| Objective: To investigate the detection of plasma pepsinogen(PG)I,PGII and I/II ratio(PGR)combined with gastrin-17 based on high-sensitivity and wide-range time-resolved fluorescence analysis in patients with precancerous lesions of ulcerative gastric cancer.Methods: A total of 547 patients underwent gastroscopy from Tong Ren Hospital from January 2010 to December 2016.Time-resolved fluorescence immunoassay and chemiluminescent microparticle immunoassay were used to detect the plasma PGI and PGII values of 447 patients with gastric diseases,and calculate PGR.Gastrin-17 in plasma of 125 patients with stomach disease was detected by enzyme-linked immunosorbent assay.45 samples were randomly selected for Helicobacter pylori plasma antibody detection.According to the pathological results and the results of gastroscopy,the differences and correlations between the groups were analyzed by non-parametric test,chi-square test and correlation analysis.Results:Two methods of detecting PG Ⅰ,PGII levels and PGR,comparing differences between the two groups was statistically significant(P < 0.05),PGI of TRFIA method is significantly higher than CMIA method.The PGI of the two methods was correlated in the high-value segment(TRFIA method PGI≥240ng/ml),and the difference between the two groups was statistically significant(P<0.05).The PGI of the non-atrophic gastritis in the acute phase was higher than that in the other non-atrophic gastritis group,and the PGI level,PGII level and PGR were different in the non-atrophic gastritis group(P<0.05).The PGI of the peptic ulcer group was significantly higher than that of other gastritis groups.The PGI level in the ulcerated atrophy group was higher than that in the ulcer group.The difference of PGI and PGII levels between the two groups was statistically significant(P ≤ 0.05).The PGI of the ulcerative gastric cancer group was higher than that of the non-ulcer gastric cancer,and the difference of PGII and PGR was statistically significant compared with the non-atrophic gastritis group(P<0.001).When the PGI ≥ 240 ng/ml of the TRFIA method was used as the judgment value of gastric mucosal injury,the sensitivity was26.2%,the specificity was 78.2%,the positive predictive value was 22%,and the negative predictive value was 82%.Atrophic gastritis was positively correlated with G-17,r=0.6068;PGR of the intraepithelial neoplasia group was negatively correlated with G-17,r=-0.7744.The positive rate of H.pylori antibody in the high PGI segment was 68.75%.Conclusion: The detection of plasma pepsinogen and gastrin-17 based on high-sensitivity wide-range time-resolved fluorescence analysis is important for precancerous screening of ulcerative gastric cancer. |
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