| Background: In recent years,with the improvement of people’s living standard and the improvement of sanitary conditions,the incidence and mortality of gastric cancer has decreased significantly.Nevertheless,it is still one of the most hottest issues that the world needs to pay close attention to.According to the WHO report,gastric cancer ranks the first in the digestive tract malignant tumor and the fourth leading cause of death in the world,which is the second cause of death in China,which seriously endangers human life and health.Therefore,from a global perspective,prevention and treatment of gastric cancer is still an important issue of health care.There are regional differences in the morbidity of gastric cancer.Compared with the developed countries with better economic conditions,gastric cancer occurs more frequently in developing countries with backward economic conditions,poor health level and higher infection rate of Helicobacter pylori.The disease is characterized by concealment of onset.Most patients have no specific clinical manifestations at the early stage,and are not easy to be noticed.Most of them are at the stage of disease progression when typical symptoms occur.The prognosis of gastric cancer is affected by many factors,such as age,nutritional status,location of tumor,pathological classification,and tumor staging,which are mainly related to the stage of tumor.Most of early gastric cancer can be treated by endoscopic minimally invasive treatment.This method has advantages of small traumatic,low patient pain and easy acceptance;the prognosis is relatively good,the five year survival rate is high,about 90%.Survival rate with the advanced tumors are far below 40%,which not only brings great pain to patients,but also brings heavy financial burden to families and countries.Therefore,early diagnosis and treatment of gastric cancer can effectively reduce its mortality.As we all know,the "gold standard" for diagnosis of gastric cancer is a combination of gastroscopy and histopathology,but it is an invasive operation,it will cause certain psychological pressure to the patient,not easy to be accepted.It is difficult to be used as a tool for large scale screening of gastric cancer in the clinical work.In recent years,more and more clinical workers are committed to finding a convenient,fast,economic and patient compliance index.With the rapid development of biology and laboratory medicine,the combined detection of serum pepsinogen(PG),gastrin 17(G17)and Helicobacter pylori(HP)has attracted more and more attention by clinicians because of its simple,economic and non invasive.Many studies have shown that there is a certain correlation between serological detection methods and early gastric cancer,atrophic gastritis and gastric ulcer.But there are less studies about the association between adenomatous polyps,as one of the precancerous lesions,and Helicobacter pylori,serum pepsinogen and gastrin 17.Objective: The purpose of this study is to investigate the association between Helicobacter pylori and serum pepsinogen and gastrin in patients with adenomatous polyp.Methods: Objective: A total of 203 patients with the symptoms of upper gastrointestinal who were admitted in our hospital from 2015.9-2017.12 were included in the study.(2)group: all the subjects were examined by gastroscopy and histopathology,and they were divided into three group : the control group(Endoscopic examination of patients with superficial gastritis)、adenomatous polyps group and gastric cancer group,of which 86 cases in control group,51 cases of adenomatous polyp group and 64 cases of gastric cancer group;(3)serological detection: all patients were collected 3ml of fasting venous blood,serum pepsinogen I(PGI),pepsinogen II(PG II)and stomach were measured by enzyme linked immunosorbent assay(ELISA).The level of secretin 17(G17)and the ratio of PGI to PG II(PGR)were calculated;(4)HP detection: using the 13 C breath test method to determine the status of Helicobacter pylori infection;5.The serological level and HP infection rate of each group were compared,and the positive patients and HP negative in each group were compared according to the difference of HP infection.The serological level of patients with adenomatous polyps were compared with the serological levels of the patients with different sizes and different parts of the polyp,and the groups were compared with the control group and the gastric cancer group.Results:1.PGI: adenomatous polyp group and gastric cancer group were lower than control group(P=0.002),and gastric cancer group was lower than adenomatous polyp group(P<0.05);PG II: adenomatous polyp group and gastric cancer group were higher than control group(P<0.05),but adenomatous polyp group was compared with gastric cancer group,the difference was not statistically significant(P>0.05);PGR: adenomatous polyp The group and gastric cancer group were lower than the control group(P<0.05),the gastric cancer group was lower than the adenomatous polyp group(P<0.05),G17: adenomatous polyp group and gastric cancer group were higher than the control group,but there was no significant difference between adenomatous polyp group and gastric cancer group(P>0.05).2.HP infection rate: the rate of HP infection in the control group was 53.5%,the HP infection rate in the adenomatous polyp group was 47%,the rate of HP infection in the gastric cancer group was 75%,the difference between the three groups was statistically significant(P<0.05),and there was no statistical difference between the control group and the adenomatous polyp group(P>0.05),and the difference of the control group and the gastric cancer group was different.There was a significant difference in P=0.006 between the adenomatous polyp group and the gastric cancer group(P<0.05).3.The serological comparison of the patients in each group according to the different HP infection: the PGI of the HP positive patients in each group was higher than that of the negative HP;the PG II of the HP positive patients in each group was higher than that of the HP negative patients;the PGR of the HP positive patients in each group was lower than that of the HP negative patients;G17: there was no statistical difference between the HP positive patients and the negative patients in each group.4.The serological comparison of the different sizes of adenomatous polyps: the adenomatous polyps were divided into two subgroups of more than 1cm and less than 1cm.The two subgroups were compared with the control group and the gastric cancer group.The results showed that the difference of the serum PGI,PG II,PGR and G17 in the polyp patients with the diameter > 1cm was compared with the gastric cancer group.The difference was not statistically significant(P > 0.05).Compared with the control group,PGI and PGR decreased,while the differences in PG II and G17 were not statistically significant.The serum PGI and PGR were higher in the patients with the diameter < 1cm than in the gastric cancer group.The differences in PG II and G17 were not statistically significant between the two groups,and the straight diameter > 1cm group and the diameter < 1cm group >,straight.The serum PGI and PGR in the group of diameter > 1cm were lower than those in the diameter group 1cm,and the difference between the two groups was statistically significant(P < 0.05),but the difference of PG II and G17 in each group was not significant(P > 0.05).5.The serological comparison of the patients with adenomatous polyps in different parts: according to the different locations of adenomatous polyps,they were divided into gastric antral polyps,gastric polyps and gastric fundus polyps.Compared with the control group and gastric cancer group,the results showed that compared with the control group,the serum PG I and PGR were decreased,and the differences of PG II and G17 were compared with the control group.There was no statistical significance;serum PG I,PG II,PGR and G17 in all regions were not statistically different from those in gastric cancer group.Compared with the gastric polyps and gastric fundus polyps,the G17 of the antral polyps was significantly lower,and the difference was statistically significant(P<0.05).Compared with the gastric and gastric polyps,the serum PG I increased in the patients with gastric antral polyps,and the difference was statistically significant(P<0.05),but there was no statistical difference between the three groups of PG II and PGR.Conclusion: 1.PGI and PGR in adenomatous polyps and gastric cancer group were lower than those in control group,PG II and G17 were higher than those in control group.2.adenomatous polyps may not be associated with HP infection;3.the level of serum PGR in HP positive patients may be lower than that of HP negative patients,and HP infection may not be related to the level of serum G17.4.The level of serum pepsinogen in patients with adenomatous polyps may be related to the size and location of polyps,but the level of serum gastrin 17 may not be related to the size of polyps,which is related to the location of polyps. |
PDF Full Text Request