摘要
目的探索血清胃蛋白酶原(PG)Ⅰ、Ⅱ及PGⅠ与PGⅡ比值(PGR值)筛查萎缩性胃炎的最佳临界值及其实践应用,为开展萎缩性胃炎筛查及监测提供依据。方法选择萎缩性胃炎病例167例,1∶1匹配正常对照组,用ELISA法检测研究对象的血清PGⅠ、PGⅡ及幽门螺杆菌抗体(Hp-IgG)水平,计算PGR值;绘制ROC曲线,确定PGⅠ、PGⅡ及PGR最佳临界值;在我国胃癌高发区居民中用该临界值开展萎缩性胃炎筛查试验。结果萎缩性胃炎组血清PGⅠ及PGR值均低于正常对照组(PGⅠ的Z=9.54,Z_(PGR)=8.47;P均<0.01);Hp阳性组血清PGⅡ水平高于Hp阴性组(PGⅡ的Z=9.20,P<0.01)、PGR值低于Hp阴性组(PGR的Z=8.48,P<0.01);血清PGⅠ及PGR值筛查萎缩性胃炎的最佳临界值分别是109.08μg/L及8.80;在胃癌高发区自然人群603人中筛查出萎缩性胃炎阳性126人,阳性率20.9%。结论血清PGⅠ水平及PGR值下降,提示可能发生萎缩性胃炎;各地应用血清胃蛋白酶原开展筛查时,应探索符合当地人群特点的该血清学指标最佳临界值。
Objective To explore the optimal cut-off values and practical application of serum pepsinogen(PG)Ⅰ,PGⅡand PGⅠ/PGⅡratio(PGR)for screening atrophic gastritis,and to provide evidence to screen and monitor atrophic gastritis.Methods A total of 167cases of atrophic gastritis were selected and matched to healthy controls on a ratio of 1∶1.Serum levels of PGⅠ,PGⅡand Hp-IgG were measured by ELISA,and PGR values were calculated.The receiver operating characteristic curve was generated to estimate the optimum cut-off values of PGⅠ,PGⅡand PGR.The cut-off values were then used to carry out screening test of atrophic gastritis among residents in high incidence regions of gastric cancer.Results Serum levels of PGⅠand PGR were both lower in atrophic gastritis group than control group(Z_(PGⅠ)=9.54,Z_(PGR)=8.47,both P<0.01).Helicobacter Pylori positive group had higher serum level of PGⅡ(Z_(PGⅡ)=9.20,P<0.05)but lower PGR(Z_(PGR)=8.476,P<0.05)than the negative group.The optimal cut-off value was 109.08μg/L for serum PGⅠ,and 8.80for PGR in diagnosing atrophic gastritis.We screened 603healthy subjects from high incidence regions of gastric cancer,126(20.9%)of whom were identified as atrophic gastritis.Conclusions Decreased levels of serum PGⅠand PGR might indicate development of atrophic gastritis.When conducting screening program for atrophic gastritis,optimal cut-off serology value that is appropriate for local population shall be explored.
作者
陈铁晖
伍思翰
林兰
刘丹凤
吴冰珊
钟文玲
郑奎城
CHEN Tiehui;WU Sihan;LIN Lan;LIU Danfeng;WU Bingshan;ZHONG Wenling;ZHENG Kuicheng(Fujian Center for Disease Control and Prevention,Fuzhou,Fujian 350012,China;Xiamen Center for Disease Control and Prevention,Xiamen,Fujian 361021,China;Fujian Provincial Hospital,Fuzhou,Fujian 350001,China;The Second Affiliated Hospital of Xiamen Medical College,Xiamen,Fujian 361010,China)
出处
《海峡预防医学杂志》
CAS
2022年第6期1-4,共4页
Strait Journal of Preventive Medicine
