胃蛋白酶原和胃泌素对萎缩性胃炎、胃癌的筛查价值及与幽门螺旋杆菌感染的关系
Journal of Ningxia Medical University(2017)
Abstract
目的 探讨血清胃蛋白酶原(PG)、胃泌素-17(G-17)联合检测能否作为筛查萎缩性胃炎及胃癌的指标,及PG和G-17与幽门螺旋杆菌(HP)感染的关系.方法 根据胃镜及病理结果 ,将261例患者分组:非萎缩性胃炎组56例,萎缩性胃炎组171例(又分为萎缩伴肠化生组43例,萎缩伴轻度异型增生组36例,萎缩伴中重度异型增生组52例),胃癌组34例;采用快速尿素酶实验及14C-呼气试验检测HP感染,采用ELISA方法定量检测各组血清PGⅠ、PGⅡ、G-17水平,并计算PGⅠ/PGⅡ(PGR),比较各组患者血清指标的变化及与HP的相关性.结果萎缩性胃炎各组及胃癌组随病情的加重,血清PGⅠ、PGR水平呈降低趋势,PGⅡ水平呈升高趋势(P<0.05);萎缩性胃炎各组PGⅠ、PGR均低于非萎缩性胃炎组(P<0.01或<0.05),胃癌组PGⅠ、PGR水平低于萎缩性胃炎各组、而PGⅡ、G-17水平高于萎缩性胃炎各组(P均<0.01);萎缩伴中重度异型增生组PGⅠ、PGR水平低于其他萎缩组、G-17水平高于其他萎缩组(P<0.01或<0.05);萎缩性胃炎各组、胃癌组G-17水平均高于非萎缩性胃炎(P<0.01或<0.05);HP感染阳性患者PG I、PG II、G-17水平高于HP阴性者,而PGR低于HP阴性者(P<0.05).结论 血清PGⅠ、PGR降低及G-17升高提示存在萎缩性胃炎和胃癌的高危风险,联合检测血清PG、G-17和HP感染可以作为萎缩性胃炎及胃癌的非侵袭性筛查手段.
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