血清胃蛋白酶原、促胃液素-17在胃癌前期病变筛查中的应用价值
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摘要
目的探讨血清胃蛋白酶原(PG)、促胃液素-17(G-17)在胃癌前期病变筛查中的应用价值。方法选择门诊初步诊断为慢性胃炎患者216例为研究对象。检测血清PGⅠ、PGⅡ以及G-17的水平,胃镜及活检观察胃黏膜萎缩、肠化及上皮内瘤变,同时检测不同可操作的与胃癌风险联系的胃炎评估(OLGA)分期和不同可操作的与胃癌风险联系的肠化生评估(OLGIM)分期患者血清PGⅠ、PGⅡ、G-17水平。结果胃黏膜萎缩120例,肠上皮化生93例,上皮内瘤变45例。有胃黏膜萎缩的、有肠化生的患者血清PGⅠ、G-17水平明显较低,差异均有统计学意义(t分别=2.10、9.96、2.39、10.41,P均<0.05)。全胃上皮内瘤变PGⅠ、G-17水平明显低于无上皮内瘤变的患者,差异均有统计学意义(t分别=8.23、5.26,P均<0.05)。随着OLGA和OLGIM分期的增加,血清PGⅠ、G-17水平呈逐渐下降的趋势,差异均有统计学意义(F分别=3.39、14.88、6.05、14.46,P均<0.05),其中OLGA分期和OLGIM分期的Ⅲ期、Ⅳ期患者血清PGⅠ、G-17水平明显低于0期患者(t分别=7.39、12.88、8.05、11.46,P均<0.05),而不同OLGA和OLGIM分期的PGⅡ水平比较,差异均无统计学意义(F分别=0.23、0.79,P均>0.05)。结论血清PGⅠ、G-17水平在胃癌前病变筛查中具有较高的诊断价值。
Objective To explore the application value of serum levels of pepsinogen and gastrin-17(G-17) in screening of precancerous lesions of gastric cancer. Methods Totally 216 cases with chronic gastritis were selected as the research subjects.The serum levels of pepsinogen(PG)Ⅰ,PG Ⅱ and G-17 were detected.The gastroscopy and biopsy were performed to observe atrophy of gastric mucosa,intestinal metaplasia and intraepithelial neoplasia.Serum levels of PG Ⅰ,PG Ⅱ and G-17 in patients with different OLGA and OLGIM stages were also examined. Results There were120 cases of gastric mucosal atrophy,93 cases of intestinal metaplasia and 45 cases of intraepithelial neoplasia.Serum levels of PG Ⅰand G-17 in patients with gastric mucosal atrophy or intestinal metaplasia were significantly lower than those in patients without atrophy or without intraepithelial neoplasia(t=2.10,9.96,2.39,10.41,P<0.05).Serum levels of PGⅠand G-17 in patients with full stomach intraepithelial neoplasia were significantly lower than those in patients with no intraepithelial neoplasia(t=8.23,5.26,P<0.05).With the increasing stage of OLGA and OLGIM,serum PG Ⅰ and G-17 levels were gradually decreased(F=3.39,14.88,6.05,14.46,P<0.05).Serum levels of PG Ⅰ and G-17 in stage Ⅲ and stage Ⅳ patients were significantly lower than those in stage 0(t =7.39,12.88,8.05,11.46,P<0.05).There was no significant differences in PGⅡ level among different stages of OLGA as well as OLGIM(F=0.23,0.79,P>0.05). Conclusion Serum levels of PG Ⅰand G-17 have high diagnostic value in the screening of gastric precancerous lesions.
Objective To explore the application value of serum levels of pepsinogen and gastrin-17(G-17) in screening of precancerous lesions of gastric cancer. Methods Totally 216 cases with chronic gastritis were selected as the research subjects.The serum levels of pepsinogen(PG)Ⅰ,PG Ⅱ and G-17 were detected.The gastroscopy and biopsy were performed to observe atrophy of gastric mucosa,intestinal metaplasia and intraepithelial neoplasia.Serum levels of PG Ⅰ,PG Ⅱ and G-17 in patients with different OLGA and OLGIM stages were also examined. Results There were120 cases of gastric mucosal atrophy,93 cases of intestinal metaplasia and 45 cases of intraepithelial neoplasia.Serum levels of PG Ⅰand G-17 in patients with gastric mucosal atrophy or intestinal metaplasia were significantly lower than those in patients without atrophy or without intraepithelial neoplasia(t=2.10,9.96,2.39,10.41,P<0.05).Serum levels of PGⅠand G-17 in patients with full stomach intraepithelial neoplasia were significantly lower than those in patients with no intraepithelial neoplasia(t=8.23,5.26,P<0.05).With the increasing stage of OLGA and OLGIM,serum PG Ⅰ and G-17 levels were gradually decreased(F=3.39,14.88,6.05,14.46,P<0.05).Serum levels of PG Ⅰ and G-17 in stage Ⅲ and stage Ⅳ patients were significantly lower than those in stage 0(t =7.39,12.88,8.05,11.46,P<0.05).There was no significant differences in PGⅡ level among different stages of OLGA as well as OLGIM(F=0.23,0.79,P>0.05). Conclusion Serum levels of PG Ⅰand G-17 have high diagnostic value in the screening of gastric precancerous lesions.
引文
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6 张贺军,金珠,崔荣丽,等.OLGA分期、分级评估系统在胃镜活检组织病理学评价中的应用[J].中华消化内镜杂志,2014,31(3):121-125.
2 吴静,田梅,俞刚.血清胃蛋白酶原与体重指数间的相关性用于胃癌高危人群筛查的价值[J].中国卫生检验杂志,2017,27(22):3253-3254.
3 王江红,项颖.早期胃癌的筛查现状及诊断进展[J].重庆医学,2009,38(20):2634-2636.
4 彭廷勇,何熙国,周琮凯.血清LXA4、G17及SF联合检测胃癌的临床诊断价值[J].标记免疫分析与临床,2017,24(9):1007-1010.
5 何坚,石兴珍.血清胃蛋白酶原Ⅰ、Ⅱ和促胃液素-17在萎缩性胃窦炎诊断中的意义[J].宁夏医科大学学报,2016,38(4):453-456.
6 张贺军,金珠,崔荣丽,等.OLGA分期、分级评估系统在胃镜活检组织病理学评价中的应用[J].中华消化内镜杂志,2014,31(3):121-125.