胃蛋白酶原联合放大染色内镜在早期胃癌诊断中的应用
|
摘要
目的探讨以乳胶增强免疫比浊法测定的血清胃蛋白酶原(PG)Ⅰ、PGⅡ以及PGⅠ/ PGⅡ比值在胃癌筛查中的价值,并比较胃蛋白酶原各种检测方法的优缺点,以及联合人工智能电子染色内镜(Fice)在早期胃癌中的诊断价值。
方法全部患者行胃蛋白酶原普查,如发现异常者,即行普通胃镜检查,普通胃镜下发现可疑病变者(如溃疡、胃癌、息肉等)再以人工智能电子染色内镜+靶向活检,最后明确病变。根据组织病理学及胃镜检查结果,将受检者分为7组。胃溃疡组79例、慢性胃炎(慢性萎缩性胃炎及慢性胃炎伴轻、中度瘤变)组138例、早期胃癌组22例、进展期胃癌组90例、胃癌手术治疗前后组59例、胃癌术后复发组16例、消化道其他疾病75例。确定胃良性病变的PGⅠ及PGⅡ、PGⅠ/ PGⅡ比值参考值范围,并与正常对照组相比较。比较慢性胃炎与胃癌,早期胃癌与进展期胃癌,胃癌术前术后PGⅠ及PGⅡ、PGⅠ/ PGⅡ的变化。
结果胃良性溃疡组患者血清PGⅠ及PGⅡ相比对照组升高, PGⅠ/ PGⅡ比值降低(P<0.05)。慢性胃炎组相比对照组PGⅠ下降, PGⅡ升高,PGⅠ/ PGⅡ比值降低。胃癌患者血清PGⅠ及PGⅠ/ PGⅡ比值较慢性胃炎组均显著降低(P<0.05),其中早期胃癌与进展期胃癌组相比PGⅠ及PGⅠ/ PGⅡ比值均无显著差异(P>0.05)。胃癌患者手术后PGⅠ及PGⅡ值均降低,PGⅠ/ PGⅡ比值升高(P<0.05)。胃癌复发时血清PGⅠ及PGⅠ/ PGⅡ比值亦升高(P<0.05)。结合FICE技术对早期胃癌早诊率达80%。
结论确定以乳胶增强免疫比浊法测定的血清PG水平在不同程度胃黏膜病变的筛选价值,可作为大规模人群胃癌的普查手段,无创,便于推广;胃蛋白酶原联合放大染色内镜可提高早期胃癌诊断率。
Objective To evaluate the use of latex-enhanced immunotur- bidimetry of serum tests: serum PGⅠ,PGⅡ, PGⅠ/PGⅡratio screen of gastric cancer,and compared pepsinogen advantages and disadvantages of various detection methods, and judge the value of uniting fuji intelligent color enhancement (Fice) in the diagnosis of early gastric cancer.
Methods All patients were censused by pepsinogen, as if we discovery people whose pepsinogen were abnormal , they were requested normal endoscopy examine, normal endoscopic suspicious lesions (such as ulcers, stomach cancer, polyps, etc.) then use fuji intelligent color enhancement and endoscopic biopsy targeting, and finally clear lesions.
These patients were divided into 7 groups based on endoscopic and histopathological findings: 79 in gastric ulcers group, 138 in chronic gastritis group (chronic atrophic gastritis and chronic gastritis with mild to moderate neoplasia), 22 in early gastric cancer group, 90 in advanced gastric cancer group, 59 in beforing and aftering gastric surgery group, 16 in gastric cancer recurrence group, 75 in other diseases of digestive tract.and 85 served as control group. Identify benign lesions of the PGⅠand PGⅡ, PG Ⅰ/ PGⅡratio of the reference range, and compared with the control group.Compare chronic gastritis and gastric cancer, early gastric cancer and gastric cancer, gastric cancer after preoperative PGⅠand PGⅡ, PGⅠ/ PGⅡchanges.
Results Patients with benign gastric ulcer group PGⅠand PGⅡhigher than the control group, PGⅠ/ PGⅡratio decreased (P <0.05).PGⅠand PGⅠ/ PGⅡratio values decreased in Chronic gastritis than the control group,but PGⅡincreased, Gastric cancer patients with PGⅠand PGⅠ/ PGⅡratio of Chronic gastritis were significantly lower (P <0.05), which early gastric cancer and advanced gastric cancer group compared with PGⅠand PGⅠ/ PGⅡratio were not significantly different (P> 0.05).Patients after gastritis surgery PGⅠand PGⅡvalues were lower, PGⅠ/ PGⅡratio increased (P <0.05). Recurrence of gastric cancer serum PGⅠand PGⅠ/ PGⅡratio also increased (P <0.05).Combined with FICE technique we can increase early diagnosis of early gastric cancer with 80%.
Conclusions The use of latex-enhanced immunoturbidimetry of serum tests: serum PGⅠ, PGⅡ, PGⅠ/PGⅡratio to screen of Gastric Cancer have impotant application value. As a means of large-scale population survey of gastric cancer, non-invasive, easy to promotion. Pepsinogen combine with fuji intelligent color enhancement can improve the rate of early gastric cancer diagnosis.
方法全部患者行胃蛋白酶原普查,如发现异常者,即行普通胃镜检查,普通胃镜下发现可疑病变者(如溃疡、胃癌、息肉等)再以人工智能电子染色内镜+靶向活检,最后明确病变。根据组织病理学及胃镜检查结果,将受检者分为7组。胃溃疡组79例、慢性胃炎(慢性萎缩性胃炎及慢性胃炎伴轻、中度瘤变)组138例、早期胃癌组22例、进展期胃癌组90例、胃癌手术治疗前后组59例、胃癌术后复发组16例、消化道其他疾病75例。确定胃良性病变的PGⅠ及PGⅡ、PGⅠ/ PGⅡ比值参考值范围,并与正常对照组相比较。比较慢性胃炎与胃癌,早期胃癌与进展期胃癌,胃癌术前术后PGⅠ及PGⅡ、PGⅠ/ PGⅡ的变化。
结果胃良性溃疡组患者血清PGⅠ及PGⅡ相比对照组升高, PGⅠ/ PGⅡ比值降低(P<0.05)。慢性胃炎组相比对照组PGⅠ下降, PGⅡ升高,PGⅠ/ PGⅡ比值降低。胃癌患者血清PGⅠ及PGⅠ/ PGⅡ比值较慢性胃炎组均显著降低(P<0.05),其中早期胃癌与进展期胃癌组相比PGⅠ及PGⅠ/ PGⅡ比值均无显著差异(P>0.05)。胃癌患者手术后PGⅠ及PGⅡ值均降低,PGⅠ/ PGⅡ比值升高(P<0.05)。胃癌复发时血清PGⅠ及PGⅠ/ PGⅡ比值亦升高(P<0.05)。结合FICE技术对早期胃癌早诊率达80%。
结论确定以乳胶增强免疫比浊法测定的血清PG水平在不同程度胃黏膜病变的筛选价值,可作为大规模人群胃癌的普查手段,无创,便于推广;胃蛋白酶原联合放大染色内镜可提高早期胃癌诊断率。
Objective To evaluate the use of latex-enhanced immunotur- bidimetry of serum tests: serum PGⅠ,PGⅡ, PGⅠ/PGⅡratio screen of gastric cancer,and compared pepsinogen advantages and disadvantages of various detection methods, and judge the value of uniting fuji intelligent color enhancement (Fice) in the diagnosis of early gastric cancer.
Methods All patients were censused by pepsinogen, as if we discovery people whose pepsinogen were abnormal , they were requested normal endoscopy examine, normal endoscopic suspicious lesions (such as ulcers, stomach cancer, polyps, etc.) then use fuji intelligent color enhancement and endoscopic biopsy targeting, and finally clear lesions.
These patients were divided into 7 groups based on endoscopic and histopathological findings: 79 in gastric ulcers group, 138 in chronic gastritis group (chronic atrophic gastritis and chronic gastritis with mild to moderate neoplasia), 22 in early gastric cancer group, 90 in advanced gastric cancer group, 59 in beforing and aftering gastric surgery group, 16 in gastric cancer recurrence group, 75 in other diseases of digestive tract.and 85 served as control group. Identify benign lesions of the PGⅠand PGⅡ, PG Ⅰ/ PGⅡratio of the reference range, and compared with the control group.Compare chronic gastritis and gastric cancer, early gastric cancer and gastric cancer, gastric cancer after preoperative PGⅠand PGⅡ, PGⅠ/ PGⅡchanges.
Results Patients with benign gastric ulcer group PGⅠand PGⅡhigher than the control group, PGⅠ/ PGⅡratio decreased (P <0.05).PGⅠand PGⅠ/ PGⅡratio values decreased in Chronic gastritis than the control group,but PGⅡincreased, Gastric cancer patients with PGⅠand PGⅠ/ PGⅡratio of Chronic gastritis were significantly lower (P <0.05), which early gastric cancer and advanced gastric cancer group compared with PGⅠand PGⅠ/ PGⅡratio were not significantly different (P> 0.05).Patients after gastritis surgery PGⅠand PGⅡvalues were lower, PGⅠ/ PGⅡratio increased (P <0.05). Recurrence of gastric cancer serum PGⅠand PGⅠ/ PGⅡratio also increased (P <0.05).Combined with FICE technique we can increase early diagnosis of early gastric cancer with 80%.
Conclusions The use of latex-enhanced immunoturbidimetry of serum tests: serum PGⅠ, PGⅡ, PGⅠ/PGⅡratio to screen of Gastric Cancer have impotant application value. As a means of large-scale population survey of gastric cancer, non-invasive, easy to promotion. Pepsinogen combine with fuji intelligent color enhancement can improve the rate of early gastric cancer diagnosis.
引文
[1] Wang C S,Hsuch S,Choco T C,et a1.Prognostic study of gastric cancer without serosal invasionl(J).J Am Coil Surg,2005,185:476-480.
[2]许国铭,姚银珍,田箐,等.鼻胃镜CGIF-N2307临床应用的初步报告.中华消化内镜杂志,2000,17(2):86.
[3]周丽雅,薛艳,林三仁,等.从25年间10万例胃镜结果分析胃病演变.胃病临床新视野,沈阳出版社, 2005年第一版:143.
[4]朱继良,余彩云,袁华斌.胃镜检查30276例分析.中华腹部疾病杂志,2006.6(10):735
[5]李玉明,刘丽艳,季颖琳,等.经鼻胃镜检查10000例临床应用价值分析.第九届国际治疗内镜和消化疾病学术会议论文汇编,2008,133.
[6]刘海峰放大胃镜和FICE技术在胃癌及癌前病变诊断中的应用[J].武警医学2007, 12(18):939-942.
[7]刘正新胃镜下胃癌的早期诊断和治疗.国际消化病杂志,2008,28(1):3-5.
[8]綦盛健,吴云林.早期胃癌筛检的标志物研究.早期胃肠肿瘤及消化病进展资料汇编,2010,90-91.
[9]宋振河,高孝忠,乔秀丽等.血清胃蛋白酶原检测对胃癌和萎缩性胃炎筛查的价值.中国实用期刊,2008,35(22):9-11.
[10]谷敬丽血清胃蛋白酶原检测在胃部疾病诊断中的意义(J).河南大学学报, 2007,26(4):46-48.
[11]宫月华,孙丽萍,袁媛.血清胃蛋白酶原及骨桥蛋白联合筛查胃癌的应用价值(J).中华肿瘤杂志2006,28(9):691-693.
[12]金晔,陈玥,苏建荣.胃良恶性溃疡治疗前后血清胃蛋白酶原含量变化的临床研究(J).北京医学2008 ,30(4):224-226.
[13]蒋叶华,黄飚,王翌,等.血清胃蛋白酶原与胃疾病相关性的分析(J).临床荟萃2007 22 (10): 689-691.
[14]黄映芳,彭孝纬,何利平,等.胃癌与十二指肠溃疡患者血清胃蛋白酶原比较(J).现代消化及介入诊疗,2006 ,11(2):61-63.
[15]何宝国,徐红,王立强.乳胶增强免疫比浊法测定血清胃蛋白酶原水平在胃癌筛查中的价值研究.中国内镜杂志,2009,15(2):135-139
[16]Parra-Blanco A, Fu KI,Nicolas-Perez D,et al.Is acetic acid really effective as a mucolytic agent for magnifying endoscopy diagnosis?[J]. Endoscopy,2007,39(10): 920-921.
[17]任建林张靖.放大内镜在胃部疾病诊断中的应用.国内讲堂,2007,1(4):10-14.
[18]Mukoubsyashi C, Yanaoka K, Ohata H, et al. Serum pepsinogen and gastric cancer screening[J].Internal Medicine,2007,46(6): 261-266.
[19]姜泊染色内镜及放大内镜下胃肠早期癌的现代诊治.现代消化及介入诊疗, 2001,6(4):1-6.
[20]Correa P .Human gastric carcinogenesis :Muhistep and muhifactodal process [J].Cancer Res,1992,52(24):6735-6 742.
[21]Samloff IM. Elevated serum pepsinogenⅠandⅡleveal differs risk facter for duodenal ulcer and gastric ulcer [J]. Gastroenterlolgy,1986, 90(3): 570- 576.
[22]蒋孟军,肖志坚,张荣军,等。血清胃蛋白酶原Ⅰ、Ⅱ与胃泌素联合检测对胃癌诊断的临床意义(J).标记免疫分析与临床,2004;11:131.
[23]Gritti I,Banfi G,Roi GS.Pepsinogens:physiology,pharmacology pathophysiology and exercise.Pharmacol Res 2000;41:265-281.
[24]Foster C,Aktar A,Kopf D,Zhang P,Guttentag S.Pepsinogen C:a type 2 cell-specific protease.Am J Physiol Lung Cell Mol Physiol 2004;286:L382-387.
[25]周红凤,刘丹,吴瑾,等.胃蛋白酶原和胃癌相关抗原与胃癌的研究进展(J).世界华人消化杂志2007,15(17):1940-1946.
[26]王冠庭.胃癌癌前病变癌变机制及其逆转的研究进展[J].世界华人消化杂志,2000,8(1):1-4.
[27]Sipponen P, Kekki M, Haapakoski J, et al. Gastric cancer risk inchronic atrophic gastritis: statistical calculations of cross-sectional data[J]. Int J Cance, 1985, 35(2):173-177.
[28]Samloff IM.PepsinogensⅠandⅡ: purification from gastric mucosa and radioimmunoassay in serum.Gastroenterology 1982;82:26-33.
[29]Sipponen P,Harkonen M,Alanko A,Suovaniemi O.Diagnosis of atrophic gastritis from a serum sample.Clim Lab 2002;48:505-515.
[30]李红涛,吴开春,李彩宁,等.血清胃蛋白酶原诊断胃体黏膜萎缩的研究。中华内镜杂志,2004;43:141-142
[31]Kitahara F,Kobayashi K,Sato T,Kojima Y,Araki T,Fujino MA.Accuracy of screening for gastric cancer using serum pepsinogen concentrations.Cut 1999;44:693-697
[32]程兆明,张宇川,陈定驹,等.血清胃蛋白酶原亚群的放免测定对胃癌及其它胃部疾病的诊断意义.镇江医学院学报,2001;11:150-152.
[33]王书奎,王自正,夏伟,等.胃蛋白酶原免疫放射分析在胃癌诊断中的应用.中华核医学杂志,2003;23:124.
[34]Plummer M,Vivas J,Fauchere JL,et al.Helicobacter pylori and stomach cancer:acase- control study in Venezuela.Cancer Epidemiol Biomarkers Prev 2000;9:961-965.
[35]盛玉祥.胃蛋白酶原免疫放射分析在胃癌诊断中的意义.江苏医药杂志,2003; 29: 554.
[36]吕国强,肖志坚,沈安东,等。胃蛋白酶原亚群在胃癌及其术后血清含量变化的临床价值(J).中华消化杂志,1999;19:265-266.
[37]Osishi Y, Kiyohara Y, Kubo M, et al. The serum pepsinogen test as a predictor of gastric cancer[J]. American Journal of Epidemiology, 2006, 7(163): 629- 637.
[38]袁荣华,孙永强,翟晓峰,等.胃癌手术治疗前后血清胃蛋白酶原含量分析(J).交通医学,2009,23(2):139-140.
[39]Pellat-Deceunynck C,Barille S,Puthier D,et al.Adhesion molecules on human myelomacells:signigicant changes in expression related to malignancy,tumor spreading,and immortalization(J).Cancer Res,1995,55(16):3647-3653.
[40]戈之铮,李为光放大内镜及窄带成像技术在慢性胃炎诊断中的应用[J].现代消化及介入诊疗2007,12 (1):23-24.
[41]Dinis-Ribeiro M , da Costa-Pereira A , Lopes C ,et al . Gast roint-est Endosc,2003;57: 498-504.
[42]黄永辉,周丽雅,林三仁等.胃黏膜萎缩、肠上皮化生及异型增生的放大内镜表现及其诊断价值.中华消化内镜杂志,2005 ,22(4):231.
[43]吴巍,吴云林分光技术与FICE的临床应用[J].国内讲堂2008,2(2):45-48.
[44]钱丽佳,李玉明.放大内镜下人工智能电子染色及窄带成像技术在消化道早癌诊断中的应用.中国微循环,2009,13(6):621-623.
[45]于中麟,冀明,杨迅,等.血清胃蛋白酶原对胃癌普查的价值探讨(J).中华消化内镜杂志2008,25(10):512-515.
[46]仲敏,黄傲霜,殷泙,等.萎缩性胃炎内镜半定量诊断进展(J).中国消化内镜2009,3(1):1-5.
[1] Wang C S,HsuchS S,Choco T C,et a1.Prognostic study of gastric cancer without serosal invasionl(J).J Am Coil Surg,2005,185:476-480
[2]李春海加强肿瘤生物学标志的研究和评价(J).中华检验医学杂志2000 23 :6-8
[3]谷敬丽血清胃蛋白酶原检测在胃部疾病诊断中的意义(J).河南大学学报, 2007,26(4):46-48
[4] Gritti I,Banfi G,Roi GS.Pepsinogens:physiology,pharmacology pathophysiology and exercise.Pharmacol Res 2000;41:265-281
[5] Foster C,Aktar A,Kopf D,Zhang P,Guttentag S.Pepsinogen C:a type 2 cell-specific protease.Am J Physiol Lung Cell Mol Physiol 2004;286:L382-387
[6]李红梅,宁佩芳,袁媛.不同胃黏膜疾病胃蛋白酶原C组织原位表达与胃蛋白酶原血清学检测水平的比较(J).世界华人消化杂志2005 ,13(20):2473-2476
[7]宫月华,孙丽萍,袁媛.血清胃蛋白酶原及骨桥蛋白联合筛查胃癌的应用价值(J).中华肿瘤杂志2006 28(9):691-693
[8]金晔,陈玥,苏建荣.胃良恶性溃疡治疗前后血清胃蛋白酶原含量变化的临床研究(J).北京医学2008 ,30(4):224-226
[9]蒋叶华,黄飚,王翌,等.血清胃蛋白酶原与胃疾病相关性的分析(J).临床荟萃2007 22 (10): 689-691
[10]黄映芳,彭孝纬,何利平,等.胃癌与十二指肠溃疡患者血清胃蛋白酶原比较(J).现代消化及介入诊疗,2006 ,11(2):61-63
[11]陈智周,范振符.胃蛋白酶原Ⅰ、Ⅱ在早期胃癌普查中的意义(J).中华肿瘤杂志2002 ,24(1):1-3
[12]袁荣华,孙永强,翟晓峰,等.胃癌手术治疗前后血清胃蛋白酶原含量分析(J).交通医学,2009,23(2):139-140
[13]Kitahara F,Kobayashi K,Sato T,Kojima Y,Araki T,Fujino MA.Accuracy of screening for gastric cancer using serum pepsinogen concentrations.Cut 1999;44:693-697
[14]张祥宏,卜玉华,王俊灵,等.血清胃蛋白酶原异常居民胃粘膜变化的随访观察(J).中国肿瘤临床,2000;27:491-494
[15]蒋孟军,肖志坚,张荣军,等。血清胃蛋白酶原Ⅰ、Ⅱ与胃泌素联合检测对胃癌诊断的临床意义(J).标记免疫分析与临床,2004;11:131
[16]Kalinovskii VP,Gamaiunova VB,Shumakov AP.Khanson KP.Radioimmunoassay of serum pepsinogen I in chronic gastritis and stomachcancer.Vopr Onkol 2000;46: 153-155
[17]吕国强,肖志坚,沈安东,等。胃蛋白酶原亚群在胃癌及其术后血清含量变化的临床价值(J).中华消化杂志,1999;19:265-266
[18]于中麟,冀明,杨迅,等.血清胃蛋白酶原对胃癌普查的价值探讨(J).中华消化内镜杂志2008 ,25(10):512-515
[19]Yamaguchi T,Takahashi T,Yokota T,Kitamura K,Noguchi A,Kamiguchi M,AhnT,Sawai K,Yamane T.Urinary pepsinogen I as a tumor marker of stomach cancer after total gastrectomy.Cancer 1991;68:906-909
[20]Pellat-Deceunynck C,Barille S,Puthier D,et al.Adhesion molecules on human myeloma cells:signigicant changes in expression related to malignancy,tumor spreading,and immortalization(J).Cancer Res,1995,55(16):3647-3653
[21]金晔,陈玥,苏建荣.胃良恶性溃疡治疗前后血清胃蛋白酶原含量变化的临床研究(J).北京医学2008 ,30(4):224-226
[22]周红凤,刘丹,吴瑾,等.胃蛋白酶原和胃癌相关抗原与胃癌的研究进展(J).世界华人消化杂志2007,15(17):1940-1946
[23]仲敏,黄傲霜,殷泙,等.萎缩性胃炎内镜半定量诊断进展(J).中国消化内镜2009,3(1):1-5
[2]许国铭,姚银珍,田箐,等.鼻胃镜CGIF-N2307临床应用的初步报告.中华消化内镜杂志,2000,17(2):86.
[3]周丽雅,薛艳,林三仁,等.从25年间10万例胃镜结果分析胃病演变.胃病临床新视野,沈阳出版社, 2005年第一版:143.
[4]朱继良,余彩云,袁华斌.胃镜检查30276例分析.中华腹部疾病杂志,2006.6(10):735
[5]李玉明,刘丽艳,季颖琳,等.经鼻胃镜检查10000例临床应用价值分析.第九届国际治疗内镜和消化疾病学术会议论文汇编,2008,133.
[6]刘海峰放大胃镜和FICE技术在胃癌及癌前病变诊断中的应用[J].武警医学2007, 12(18):939-942.
[7]刘正新胃镜下胃癌的早期诊断和治疗.国际消化病杂志,2008,28(1):3-5.
[8]綦盛健,吴云林.早期胃癌筛检的标志物研究.早期胃肠肿瘤及消化病进展资料汇编,2010,90-91.
[9]宋振河,高孝忠,乔秀丽等.血清胃蛋白酶原检测对胃癌和萎缩性胃炎筛查的价值.中国实用期刊,2008,35(22):9-11.
[10]谷敬丽血清胃蛋白酶原检测在胃部疾病诊断中的意义(J).河南大学学报, 2007,26(4):46-48.
[11]宫月华,孙丽萍,袁媛.血清胃蛋白酶原及骨桥蛋白联合筛查胃癌的应用价值(J).中华肿瘤杂志2006,28(9):691-693.
[12]金晔,陈玥,苏建荣.胃良恶性溃疡治疗前后血清胃蛋白酶原含量变化的临床研究(J).北京医学2008 ,30(4):224-226.
[13]蒋叶华,黄飚,王翌,等.血清胃蛋白酶原与胃疾病相关性的分析(J).临床荟萃2007 22 (10): 689-691.
[14]黄映芳,彭孝纬,何利平,等.胃癌与十二指肠溃疡患者血清胃蛋白酶原比较(J).现代消化及介入诊疗,2006 ,11(2):61-63.
[15]何宝国,徐红,王立强.乳胶增强免疫比浊法测定血清胃蛋白酶原水平在胃癌筛查中的价值研究.中国内镜杂志,2009,15(2):135-139
[16]Parra-Blanco A, Fu KI,Nicolas-Perez D,et al.Is acetic acid really effective as a mucolytic agent for magnifying endoscopy diagnosis?[J]. Endoscopy,2007,39(10): 920-921.
[17]任建林张靖.放大内镜在胃部疾病诊断中的应用.国内讲堂,2007,1(4):10-14.
[18]Mukoubsyashi C, Yanaoka K, Ohata H, et al. Serum pepsinogen and gastric cancer screening[J].Internal Medicine,2007,46(6): 261-266.
[19]姜泊染色内镜及放大内镜下胃肠早期癌的现代诊治.现代消化及介入诊疗, 2001,6(4):1-6.
[20]Correa P .Human gastric carcinogenesis :Muhistep and muhifactodal process [J].Cancer Res,1992,52(24):6735-6 742.
[21]Samloff IM. Elevated serum pepsinogenⅠandⅡleveal differs risk facter for duodenal ulcer and gastric ulcer [J]. Gastroenterlolgy,1986, 90(3): 570- 576.
[22]蒋孟军,肖志坚,张荣军,等。血清胃蛋白酶原Ⅰ、Ⅱ与胃泌素联合检测对胃癌诊断的临床意义(J).标记免疫分析与临床,2004;11:131.
[23]Gritti I,Banfi G,Roi GS.Pepsinogens:physiology,pharmacology pathophysiology and exercise.Pharmacol Res 2000;41:265-281.
[24]Foster C,Aktar A,Kopf D,Zhang P,Guttentag S.Pepsinogen C:a type 2 cell-specific protease.Am J Physiol Lung Cell Mol Physiol 2004;286:L382-387.
[25]周红凤,刘丹,吴瑾,等.胃蛋白酶原和胃癌相关抗原与胃癌的研究进展(J).世界华人消化杂志2007,15(17):1940-1946.
[26]王冠庭.胃癌癌前病变癌变机制及其逆转的研究进展[J].世界华人消化杂志,2000,8(1):1-4.
[27]Sipponen P, Kekki M, Haapakoski J, et al. Gastric cancer risk inchronic atrophic gastritis: statistical calculations of cross-sectional data[J]. Int J Cance, 1985, 35(2):173-177.
[28]Samloff IM.PepsinogensⅠandⅡ: purification from gastric mucosa and radioimmunoassay in serum.Gastroenterology 1982;82:26-33.
[29]Sipponen P,Harkonen M,Alanko A,Suovaniemi O.Diagnosis of atrophic gastritis from a serum sample.Clim Lab 2002;48:505-515.
[30]李红涛,吴开春,李彩宁,等.血清胃蛋白酶原诊断胃体黏膜萎缩的研究。中华内镜杂志,2004;43:141-142
[31]Kitahara F,Kobayashi K,Sato T,Kojima Y,Araki T,Fujino MA.Accuracy of screening for gastric cancer using serum pepsinogen concentrations.Cut 1999;44:693-697
[32]程兆明,张宇川,陈定驹,等.血清胃蛋白酶原亚群的放免测定对胃癌及其它胃部疾病的诊断意义.镇江医学院学报,2001;11:150-152.
[33]王书奎,王自正,夏伟,等.胃蛋白酶原免疫放射分析在胃癌诊断中的应用.中华核医学杂志,2003;23:124.
[34]Plummer M,Vivas J,Fauchere JL,et al.Helicobacter pylori and stomach cancer:acase- control study in Venezuela.Cancer Epidemiol Biomarkers Prev 2000;9:961-965.
[35]盛玉祥.胃蛋白酶原免疫放射分析在胃癌诊断中的意义.江苏医药杂志,2003; 29: 554.
[36]吕国强,肖志坚,沈安东,等。胃蛋白酶原亚群在胃癌及其术后血清含量变化的临床价值(J).中华消化杂志,1999;19:265-266.
[37]Osishi Y, Kiyohara Y, Kubo M, et al. The serum pepsinogen test as a predictor of gastric cancer[J]. American Journal of Epidemiology, 2006, 7(163): 629- 637.
[38]袁荣华,孙永强,翟晓峰,等.胃癌手术治疗前后血清胃蛋白酶原含量分析(J).交通医学,2009,23(2):139-140.
[39]Pellat-Deceunynck C,Barille S,Puthier D,et al.Adhesion molecules on human myelomacells:signigicant changes in expression related to malignancy,tumor spreading,and immortalization(J).Cancer Res,1995,55(16):3647-3653.
[40]戈之铮,李为光放大内镜及窄带成像技术在慢性胃炎诊断中的应用[J].现代消化及介入诊疗2007,12 (1):23-24.
[41]Dinis-Ribeiro M , da Costa-Pereira A , Lopes C ,et al . Gast roint-est Endosc,2003;57: 498-504.
[42]黄永辉,周丽雅,林三仁等.胃黏膜萎缩、肠上皮化生及异型增生的放大内镜表现及其诊断价值.中华消化内镜杂志,2005 ,22(4):231.
[43]吴巍,吴云林分光技术与FICE的临床应用[J].国内讲堂2008,2(2):45-48.
[44]钱丽佳,李玉明.放大内镜下人工智能电子染色及窄带成像技术在消化道早癌诊断中的应用.中国微循环,2009,13(6):621-623.
[45]于中麟,冀明,杨迅,等.血清胃蛋白酶原对胃癌普查的价值探讨(J).中华消化内镜杂志2008,25(10):512-515.
[46]仲敏,黄傲霜,殷泙,等.萎缩性胃炎内镜半定量诊断进展(J).中国消化内镜2009,3(1):1-5.
[1] Wang C S,HsuchS S,Choco T C,et a1.Prognostic study of gastric cancer without serosal invasionl(J).J Am Coil Surg,2005,185:476-480
[2]李春海加强肿瘤生物学标志的研究和评价(J).中华检验医学杂志2000 23 :6-8
[3]谷敬丽血清胃蛋白酶原检测在胃部疾病诊断中的意义(J).河南大学学报, 2007,26(4):46-48
[4] Gritti I,Banfi G,Roi GS.Pepsinogens:physiology,pharmacology pathophysiology and exercise.Pharmacol Res 2000;41:265-281
[5] Foster C,Aktar A,Kopf D,Zhang P,Guttentag S.Pepsinogen C:a type 2 cell-specific protease.Am J Physiol Lung Cell Mol Physiol 2004;286:L382-387
[6]李红梅,宁佩芳,袁媛.不同胃黏膜疾病胃蛋白酶原C组织原位表达与胃蛋白酶原血清学检测水平的比较(J).世界华人消化杂志2005 ,13(20):2473-2476
[7]宫月华,孙丽萍,袁媛.血清胃蛋白酶原及骨桥蛋白联合筛查胃癌的应用价值(J).中华肿瘤杂志2006 28(9):691-693
[8]金晔,陈玥,苏建荣.胃良恶性溃疡治疗前后血清胃蛋白酶原含量变化的临床研究(J).北京医学2008 ,30(4):224-226
[9]蒋叶华,黄飚,王翌,等.血清胃蛋白酶原与胃疾病相关性的分析(J).临床荟萃2007 22 (10): 689-691
[10]黄映芳,彭孝纬,何利平,等.胃癌与十二指肠溃疡患者血清胃蛋白酶原比较(J).现代消化及介入诊疗,2006 ,11(2):61-63
[11]陈智周,范振符.胃蛋白酶原Ⅰ、Ⅱ在早期胃癌普查中的意义(J).中华肿瘤杂志2002 ,24(1):1-3
[12]袁荣华,孙永强,翟晓峰,等.胃癌手术治疗前后血清胃蛋白酶原含量分析(J).交通医学,2009,23(2):139-140
[13]Kitahara F,Kobayashi K,Sato T,Kojima Y,Araki T,Fujino MA.Accuracy of screening for gastric cancer using serum pepsinogen concentrations.Cut 1999;44:693-697
[14]张祥宏,卜玉华,王俊灵,等.血清胃蛋白酶原异常居民胃粘膜变化的随访观察(J).中国肿瘤临床,2000;27:491-494
[15]蒋孟军,肖志坚,张荣军,等。血清胃蛋白酶原Ⅰ、Ⅱ与胃泌素联合检测对胃癌诊断的临床意义(J).标记免疫分析与临床,2004;11:131
[16]Kalinovskii VP,Gamaiunova VB,Shumakov AP.Khanson KP.Radioimmunoassay of serum pepsinogen I in chronic gastritis and stomachcancer.Vopr Onkol 2000;46: 153-155
[17]吕国强,肖志坚,沈安东,等。胃蛋白酶原亚群在胃癌及其术后血清含量变化的临床价值(J).中华消化杂志,1999;19:265-266
[18]于中麟,冀明,杨迅,等.血清胃蛋白酶原对胃癌普查的价值探讨(J).中华消化内镜杂志2008 ,25(10):512-515
[19]Yamaguchi T,Takahashi T,Yokota T,Kitamura K,Noguchi A,Kamiguchi M,AhnT,Sawai K,Yamane T.Urinary pepsinogen I as a tumor marker of stomach cancer after total gastrectomy.Cancer 1991;68:906-909
[20]Pellat-Deceunynck C,Barille S,Puthier D,et al.Adhesion molecules on human myeloma cells:signigicant changes in expression related to malignancy,tumor spreading,and immortalization(J).Cancer Res,1995,55(16):3647-3653
[21]金晔,陈玥,苏建荣.胃良恶性溃疡治疗前后血清胃蛋白酶原含量变化的临床研究(J).北京医学2008 ,30(4):224-226
[22]周红凤,刘丹,吴瑾,等.胃蛋白酶原和胃癌相关抗原与胃癌的研究进展(J).世界华人消化杂志2007,15(17):1940-1946
[23]仲敏,黄傲霜,殷泙,等.萎缩性胃炎内镜半定量诊断进展(J).中国消化内镜2009,3(1):1-5