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目的:研究胃蛋白酶原Ⅰ(PGⅠ)、胃蛋白酶原Ⅱ(PGⅡ)在胃癌组织中的表达及意义。方法:将我院2011年5月至2013年10月收治的上消化道疾病患者243例纳入研究,根据胃镜及病理组织学结果,按照胃癌、慢性萎缩性胃炎、慢性非萎缩性胃炎、不典型增生以及胃溃疡分为5组,对照组为57名来我院检查的健康的人群。应用酶联免疫法测定各组血清PGⅠ、PGⅡ的含量并计算胃蛋白酶原比值(PGR),比较胃癌患者手术前后血清PGⅠ、PGⅡ的含量以及PGR,并通过ROC曲线下面积评价血清PGⅠ、PGⅡ以及PGR诊断胃癌的效能。结果:与对照组比较,胃溃疡组PG Ⅰ、PG ⅠⅠ均明显升高,PGR降低(P<0.05),慢性萎缩性胃炎组、不典型增生组及胃癌组PGⅠ、PGR均明显降低(P<0.05);与慢性萎缩性胃炎组比较,不典型增生组和胃癌组PGR显著降低(P<0.05)。手术治疗后,胃癌患者血清PGⅠ、PGⅡ含量较手术前明显下降(P<0.05)。血清PGⅠ、PGⅡ以及PGR含量诊断胃癌的ROC曲线下面积依次为0.779、0.920以及0.991。结论:胃癌患者血清PGⅠ、PGR均明显降低,二者可用于初步筛查胃癌。
Objective: To study the expression and significance of pepsinogen Ⅰ (PGⅠ) and pepsinogen Ⅱ (PGⅡ) in gastric cancer. Methods: Totally 243 patients with upper gastrointestinal diseases admitted to our hospital from May 2011 to October 2013 were enrolled. According to endoscopy and histopathological results, according to the results of gastric cancer, chronic atrophic gastritis, chronic non-atrophic gastritis, atypical Hyperplasia and gastric ulcer were divided into 5 groups, the control group of 57 to our hospital to check the health of the crowd. Serum levels of PGⅠ and PGⅡ were determined by enzyme-linked immunosorbent assay (ELISA), and pepsinogen ratio (PGR) was calculated. Serum levels of PGⅠ and PGⅡ and PGR were compared before and after operation. The serum PGⅠ, PGR diagnosis of gastric cancer efficacy. Results: Compared with the control group, the levels of PG Ⅰ and PG Ⅰ Ⅰ were significantly increased and PGR was decreased in the gastric ulcer group (P <0.05). The levels of PG Ⅰ and PGR were significantly decreased in the patients with chronic atrophic gastritis, dysplasia and gastric cancer (P < 0.05). Compared with chronic atrophic gastritis group, PGR in atypical hyperplasia group and gastric cancer group was significantly lower (P <0.05). After operation, the serum levels of PGⅠ and PGⅡ in patients with gastric cancer were significantly lower than those before operation (P <0.05). The areas under the ROC curve of serum PGⅠ, PGⅡ and PGR in diagnosis of gastric cancer were 0.779, 0.920 and 0.991, respectively. Conclusion: The serum levels of PGⅠ and PGR in patients with gastric cancer are significantly lower, both of which can be used for primary screening of gastric cancer.