Diagnostic Value Of Saliva Pepsin Detection For Gastroesophageal Reflux Disease

Objective: In recent years,measuring the concentration of pepsin in saliva is a new non-invasive method for gastroesophageal reflux disease,which has been widely studied by scholars at home and abroad,but there is no consensus on the sampling timing and diagnostic threshold of saliva pepsin.To compare the diagnostic value of salivary pepsin concentration in early morning and one hour after three meals for gastroesophageal reflux disease.Methods:Prospective case-control study was adopted,and 108 gastroesophageal reflux disease patients and 32 healthy controls were included.The cases were divided into reflux esophagitis subgroup(50 cases)and non-erosive reflux disease subgroup(58 cases)according to the presence or absence of erosive esophagitis under endoscopy.enzyme-linked immunosorben assay method was used to measure the concentration of salivary pepsin when waking up in the morning and one hour after three meals.Results: The concentration of salivary pepsin in gastroesophageal reflux disease group was significantly higher than that in healthy control group,and that in reflux esophagitis group was significantly higher than that in non-erosive reflux disease group.In gastroesophageal reflux disease group,the concentration of salivary pepsin in early morning was significantly higher than that in one hour after three meals,and there was no significant difference in the distribution of salivary pepsin in one hour after three meals.The concentration of pepsin in early morning in reflux esophagitis and non-erosive reflux disease subgroups was significantly higher than that in one hour after three meals,but there was no significant difference in the concentration distribution of salivary pepsin in one hour after three meals.When the early morning samples were analyzed,the receiver operating characteristic curve showed that the diagnostic threshold of salivary pepsin was 53.76ng/ml,the sensitivity was 95.4%,the specificity was 100%,Youden’s index was 0.95.When samples after breakfast were analyzed,the receiver operating characteristic curve showed that the diagnostic threshold of salivary pepsin was 54.56ng/ml,the sensitivity was 86.1%,the specificity was 100%,Youden’s index was 0.86.When samples after lunch were analyzed,the receiver operating characteristic curve showed that the diagnostic threshold of salivary pepsin was 28.26 ng/ml,the sensitivity was 95.4%,the specificity was 90.6%,Youden’s index was 0.86.When samples after dinner were analyzed,the receiver operating characteristic curve showed that the diagnostic threshold of salivary pepsin was 19.81 ng/ml,the sensitivity was 98.1%,the specificity was 87.5%,Youden’s index was 0.86.Conclusion: Salivary pepsin detection is of great significance in the diagnosis of gastroesophageal reflux disease,and it is non-invasive,efficient,simple and easy to accept.It is expected to become an important diagnostic tool for gastroesophageal reflux disease.Early morning waking can be used as the most appropriate sampling time for saliva pepsin detection.