血清胃蛋白酶原亚群在老年胃癌及其胃癌前病变诊断中意义.docVIP

血清胃蛋白酶原亚群在老年胃癌及其胃癌前病变诊断中意义【摘要】 目的 探讨血清胃蛋白酶原PGⅠ、PGⅡ与老年胃癌及癌前病变的关系。方法对已行常规胃镜检查和病理活检确诊的118例老年患者（其中慢性非萎缩性胃炎31例，慢性萎缩性胃炎33例，胃溃疡糜烂24例，胃癌30例）。用ELISA法定量检测血清PGⅠ和PGⅡ水平，并计算PGR（PGⅠ/PGⅡ）值。结果 慢性萎缩性胃炎及胃癌组血清PGⅠ、PGR水平同慢性非萎缩性胃炎组相比差异有统计学意义（P＜0.05）。但PGⅠ水平及PGR值在慢性萎缩性胃炎组与胃癌组之间差异无统计学意义（P＞0．05）。胃癌组中以PGⅠ＜70 μg/L、PGR＜3作为阳性指标，同时符合这两项的确诊率为23．3%，特异性为93．3%。而如以PGⅠ＜70 μg/L或 PGR＜3作为阳性指标，确诊率和特异性分别为73．3%、 76．7%。结论 血清PGⅠ、PGR水平与老年患者萎缩性胃炎和胃癌有关，可以作为老年高危患者胃黏膜萎缩、癌变的一项血清学筛查指标。? 【关键词】癌前病变；胃肿瘤；胃蛋白酶原类；老年人?? The diagnostic significance of serum pepsinogens in elder patients with gastric cancer and precancerous changes CHEN Guo-bing,HUANG Wei,CAI Mei-zhu.Putuo District Liqun Hospital,Shang hai200333,China? 【Abstract】 Objective To explore the diagnostic significance of serum pepsinogen(PG) Ⅰ,PGⅡlevels in detection of gastric cancer and precancerous changes in elder patients. Methods 118 subjects were selected in the study including 31 cases of chronic non-atrophic gastritis, 33 cases of atrophic gastritis, 30 cases of gastric cancer and 24 cases of gastric ulcer. Serum PGⅠand PGⅡlevels were detected by enzyme-linked immunosorbent assay(ELISA). Results PGⅠand PGR( PGⅠ/PGⅡ ratio) values decreased significantly in both atrophic gastritis and gastric cancer groups(P＜0．05).But there were no obvious different of PGⅠ and PGR values between gastric cancer and atrophic gastritis((P＞0．05).If PGⅠ＜70 μg/L， PGR＜3 were used as positive indexes, accurate diagnostic ratio conforming to the two indexes was 23.3 %,and distinctive property was 93．3 %.But if PGⅠ＜70 μg/L or PGR＜3 were used as positive indexes, accurate diagnostic ratio and distinctive property were 73．3% and 76．7% respectively. Conclution Lower PGⅠand PGR levels are biomarkers of atrophic gastritis and gastric cancer in elder patients.They can be used as serum risk markers in monitoring gastric atrophy and carcingogenesis in elder patients. ? 【Key words】 Gastric precancerous changes；Stomach neoplasms； Pepsinogens； Elder patients 胃癌是我国最常见肿瘤之一，其死亡率居消化道肿瘤之首