摘要
目的分析检测血清胃蛋白酶原Ⅰ(PGⅠ)、胃蛋白酶原Ⅱ(PGⅡ)及胃泌素17(G-17)在胃癌及萎缩性胃炎中的诊断价值。方法选取接受胃镜检查的患者865例,其中浅表性胃炎患者339例作为浅表性胃炎组,萎缩性胃炎患者318例作为萎缩性胃炎组,胃癌患者208例作为胃癌组。采用酶联免疫吸附试验(ELISA)检测3组患者的血清G-17水平;采用胶乳免疫比浊法检测3组患者的血清PGⅠ、PGⅡ水平,并计算胃蛋白酶原比值(PGR);采用单纯取胃体组织做快速尿素酶测定(RUT)法和幽门螺旋杆菌(HP)尿素酶抗体检测试剂盒检测HP值。对3组患者的各指标进行比较,评价其诊断胃癌和萎缩性胃炎的价值。结果胃癌组患者的PGⅠ水平低于萎缩性胃炎组和浅表性胃炎组(P﹤0.05);萎缩性胃炎组和胃癌组患者的PGⅡ水平低于浅表性胃炎组(P﹤0.05);胃癌组患者的G-17水平高于浅表性胃炎组和萎缩性胃炎组(P﹤0.05);胃癌组患者的PGR值小于浅表性胃炎组和萎缩性胃炎组,萎缩性胃炎组患者的PGR值小于浅表性胃炎组(P﹤0.05)。PGⅠ和PGR检测胃癌的灵敏度分别为88.9%、86.9%,特异度分别为73.6%、59.4%;PGⅠ、PGR和G-17检测萎缩性胃炎的灵敏度分别为69.9%、70.8%、66.1%,特异度分别为49.8%、51.4%、64.2%。HP阳性患者的PGⅠ和PGⅡ水平均高于HP阴性患者,PGR值小于HP阴性患者(P﹤0.05)。结论血清检测PG水平的方法在诊断胃癌时的特异度和灵敏度均较高,是胃癌患者诊断的一个重要血清学指标,可用于胃癌的早期诊断。
Objective To analyze the value of serum PGⅠ, PGⅡ and G-17 in the diagnosis of gastric carcinoma and atrophic gastritis. Method 865 patients who underwent gastroscopy were enrolled in the study, in which there were 339 cases of superficial gastritis, 318 cases of atrophic gastritis, and 208 cases of gastric cancer. ELISA was used to detect the serum G-17 levels in the three groups, and latex immunoturbidimetry was utilized to detect the serum PGⅠ and PGⅡ level,and the PGR value was calculated; rapid urease test（RUT） was performed with gastric tissues and HP urease antibody detection kit was applied to detect HP value. The indexes stated above in the three groups were compared, and the diagnostic value was evaluated. Result The level of PGⅠ in gastric cancer patients was significantly lower than those with atrophic gastritis and superficial gastritis（P〈0.05）; atrophic gastritis patients had lower PGⅡ than those with superficial gastritis; gastric cancer patients were observed with higher G-17 levels compared with superficial gastritis and atrophic gastritis patients（P〈0.05）; gastric cancer group had the lowest PGR in the three groups, and the PGR in atrophic gastritis group was less than that in superficial gastritis group（P〈0.05）. The sensitivity of PGⅠ and PGR in detection of gastric cancer were 88.9%, 86.9%, with specificity being 73.6% and 59.4%, respectively; as for PGⅠ, PGR and G-17, the sensitivity for diagnosing atrophic gastritis were 69.9%, 70.8%, and 66.1%, the specificity were 49.8%, 51.4% and 64.2%, respectively.The levels of PGⅠ and PGⅡ in HP positive patients were higher, while the PGR value was lower than those with negative HP（P〈0.05）. Conclusion The detection of serum PG is of high sensitivity and specificity in the diagnosis of gastric cancer, and are important serological markers for the early diagnosis of gastric cancer.
出处
《癌症进展》
2017年第6期654-656,共3页
Oncology Progress
