The Value Of Pepsinogen And Multiple Tumor Markers Joint Detection In The Diagnosis Of Hp Positive Early Gastric Cancer

Objective: Explore the joint detection of the serum carcinoembryonic antigen(CEA), carbohydrate antigen 19-9(CA19-9), carbohydrate antigen 72-4(CA72-4), carbohydrate antigen 242(CA242), carbohydrate antigen 50(CA50), carbohydrate antigen 125(CA125) and pepsinogen I(PGⅠ)、pepsinogenⅡ(PGⅡ)on the application value of early diagnosis of gastric cancer.Methods: Chemiluminescence immune method and double antibody sandwich enzyme linked immuneosorbent assay was used in 363 cases of gastric cancer patients, 131 cases of chronic atrophic gastritis, 344 cases of Chronic non-atrophic gastritis and 100 cases of healthy human to determine serum CEA、CA19-9、CA72-4、CA242、CA50、CA125、PG and PG levels and compare the dⅠ Ⅱ ifferences between different disease groups.At the same time, Helicobacter pylori was detected in gastric cancer group, chronic atrophic gastritis, chronic non-atrophic gastritis group and normal control group by 14 C urea breath test(14C-UBT).Compare the differences of Helicobacter pylori(Hp) infection rate between Helicobacter pylori(Hp) positive group and between negative group.And observe the relationship between Helicobacter pylori(Hp) infection and serum pepsinogen PGⅠ,PGⅡ, PGⅠ/PGⅡ) levels.Results:1.The comparison of serum CEA、CA19-9、CA72-4、CA242、CA50、CA125 levels among patients between gastric cancer,chronic atrophic gastritis, chronic non-atrophic gastritis and healthy control group was statistically significant(P<0.05);However, the difference between gastric cancer,chronic atrophic gastritis and chronic non-atrophic gastritis was not statistically significant(P >0.05).2.(1)Pepsinogen Ⅰ:Compared with the healthy control group, the difference was statistically significant between the gastric cancer group and the chronic atrophic gastritis group(P<0.05);(2) Pepsinogen Ⅱ:The comparison among gastric cancer group, chronic atrophic gastritis group and the healthy control group was statistically significant(P<0.05);While there was no significant difference between chronic nonatrophic gastritis group and healthy control group(P>0.05).(3)PGⅠ/PGⅡ(PGR):In addition to the chronic non atrophic gastritis group, the difference was statistically significant in gastric cancer group and chronic atrophic gastritis group compared with the healthy control group(P<0.05).3.(1)The sensitivity of gastric cancer among CEA、CA19-9、CA72-4、CA242、CA50、CA125 and PGR was 27.27%, 39.12%, 50.41%, 46.01%, 45.73%,77.13%, 62.26% respectively.The sensitivity of 7 combined detection for the diagnosis of gastric cancer was 83.20%.Compared with the single detection, the difference was statistically significant(P<0.05);(2)The specific degree of gastric cancer among CEA、CA19-9、CA72-4、CA242、CA50、CA125 and PGR was 91.86%, 91.57%, 95.06%, 88.66%, 90.12%, 86.34%, 87.79% respectively.The specificity of the 7 joint detection was 80.52%.4.(1)The positive rate of Hp among gastric cancer group, chronic atrophic gastritis group, chronic non atrophic gastritis group and healthy control group was 70.2%(255 cases), 69.5%(91 cases), 64.5%(222 cases), 56%(56 cases) in turn.The positive rate of Hp in gastric cancer group was the highest, and the positive rate of Hp in healthy control group was the lowest.(2)The comparison of Hp positive rate among gastric cancer group, chronic atrophic gastritis group, chronic non atrophic gastritis group and healthy control group was not statistically significant(P>0.05).5. The pepsinogen(PGⅠ 、 PGⅡ 、PGⅠ/PGⅡ)levels in patients with gastric cancer,chronic atrophic gastritis, chronic non-atrophic gastritis group and healthy control group with Hp infection and non-Hp infection in the peripheral blood were compared,and the results were not statistically significant(P>0.05).Conclusions: The changes of serum CEA, CA19-9, CA72-4, CA242, CA50, CA125, PGⅠ,PGⅡ, PGⅠ/PG levels are related to the development of gastrⅡ ic cancer and can be used as an auxiliary means for early diagnosis of gastric cancer.The combined detection of CEA, CA19-9, CA72-4, CA242, CA50, CA125, PGⅠ/PGⅡ in patients with gastric cancer increases sensitivity significantly, as well as improves the detection rate of gastric cancer. Joint detection is more conducive to the early diagnosis of gastric cancer.The serum levels of PG Ⅰand PGⅠ/PGⅡ have an important significance in diagnosis of early gastric cancer.We should be vigilant the incidence of gastric cancer when they reduce.The Hp infection rate is the highest in gastric cancer group and the lowest in healthy control group, so it is necessary for Hp positive patients to eradicate in time.The changes of serum levels of PG and Hp infection is not related,and it still needs further research.