摘要
目的以血清胃蛋白酶原Ⅰ(PGⅠ)、Ⅱ(PGⅡ)及其PGⅠ/PGⅡ比值(PGR)作为筛查慢性萎缩性胃炎和胃癌前期病变指标,评价其诊断效能。方法收集经胃镜排除胃肿瘤的患者474例,进一步将受检者分为轻度非萎缩性胃炎组(对照组,n=164)、萎缩性胃炎组(n=162)和萎缩性胃炎伴肠上皮化生(简称肠化)组(n=148)。以乳胶增强免疫比浊法定量检测血清PGⅠ和PGⅡ,计算PGR,通过受试者工作特征曲线(ROC)评价PGⅠ、PGⅡ和PGR的诊断价值。结果萎缩性胃炎组和萎缩性胃炎伴肠化组PGⅠ、PGⅡ和PGR较对照组显著降低(P<0.01)。PGⅠ、PGⅡ和PGR诊断萎缩性胃炎,其ROC曲线下面积(AUCROC)分别为0.679、0.593和0.622,最佳临界值分别为71.8、9.1和8.12,灵敏度分别为66.1%、54.3%和77.2%,特异度分别为61.0%、61.6%和43.9%;诊断萎缩性胃炎伴肠化AUCROC分别为0.787、0.583和0.836,最佳临界值分别为59.4、9.8和6.76,灵敏度分别为64.9%、58.8%和81.8%,特异度分别为78.1%、55.5%和77.4%。PGⅠ和PGR平行联合,灵敏度为93.6%、特异度为60.4%;PGⅠ和PGR序列联合,灵敏度为53%、特异度为95%。结论 PGⅠ和PGR作为监测胃黏膜状态的指标,联合运用能提高诊断效率;当PGⅠ和PGR同时小于最佳临界值时可预测萎缩性胃炎伴肠化。
Objective To evaluate the diagnostic performance of adopting serum pepsinogen Ⅰ （PG Ⅰ ）, pepsinogen Ⅱ （PGⅡ ）, and the ratio of PG Ⅰand PG Ⅱ（PGR） as indexes for screening the chronic atrophic gastritis and precursor lesions of gastric cancer. Methods A total of 474 patients who were diagnosed with diseases other than gastric cancer by the gastroscope were selected and divided into the minor non-atrophic gastritis group （control group, n =164）, chronic atrophic gastritis group （n =162）, and chronic atrophic gastritis with intestinal metaplasia group （n =148）. Serum PG I and PG 11 levels were quantitatively measured by the latex-enhanced immunoturbidimetric method and the PGR was calculated. The diagnostic performance of PG Ⅰ , PG Ⅱ, and PGR was evaluated by the receiver operator characteristic （ROC） curve. Results Compared with the control group, PG Ⅰ level, PG Ⅱ level, and PGR of the chronic atrophic gastritis group and chronic atrophic gastritis with intestinal metaplasia group decreased significantly （P〈0.01）. Values of the area under the ROC （AUCaoc） of PGⅠ , PGⅡ, and PGR for diagnose of chronic atrophic gastritis were 0. 679, 0. 593, and 0. 622; the best cutoff values were 71.8, 9.1, and 8.12; the values of sensitivity were 66.1%, 54.3%, and 77.2% ; and the values of specificity were 61.0%, 61.6% and, 43.9%. Values of AUCaoc of PGⅠ , PGⅡ, and PGR for diagnosis of atrophic gastritis with intestinal metaplasia were 0. 787, 0. 583, and 0. 836; the best cut-off values were 59.4, 9.8, and 6.76; the values of sensitivity were 64.9%, 58.8%, and 81.8% ; and the values of specificity were 78.1%, 55.5% and 77.4%. The values of parallel combined sensitivity and specificityof PG I and PGR were 93.6% and 60.4%, while the values of series combined sensitivity and specificity of PG Ⅰ and PGR were 53% and 95%. Conclusion Combined use of PG Ⅰ level and PGR as indexes for monitoring the status of gastric mucosa can improve the diagnostic performance. It is a
出处
《上海交通大学学报（医学版）》
CAS
CSCD
北大核心
2015年第6期860-863,共4页
Journal of Shanghai Jiao tong University:Medical Science
