康晶,
马振东,
程慧,
冯晓莹^,
大连医科大学附属第二医院 消化内科, 辽宁 大连 116027

基金项目: 大连市医学科学研究计划项目（1612028）


详细信息 作者简介: 康晶(1991-), 女, 硕士研究生。E-mail:1397473141@qq.com




通讯作者: 冯晓莹, 主任医师。E-mail:fxy19692008@hotmail.com 中图分类号: R573


摘要:目的 探讨血清学胃蛋白酶原（pepsinogen，PG）检测对慢性胃炎、胃癌诊断的临床意义。方法 回顾性分析2018年6月至2019年5月就诊于大连医科大学附属第二医院，行胃蛋白酶原Ⅰ（PGⅠ）、胃蛋白酶原Ⅱ（PGⅡ）检测，符合纳入标准的患者230例。根据胃镜及病理检查结果分为胃炎组208例，胃癌组22例，再将其中胃炎组分为非萎缩性胃炎组105例、萎缩性胃炎组103例，通过比较各组间PGⅠ、PGⅡ、PGⅠ/PGⅡ（PGR）值的变化，探讨PG水平对萎缩性胃炎、胃癌诊断的临床意义，通过单因素分析和多因素分析，分析胃癌的危险因素。结果 与胃炎组相比，胃癌组PG Ⅱ水平升高，PGR水平降低，差异有统计学意义（P < 0.05）。进一步对非萎缩性胃炎组、萎缩性胃炎组、胃癌组三组间分析显示，与非萎缩性胃炎组相比，萎缩性胃炎组PGR下降（P < 0.001），胃癌组PG Ⅱ水平升高（P < 0.001），PGR下降（P < 0.01）；与萎缩性胃炎组相比，胃癌组PG Ⅱ升高（P < 0.05）。单因素分析结果显示性别、年龄、PG Ⅰ、PG Ⅱ是与胃癌相关的危险因素，进一步行多因素Logistic回归分析，提示性别、年龄、PG Ⅱ是与胃癌相关的独立危险因素。结论 血清PGⅠ、PGⅡ、PGⅠ/PGⅡ检测对萎缩性胃炎、胃癌诊断具有一定的临床意义，PGR水平降低、PGⅡ水平升高提示存在萎缩或病情进展，胃癌风险增高。
关键词: 胃蛋白酶原/
萎缩性胃炎/
胃癌


Abstract:Objective To investigate the clinical value of serological detection of pepsinogen (PG) in the diagnosis of chronic gastritis and gastric cancer.Methods A retrospective analysis was made on the detection of pepsinogen Ⅰ (pepsinogen I, PG Ⅰ) and pepsinogen Ⅱ (pepsinogen Ⅱ, PG Ⅱ) in the second affiliated Hospital of Dalian Medical University from 2018.6 to 2019.5. There were 230 patients who met the inclusion criteria. According to the results of gastroscopy and pathological examination, the patients were divided into gastritis group (n=208) and gastric cancer group (n=22), and the gastritis group was subdivided into non-atrophic gastritis group (n=105) and atrophic gastritis group (n=103). The changes of PGⅠ, PGⅡ, and PGⅠ/ PGⅡ (PGR) were compared among the three groups to understand the clinical value of PG level in the diagnosis of atrophic gastritis and gastric cancer. Univariate analysis and multivariate analysis were performed to explore the risk factors of gastric cancer.Results Compared with gastritis group, the level of PGⅡ increased and the level of PGR decreased in gastric cancer group (P < 0 05). Further analysis revealed that compared with non-atrophic gastritis group, PGR decreased in atrophic gastritis group (P < 0.001), PGⅡ increased (P < 0.001) and PGR decreased (P < 0.01) in gastric cancer group. Compared with atrophic gastritis group, PGⅡ increased in gastric cancer group (P < 0.05). The results of univariate analysis showed that sex, age, PGⅠ and PGⅡ were risk factors for gastric cancer. Multivariate Logistic regression analysis revealed that sex, age, and PGⅡ were independent risk factors for gastric cancer.Conclusion The detection of serum PGⅠ, PGⅡ and PGⅠ/PGⅡ has certain clinical application value in the diagnosis of atrophic gastritis and gastric cancer. The decrease of PGR or the increase of PGⅡ level indicates atrophy, aggravation of the disease, or increased risk of gastric cancer.
Keywords:pepsinogen/
gastric cancer/
atrophic gastritis

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