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联合胃蛋白酶原、胃泌素、粪便Hp抗原检测对萎缩性胃炎和胃癌的诊断价值
作者:蔡惠美1  林晖1  欧希龙2  黄玉钿3  方跃华4  孙娟1  曹文瑜1  傅建英1 
单位:1. 福建医科大学附属福州市第一医院 消化内科, 福建 福州 350000;
2. 东南大学附属中大医院 消化科, 江苏 南京 210000;
3. 福建医科大学附属福州市第一医院 病理科, 福建 福州 350000;
4. 福建医科大学附属福州市第一医院 检验科, 福建 福州 350000
关键词:胃蛋白酶原 胃泌素 粪便幽门螺杆菌抗原 诊断 胃癌 萎缩性胃炎 
分类号:R573.32;R735.2
出版年·卷·期(页码):2018·37·第三期(406-410)
摘要:

目的:探索胃蛋白酶原(PG)、胃泌素及粪便幽门螺杆菌抗原(HpSA)在萎缩性胃炎及胃癌中的诊断价值。方法:使用酶联免疫吸附法检测萎缩性胃炎及胃癌患者血清中PGⅠ、PGⅡ及胃泌素-17(G-17)水平,并计算PGR (PGⅠ/PGⅡ)值;采用受试者工作特征曲线(ROC曲线)分析各指标的诊断价值;使用免疫胶体金法检测HpSA的阳性率。结果:萎缩性胃炎组和胃癌组较对照组的PGⅠ水平和PGR值下降,G-17水平上升,HpSA阳性率增高,差异均具有统计学意义。PGⅠ、PGR及G-17具有诊断萎缩性胃炎和胃癌的价值。联合PGⅠ、PGR、G-17和HpSA检测对萎缩性胃炎和胃癌的诊断评估效果最佳。结论:联合检测PG、G-17和HpSA可有效诊断萎缩性胃炎和胃癌。

Objective: To investigate the diagnostic value of serum pepsinogen(PG), gastrin and Helicobacter pylori stool antigen(HpSA) in atrophic gastritis and gastric cancer.Methods: The serum levels of PGⅠ, PGⅡ and gasrin-17(G-17) in patients with atrophic gastritis and gastric cancer were determined using ELISA kit. The PGR(PGⅠ/PGⅡ) value was calculated. Receiver operating characteristic curve(ROC) was plotted to analyze the diagnostic value of the parameters. The positive rates of HpSA were evaluated by colloidal immunization methods.Results: The levels of PGⅠ and PGR were down-regulated, the concentration of G-17 was up-regulated and the HpSA positive rate was higher in atrophic gastritis and gastric cancer patients compared with that in the controls. All the differences were statistically significant. The ROC curve revealed that PGⅠ, PGR and G-17 had significant diagnostic value for atrophic gastritis and gastric cancer. Moreover, combined determination of PGⅠ, PRG, G-17 and HpSA was the best choice for the diagnosis of atrophic gastritis and gastric cancer.Conclusion: Combined detection of serum PG, gastrin and HpSA is an efficient approach to the diagnosis of atrophic gastritis and gastric cancer.

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