摘要
目的观察血清胃泌素17(G-17)、胃蛋白酶原(PGⅠ、PGⅡ)联合内镜下窄带成像(NBI)技术对早期胃癌的诊断价值。方法选取2021年1-9月舟山医院收治的疑似胃癌患者86例为研究对象,均进行血清G-17、PGⅠ、PGⅡ和NBI检查,并计算PGⅠ/PGⅡ比值(PGR),以病理检查为金标准,计算血清G-17、PGⅠ、PGⅡ联合NBI检查诊断早期胃癌的敏感度、特异度和准确率。结果胃癌组患者血清G-17[(20.14±4.59)pmol/L]、PGR[(20.21±4.50)µg/L]水平均高于萎缩性胃炎组[(17.06±4.05)pmol/L、(17.15±4.08)µg/L](q=4.12、3.77,均P<0.05)、非萎缩性胃炎组[(12.35±3.31)pmol/L、(10.82±5.26)µg/L](q=9.34、10.39,均P<0.05);PGⅠ[(63.90±14.41)µg/L]、PGR[(3.17±2.08)]水平均低于萎缩性胃炎组[(79.34±16.25)µg/L、(5.04±3.61)](q=5.33、3.44,均P<0.05)和非萎缩性胃炎组[(106.42±20.18)µg/L、(9.22±4.06)](q=13.16、9.97,均P<0.05)。86例患者中,病理检查共检出胃癌43例,其中病理诊断为早期胃癌37例,累及肌层或浆膜层胃癌6例;NBI诊断早期胃癌的符合率为83.78%(31/37),血清G-17、胃蛋白酶原联合NBI诊断早期胃癌的符合率为91.89%(34/37)。以病理检查为金标准,血清G-17联合胃蛋白酶检查诊断早期胃癌的敏感度为72.97%(27/37)、特异度为77.55%(38/49)、阳性预测值为71.05%(27/38)、阴性预测值为79.17%(38/48);NBI诊断早期胃癌的敏感度为83.78%(31/37)、特异度为85.71%(42/49)、阳性预测值为83.10%(31/38)、阴性预测值为87.50%(42/48);血清G-17、胃蛋白酶原联合NBI诊断早期胃癌的敏感度为91.89%(34/37)、特异度为91.84%(45/49)。结论血清G-17、胃蛋白酶原联合NBI检查能提高早期胃癌的诊断准确率,可作为筛查早期胃癌的有效方法。
Objective To investigate the value of serum gastrin-17(G-17),pepsinogen(PG)I and II,and narrow-band imaging endoscopy in combination for identifying early gastric cancer.Methods A total of 86 patients with suspected gastric cancer admitted to Zhoushan Hospital from January to September 2021 were included in this study.These patients underwent serum G-17,PG I,and PG II examination and narrow-band imaging endoscopy.PG I/PG II ratio(PGR)was calculated.Taking pathological results as a gold standard,the sensitivity,specificity,and accuracy of serum G-17,PG I,PG II,and narrow-band imaging endoscopy in combination for identifying early gastric cancer were calculated.Results Serum G-17 level and PGR in the gastric cancer group were(20.14±4.59)pmol/L and(20.21±4.50)µg/L,respectively,which were significantly higher than(17.06±4.05)pmol/L and(17.15±4.08)µg/L in the atrophic gastritis group(q=4.12,3.77,both P<0.05)and(12.35±3.31)pmol/L and(10.82±5.26)µg/L in the non-atrophic gastritis group(q=9.34,10.39,both P<0.05).PG I and PGR in the gastric cancer group were(63.90±14.41)µg/L and(3.17±2.08),respectively,which were significantly lower than(79.34±16.25)µg/L and(5.04±3.61)in the atrophic gastritis group(q=5.33,3.44,both P<0.05)and(106.42±20.18)µg/L and(9.22±4.06)in the non-atrophic gastritis group(q=13.16,9.97,both P<0.05).Among the 86 patients included,gastric cancer was determined by biopsy in 43 patients.Pathological results showed that 37 patients had early gastric cancer and 6 patients had gastric cancer involving the muscle layer or serous layer.Narrow-band imaging endoscopy results showed that 83.78%(31/37)of patients had early gastric cancer.Serum G-17,PG,and narrow-band imaging endoscopy in combination showed that 91.89%(34/37)of patients had early gastric cancer.Taking pathological results as a gold standard,the sensitivity,specificity,positive predictive value,and negative predictive value of serum G-17 combined with PG for screening early gastric cancer were 72.97%(27/37),77.55%(38/49),71.05%(27/38),and 79.17%(38/48),respectively.The sensitivity,specificity,positive predictive value,and negative predictive value of narrow-band imaging endoscopy for screening early gastric cancer were 83.78%(31/37),85.71%(42/49),83.10%(31/38),and 87.50%(42/48).The sensitivity and specificity of serum G-17,PG,and narrow-band imaging endoscopy in combination for screening early gastric cancer were 91.89%(34/37)and 91.84%(45/49),respectively.Conclusion Serum G-17,pepsinogen,and narrow-band imaging endoscopy in combination can improve the diagnostic accuracy of early gastric cancer and is an effective method for screening early gastric cancer.
作者
娄静静
徐前成
Lou Jingjing;Xu Qiancheng(Department of Gastroenterology,Zhoushan Hospital,Zhoushan 316000,Zhejiang Province,China)
出处
《中国基层医药》
CAS
2023年第5期641-645,共5页
Chinese Journal of Primary Medicine and Pharmacy
基金
浙江省医药卫生科技项目(2020KY997)。
