摘要
目的评价胃泌素17(G17)、胃蛋白酶原(PG)在健康体检人群中的早期胃癌筛查的效用。方法选取2018年1月-2020年7月苏州大学附属第一医院治疗患者和体检者325例,所有入选者均行胃镜检查及血清G17、胃蛋白酶原Ⅰ(PGⅠ)、胃蛋白酶原Ⅱ(PGⅡ)测定,计算PGⅠ/PGⅡ(PR)。结果经胃镜及病理证实:正常106例,非特异性炎症88例,低级别上皮内瘤变45例,高级别上皮内瘤变30例,黏膜内癌24例,进展胃癌32例。并分为正常组、非特异性炎症组、癌前病变组(低级别上皮内瘤变)、早期胃癌组(高级别上皮内瘤变及黏膜内癌)、进展期胃癌组。进展期胃癌及早期胃癌患者G17、PGⅡ高于正常组,PR低于正常组,差异有统计学意义(P<0.05)。G17、PGⅠ、PGⅡ及PR的ROC曲线下面积分别为0.737、0.696、0.761、0.668,其诊断胃癌的敏感性分别为72.1%、59.3%、83.7%、56.6%,特异性分别为69.8%、81.1%、63.2%、81.1%。联合G17及PR(G17>3.9 pmol/L,PR<8.70),灵敏度为95.4%,特异度为63.2%,正确指数为0.586(P<0.001),Kappa=0.564(P<0.001)。结论G17、PR在健康体检胃癌筛查中有一定预测价值,一致性一般。目前胃癌早期筛查仍需依赖定期健康体检及胃镜筛查。
Objective To evaluate the efficacy of gastrin 17(G17)and pepsinogen(PG)in early gastric cancer screening in healthy people.Methods 325 patients and physical examiners were selected from the First Affiliated Hospital of Soochow University from January 2018 to July 2020.All enrollees underwent gastroscopy and serum G17,pepsinogenⅠ(PGⅠ),and pepsinogenⅡ(PGⅡ)were determined,and PGⅠ/PGⅡ(PR)was calculated.Results Gastroscopy and pathology confirmed that there were 106 cases of normal,88 cases of non-specific inflammation,45 cases of low-grade intraepithelial neoplasia,30 cases of high-grade intraepithelial neoplasia,24 cases of intramucosal carcinoma,and 32 cases of advanced gastric cancer.They were divided into normal group,non-specific inflammation group,precancerous lesion group(low grade intraepithelial neoplasia),early gastric cancer group(high-grade intraepithelial neoplasia and intramucosal carcinoma),and advanced gastric cancer group.Compared with normal group,early gastric cancer group and advanced gastric cancer group had a significantly higher G17 and PGⅡlevel and lower PR(P<0.05).The area under the ROC curve of G17,PGⅠ,PGⅡ,and PR were 0.737,0.696,0.761,and 0.668 respectively.The sensitivity for the diagnosis of gastric cancer was 72.1%,59.3%,83.7%,and 56.6%,and the specificity was 69.8%,81.1%,63.2%,and 81.1%,respectively.Combined with G17 and PR(G17>3.9 pmol/L,PR<8.70),the sensitivity was 95.4%,the specificity was 63.2%,Youden's index was 0.586(P<0.001),and Kappa=0.564(P<0.001).Conclusion G17 and PR have certain predictive value in gastric cancer screening in health examinations,and the consistency is general.Early gastric cancer screening currently still depends on periodic health check-up and endoscopy screening.
作者
刘丹
郑香
严苏
朱婧
LIU Dan;ZHENG Xiang;YAN Su;ZHU Jing(Department of Health Management Center,the First Affiliated Hospital of Soochow University,Suzhou,Jiangsu,215006,China)
出处
《中国血液流变学杂志》
CAS
2021年第4期549-552,共4页
Chinese Journal of Hemorheology
