摘要
目的对血清胃蛋白酶原(PG)Ⅰ、PGⅡ联合幽门螺杆菌(Hp)抗体检测诊断胃癌的可行性进行分析。方法对2015年1月至2017年12月于该院消化内科治疗并行胃镜检查的1800例患者进行横断面研究。根据病理诊断标准将研究对象分为对照组(胃黏膜正常)999例、萎缩性胃炎组758例、胃癌组43例。采集所有研究对象血液标本,并检测血清PGⅠ、PGⅡ及Hp抗体水平。对比3组患者血清PGⅠ、PGⅡ、PGⅠ/PGⅡ比值(PGR)及Hp抗体。Logistic回归分析用于分析PG单独及联合Hp抗体预测萎缩性胃炎及胃癌的准确率。对各项指标预测萎缩性胃炎及胃癌的灵敏度、特异度及最佳临界值进行受试者工作特征(ROC)曲线分析。结果血清PGⅠ、PGR的表达在对照组、萎缩性胃炎组及胃癌组中呈逐渐下降趋势,3组总体比较,差异均有统计学意义(P<0.05)。萎缩性胃炎组及胃癌组患者血清PGⅠ、PGR表达均低于对照组患者,差异有统计学意义(P<0.05);胃癌组PGR表达低于萎缩性胃炎组,差异有统计学意义(P<0.05)。Hp-IgG阳性率由低到高分别为对照组(32.53%)、胃癌组(65.12%)、萎缩性胃炎组(74.67%)。Logistic回归分析结果显示,PG单独及PG联合Hp抗体检测对萎缩性胃炎的预测准确率分别为77.8%和81.8%,对胃癌的预测准确率分别为72.1%和76.7%。ROC曲线分析结果显示,PGⅠ诊断萎缩性胃炎和胃癌的最佳临界值分别为83.24、63.55μg/L,AUC分别为0.81、0.72(P<0.05)。PGR诊断萎缩性胃炎和胃癌的最佳临界值分别为4.13、3.53,AUC分别为0.67、0.63(P<0.05)。结论PGⅠ、PGR可作为胃癌的病情变化指标,PG与Hp抗体联合检测可作为胃癌的筛查手段。
Objective To investigate the diagnostic value of serum pepsinogen(PG)Ⅰ,PGⅡ,and Helicobacter pylori(Hp)antibody for gastric cancer.Methods A cross-sectional study was performed on 1800 subjects underwent gastroscopy and they were divided into three groups according to the pathological diagnostic criteria,including control group(n=999),atrophic gastritis group(n=758),and gastric cancer group(n=43).Then the levels of PGⅠ,PGⅡ,PGⅠ/PGⅡ(PGR)and Hp antibody of the three groups were detected and compared.Logistic regression analysis was used to analyzed the accuracy of PG alone and combined with Hp antibody in predicting atrophic gastritis and gastric cancer.ROC analysis was conducted to analyzed the sensitivity,specificity and optimal critical value of the above indicators in predicting atrophic gastritis and gastric cancer.Results The levels of serum PGⅠand PGR in the control group,atrophic gastritis group and gastric cancer group showed a decreasing trend,with statistical difference(P<0.05).The expressions of serum PGⅠand PGR in the atrophic gastritis group and gastric cancer group were lower than those in the control group(P<0.05).Hp-IgG positive rate ranked in an ascending order was control group(32.53%),gastric cancer group(65.12%)and atrophic gastritis group(74.67%).Logistic regression analysis showed that the prediction value of the single detection of PG or combining with Hp were 77.8%and 81.8%for atrophic gastritis,which were 72.1%and 76.7%for gastric cancer.ROC analysis showed that the optimal cut-off values for PGⅠin the diagnosis of atrophic gastritis and gastric cancer were 83.24,63.55μg/L respectively,and their AUC were 0.81 and 0.72 respectively(P<0.05).The optimal cut-off values for PGR in the diagnosis of atrophic gastritis and gastric cancer were 4.13 and 3.53 respectively,and AUC were 0.67 and 0.63 respectively(P<0.05).Conclusion PGⅠand PGR could be used as indicators of disease progression in gastric cancer,combining PG and Hp antibody could be used as a screening method for gastric cancer.
作者
唐与浓
陈凌
肖静
宫大为
于子涵
TANG Yunong;CHEN Ling;XIAO Jing;GONG Dawei;YU Zihan(Department of Gastroenterology,Jinqiu Hospital of Liaoning,Shenyang,Liaoning 110000,China)
出处
《检验医学与临床》
CAS
2020年第1期73-76,共4页
Laboratory Medicine and Clinic
关键词
胃蛋白酶原
幽门螺杆菌
胃癌
胃炎
可行性
Pepsinogen
Helicobacter pylori
gastric cancer
gastritis
feasibility
