| Purpose:The relationship among the levels of serum pepsinogen(PGI and PGII),PGI and PGII ratio(PGR),gastrin 17(G-17)under different gastric mucosal states as well as its application value in ethnic minority areas were discussed.Method:The 45 patients who were diagnosed as gastric cancer by endoscopy and pathological biopsy after admission to the People’s Hospital of Kizilsu Kirghiz Autonomous Prefecture in Xinjiang Uygur Autonomous Region due to gastrointestinal symptoms from May 2016 to December 2016 were collected as the gastric cancer group,and 45 patients who were diagnosed as non-atrophic gastritis and atrophic gastritis respectively by endoscopy and pathological biopsy from the same areas and in the same period were selected as the control groups.There was no difference in the nationality composition ratio among the groups.The levels of PGI,PGII,G17,Hp-IgG antibody in serum under empty belly of all patients were tested by the enzyme-linked immunosorbent assay(ELISA),and ratio between PGI and PGII was calculated The receiver operating characteristic curve was made,which was hereinafter referred to as ROC curve.According the pathological results and ROC curve,the change characteristics and correlation on the levels of serum pepsinogen,gastrin 17 and Hp-IgG antibody under the different gastric mucosal states were analyzed.Results:As compared with the non-atrophic gastritis group,the levels of serum PGI and PGR in the gastric cancer group decreased,while the levels of PGII and G-17 increased(P<0.05);as compared with the non-atrophic gastritis group,the level of serum G-17 in the atrophic gastritis group increased and PGR level decreased,while there was no statistical difference in the levels of serum PGI and PGII between atrophic gastritis groups(P>0.05);as compared with the atrophic gastritis group,the level of G-17 in gastric cancer group increased while the level of PGR decreased(P<0.05),and there is no significant difference in the levels of PGI and PGII(no<0.05).The optimal critical value for PGI,PGII,PGR and G-17 to diagnose the onset of gastric cancer was 78.2μg/L(sensitivity 62.2%,specificity 58.9%),34.98μg/L(sensitivity 80.0%,specificity 97.8%),4.42(sensitivity 75.6%,specificity 71.1%),7.82 pmol/L(sensitivity 86.7%,specificity 64.4%)separately;the optimal critical value for PGR to reveal the possibility of atrophic gastritis was 6.75(sensitivity 88.9%,specificity 48.9%),and the optimal critical value for G-17 to reveal the atrophic gastritis was 10.1 pmol/L(sensitivity 66.7%,specificity 75.6%).The levels of PGI and PGII in Hp-positive patients were higher than those of Hp-negative patients(P<0.05),and the PGI level was more significantly increased than that of PGII level.There was no statistical significance on the difference in the levels of PGR and G-17 between Hp-positive patients and negative patients(P>0.05).Conclusion:During the serological screening of patients with different gastric mucosal state changes in ethnic minority areas of Kizilsu Kirghiz Autonomous Prefecture,it was found that,the high levels of G-17 and PGII as well as the low levels of PGI and PGR may reveal the high risk of gastric cancer,and their sensitivity and specificity on revealing gastric cancer were acceptable;the decrease of serum PGR and G-17 levels may reveal the possibility of atrophic gastritis.PGR and G-17 had an acceptable sensitivity and specificity on the diagnosis of atrophic gastritis.Serum levels of PG I and PGⅡ in patients with Helicobacter pylori infection were higher than those in patients without infection,and the level of PG I increased more significantly than that of PG II.Serology PG and G-17 have a positive reference value for the diagnosis of gastric cancer or atrophic gastritis,which was favorable to improving the early detection rate of gastric cancer in China and reducing death rate of gastric cancer to certain extent. |
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