μmol/L, respectively,which showed an increased tendency, and the overall difference was statistically significant（P0.05）; PGⅠ levels were respectively（67.63±15.91） μg/L,（55.39±15.18） μg/L,（46.18±14.97） μg/L,（39.72±15.50） μg/L, PGⅡ levels were respectively（18.02±3.97） μg/L,（17.25±4.25） μg/L,（16.34±4.50） μg/L,（15.38±4.12） μg/L, and PGR levels were respectively（3.87±2.28）,（3.38±2.56）,（2.76±3.31）,（2.02±3.54）, which all showed a decreased trendency, with statistically significant overall differences（P0.05）. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of PGⅠ＋PGR＋Hcy in the diagnosis of gastric cancer were 89.00%, 95.00%, 94.68%, 89.62%, 92.00%, respectively, which were significantly higher than those of PGⅠ＋PGR（76.00%, 83.00%, 81.72%, 77.57%, 79.50%, respectively） and Hcy（71.00%, 86.00%, 83.53%, 74.78%, 78.50%, respectively）（P0.05）. Conclusion Serum PG and Hcy can be used to evaluate the disease state of gastric mucosa. The combination of the two indexes is helpful for the early diagnosis of benign gastric lesions and gastric cancer, which can be used to improve the diagnostic value of gastric cancer.
出处
《海南医学》
CAS
2017年第8期1274-1277,共4页
Hainan Medical Journal
基金
河北省2014年度石家庄市科学技术研究与发展指导计划项目(编号:141462833)
关键词
胃蛋白酶原
同型半胱氨酸
胃良性病变
胃癌
诊断价值
Pepsinogen（PG）
Homocysteine（Hcy）
Benign gastric lesions
Gastric cancer
Diagnostic value
