| Objective:In this study,by analyzing the histopathological manifestations of patients with chronic atrophic gastritis(CAG)and gastric cancer and detecting their serum gastric function(SGF)levels,i.e.pepsinogen Ⅰ(PGⅠ),pepsinogen Ⅱ(PGⅡ),PGⅠ/PGⅡ ratio(PGR),and gastrin-17(G-17)levels,we explored the diagnostic value of SGF for CAG and gastric cancer.Methods:There were 138 cases of CAG,61 cases of gastric cancer and 64 cases of healthy patients were diagnosed by normal white light gastroscopy and random biopsy of histopatholog and enrolled in the study.All the subjects extracted fasting venous blood before gastroscopy using ELISA to detect PGⅠ,PGⅡ,G-17 levels and calculated PGR.Logistic regression analysis and ROC curve were used to analyze the diagnostic value of SGF for CAG and gastric cancer.Results:The proportion of patients with simple atrophy of gastric mucosa was 40.58%in CAG group,and that with intestinal metaplasia was 39.13%and 20.29%in patients with dysplasia;In the gastric cancer group,the proportion of early gastric cancer was 24.59%,and the proportion of advanced gastric cancer was 75.41%.Compared with the healthy control group,the PGⅠ and PGR levels in CAG group and gastric cancer group were decreased,the differences were statistically significant(P<0.05),the levels of G-17 in gastric cancer group were increased,the difference was statistically significant(P<0.05).Compared with the CAG group,the PGⅠ and PGR levels in the gastric cancer group decreased,and the differences were statistically significant(P<0.05),the levels of G-17 in gastric cancer group were increased,the difference was statistically significant(P<0.05).When SGF is used to diagnose CAG,the joint index of the four indexes of SGF,whose area under the ROC curve(AUC)is 0.909,is of high diagnostic value to the CAG,and its AUC is higher than the AUC of each single index,and the differences were statistically significant(P<0.05).When SGF is used to diagnose gastric cancer,the diagnostic value of PGⅠ in the diagnosis of gastric cancer is high,the optimum critical value is 83.35μg/L,the sensitivity is 95.1%and the specificity is 85.1%.The diagnostic value of PGR in the diagnosis of gastric cancer is high,the ptimum critical value of 6.76,sensitivity of 91.8%and specificity of 85.6%.The joint index of the four indexes of SGF,whose area under the ROC curve(AUC)is 0.983,is of high diagnostic value to the gastriccancer,and the AUC of the joint index was greater than that of PGⅠ,the difference was statistically significant(P=0.002,P<0.05),the AUC of the joint index was greater than that of PGR,the difference was statistically significant(P=0.003,P<0.05),there was no significant difference in AUC between PGⅠ and PGR(P=0.271,P>0.05).Conclusion:1.SGF is expected to be an important and effective indicator for dynamic monitoring of CAG follow-up in clinical practice.2.PGⅠ≤83.35μg/L or PGR≤6.76 is of great significance to early gastric cancer screening in large-scale population and is worth popularizing. |
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