血清胃蛋白酶原在胃溃疡高危人群中的筛查价值

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Abstract Objective: To evaluate the diagnostic value of serum pepsinogen in gastric ulcer and find out the optimal PG cutoff value for determining gastric ulcer. Methods: A total number of 388 patients with stomach discomfort treated in the Third Affiliated Hospital of Wenzhou Medical University from January 2016 to February 2017 were enrolled in this study. Before gastroscopy, fasting serum pepsinogen was analyzed by ELISA. The efficacy of pepsinogen was evaluated according to endosopic and pathological results. Results: According to the results of the pathological diagnosis, 388 cases were divided as superficial gastritis group (control group, 132 cases), atrophic gastritis group (168 cases), gastric ulcer group (48 cases) and gastric cancer group (40 cases). Serum PG I and PG II levels were significantly increased, PGR (PG I/PG II) significantly decreased (P<0.05) in gastric ulcer group compared with the control group. Serum PG I and PG II levels were significantly increased (P<0.05) in gastric cancer group compared with atrophic gastritis group. No statistical difference (P<0.05) in serum PG I, PG II and PGR levels were found between gastric ulcer group and gastric cancer group. Serum PG II levels were higher and PGR levels lower in gastric cancer group compared with the control group (P<0.05). PG I, PG II, PGR and AUC for gastric ulcer was 0.688, 0.704, 0.627 and 0.709 respectively. The cut-off value of PG I, PG II, PGR was 164.1 μg/L, 15.05 μg/L and 11.76. The test combined with PG I, PG II and PGR diagnosed for gastric ulcer was defined as PG I>165.7 μg/L, PG II>19.1 μg/L and PGR<8.68. The sensitivity and specificity were 68.8% and 65.9%. Conclusion: High PG I and PG II but low PGR are indicators of gastric ulcer. Combined diagnosis of PG I, PG II and PGR shows the best diagnostic value for gastric ulcer. Gastric ulcer can be screened in large scale by the combination of PG I and PG II and PGR in to improve the early diagnosis of gastric ulcer and precancerous lesion.

Key words： pepsinogens stomach ulcer stomach neoplasms ROC curve

Received: 14 August 2017

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	CHEN Lei
	GU Yunfeng
	ZHAN Aixia
	QIAN Dingliang
	ZHENG Jingwei
	ZHENG Meiqin

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https://xb.wmu.edu.cn/EN/ OR https://xb.wmu.edu.cn/EN/Y2018/V48/I7/524

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