摘要
背景癌症的早期筛查一直是癌症研究领域的重点,胃癌作为全世界常见的癌症,发病率和死亡率常年居高不下,且癌变不易察觉,目前的检测方法对早期发现胃癌和癌前病变效果不理想.目的探讨血清胃蛋白酶原(pepsinogen,PG)、胃泌素17(gastrin-17,G-17)、肝肠钙黏连蛋白-17(cadherin-17,CDH-17)检测联合窄带成像放大内镜在鉴别早期胃癌及癌前病变中的价值.方法回顾性分析2018-01/2021-01我院早期胃癌患者(106例)及癌前病变患者(134例)的临床资料,所有患者均行窄带成像放大内镜检查,并检测血清PG(包括PGⅠ、PGⅡ)、G-17、CDH-17水平.分析PG、G-17、CDH-17和窄带成像放大内镜单独和联合诊断早期胃癌、癌前病变的敏感度、特异度、准确度.结果早期胃癌组的窄带成像放大内镜检查中,病灶有边界限、黏膜微血管不规则、表层腺管不规则、腺间距增大发生率高于癌前病变组组(P<0.05);窄带成像放大内镜对早期胃癌、癌前病变诊断符合率分别为83.02%、85.07%,差异无统计学意义;早期胃癌组的血清PGⅠ水平低于癌前病变组,血清G-17、CDH-17水平高于癌前病变组(P<0.05),两组血清PGⅡ无明显差异;血清PGⅠ、G-17、CDH-17单独诊断符合率差异无统计学意义;血清PGⅠ、G-17、CDH-17联合窄带成像放大内镜诊断早期胃癌、癌前病变的灵敏度、特异度、准确度高于单独血清(PGⅠ/G-17/CDH-17)诊断或单独窄带成像放大内镜(P <0.05).结论血清PG、G-17、CDH-17检测联合窄带成像放大内镜鉴别诊断早期胃癌及癌前病变的敏感度、特异度、准确度较高,具有较高应用价值.
BACKGROUND The early screening of cancer has always been the focus of cancer research.As a common cancer in the world,gastric cancer has had a high incidence rate and mortality for many years,and canceration is difficult to detect.Current detection methods are not ideal for early detection of gastric cancer and precancerous lesions.AIM To assess the value of detection of serum pepsinogen(PG),gastrin(G-17),and hepato-intestinal cadherin-17(CDH-17) combined with narrowband imaging magnifying endoscopy in the identification of early gastric cancer and precancerous lesions.METHODS The clinical data of patients with early gastric cancer(106 cases) and precancerous lesions(134 cases) at our hospital from January 2018 to January 2021 were retrospectively analyzed.All patients underwent narrow-band imaging magnifying endoscopy and detection of serum PG(including PGⅠ and PGⅡ),G-17,and CDH-17 levels.The sensitivity,specificity,and accuracy of PG,G-17,CDH-17,and narrowband imaging magnifying endoscopy,alone and in combination,in the diagnosis of early gastric cancer and precancerous lesions were calculated.RESULTS In the early gastric cancer group,the incidence of lesions with border limits,mucosal microvascular irregularities,irregular surface ducts,and increased glandular spacing as detected by narrow-band imaging magnifying endoscopy was higher than that in the precancerous lesion group(P 0.05).Serum PGⅠ level in the early gastric cancer group was lower than that of the precancerous lesion group,but there was no significant difference in serum PGⅡ between the two groups(P > 0.05);serum G-17 and CDH-17 levels were higher than those of the precancerous lesion group(P 0.05).The sensitivity,specificity and accuracy of serum PGⅠ,G-17,and CDH-17 combined with narrow-band imaging magnifying endoscopy in the diagnosis of early gastric cancer and precancerous lesions were higher than those of any serum index alone(PGⅠ/G-17/CDH-17) or narrowband imaging magnifying endoscopy alone(P < 0.05).CONCLUSION The detection of s
作者
潘杰
雷李美
Jie Pan;Li-Mei Lei(Zhejiang Chinese Medicine University,Hangzhou 310053,Zhejiang Province,China;General Medicine Department of Lishui People’s Hospital,Lishui 323000,Zhejiang Province,China)
出处
《世界华人消化杂志》
CAS
2022年第21期964-970,共7页
World Chinese Journal of Digestology
