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目的探讨胃癌患者血清胃蛋白酶原(pepsinogen,PG)Ⅰ、PGⅡ、PGⅠ/PGⅡ比值(PGR)、胃泌素(GAS)-17和MG7-Ag水平变化和临床意义。方法根据胃镜和组织病理学检查结果将149例胃镜受检者分为4组。①正常对照组:胃黏膜正常或示非萎缩性胃炎50例。②十二指肠溃疡组32例。③萎缩性胃炎伴肠化生及异型增生组27例。④胃癌组40例。分别对①～④组用ELISA方法定量测定血清GAS-17和MG7-Ag水平,同时以乳胶增强免疫比浊法定量测定PGⅠ、PGⅡ水平。结果胃癌组PGⅡ显著高于正常对照组(P<0.05),PGR显著低于正常对照组(P<0.01);进展期胃癌GAS-17和MG7-Ag水平均显著高于早期胃癌(P<0.05)。结论以PGⅠ≤70 ng/ml且PGR≤3.0为界值诊断胃癌的方法特异性好(93.6%),敏感性为17.5%。血清GAS-17和MG7-Ag水平变化与癌肿分化程度有关,其值越高,预后越差。
Objective To investigate the changes and clinical significance of serum levels of pepsinogen Ⅰ, PGⅡ, PGⅠ / PGⅡ (PGR), gastrin (GAS) -17 and MG7-Ag in patients with gastric cancer. Methods According to the results of endoscopy and histopathology, 149 cases of endoscopy were divided into 4 groups. ① normal control group: gastric mucosa showed normal or non-atrophic gastritis in 50 cases. ② duodenal ulcer group of 32 cases. ③ atrophic gastritis with intestinal metaplasia and dysplasia group of 27 cases. ④ gastric cancer group of 40 cases. Serum levels of GAS-17 and MG7-Ag were quantified by ELISA respectively in ① ~ ④ groups, and PGⅠ and PGⅡ levels were quantitatively determined by latex enhanced turbidimetry. Results The levels of PGⅡ in gastric cancer group were significantly higher than those in normal control group (P <0.05), PGR was significantly lower than that in normal control group (P <0.01). The levels of GAS-17 and MG7-Ag in advanced gastric cancer group were significantly higher than those in early gastric cancer group ). Conclusion The method of diagnosing gastric cancer with PGⅠ≤70 ng / ml and PGR≤3.0 is good (93.6%) and the sensitivity is 17.5%. Serum GAS-17 and MG7-Ag levels and cancer differentiation, the higher the value, the worse the prognosis.