Diagnostic Value Of Gastrin 17,Pepsinogen,Carcinoembryonic Antigen And Helicobacter Pylori In Early Gastric Cancer

Objective To explore the application value of gastrin 17,pepsinogen,carcinoembryonic antigen and Helicobacter pylori in the diagnosis of early gastric cancer.Methods 114 patients with gastric diseases（including 35 cases of gastric ulcer,40cases of atrophic gastritis,39 cases of gastric cancer）in our hospital were selected as the research objects,and 32 cases of normal population examined by gastroscopy during the same period were selected as the control group.Quantum dots fluorescence immune-chromatography was used to determine the levels of gastrin 17,pepsinogen,and chemiluminescencemicroparticle immunoassay was used to determine the expression of CEA.Helicobacter pylori infection was determined using the ¹³C breath test.The levels of serum G-17,PGⅠ,PGⅡ,CEA and HP positive rate of the selected population were compared,and the sensitivity of early gastric cancer was detected by ROC curve analysis.Meanwhile,Meta analysis was carried out on 21 diagnostic experiments published in China about serum G-17,PG and PGR detection of gastric cancer.Results There were no significant differences in the data composition of age and gender among all groups of patients（P>0.05）.The level of gastrin 17 was not significantly different between the control group,gastric ulcer group and atrophic gastritis group（P>0.05）;the level of gastrin 17 in the gastric cancer group was significantly higher than that of the other three groups（P<0.05）The levels of pepsinogenⅠandⅡin the atrophic gastritis group and gastric cancer group were lower than those in the control group,and the difference was significant（P<0.05）.The CEA level of gastric cancer group was higher than that of atrophic gastritis group and gastric ulcer group（P<0.05）.The positive rate of Helicobacter pylori in the control group was 53.1%（17/32）,the positive rate of Helicobacter pylori in the gastric ulcer group was 85.7%（30/35）,and the positive rate of Helicobacter pylori in the gastric cancer group was 87.2%（34/39）.Atrophic gastritis Helicobacter pylori was 85.0%（34/40）.In each group,only the positive rate of the control group was lower than 85.0%,and the remaining groups were higher than 85.0%.The expression of gastrin 17,pepsinogen and CEA levels in Helicobacter pylori positive and negative patients suggested that the indicators of Helicobacter pylori positive group patients were not significantly higher than those of Helicobacter pylori negative group,the difference was not statistically significant（P>0.05）.The curve area of the single test PGⅠwas the highest,which was 0.978,followed by PGⅠ,PGⅡ,and CEA.The four-joint test had the highest curve area of 1.000.Meta analysis showed that the area under the SROC curve was AUC（G-17）=0.83、AUC（PGⅠ）=0.86、AUC（PGR）=0.80.All of them were between 0.7 and 0.9,which had good application value.Conclusion1.The level of gastrin 17 was not significantly different between the control group,gastric ulcer group and atrophic gastritis group;the level of gastrin 17 in the gastric cancer group was significantly higher than that of the other three groups,pepsin in the atrophic gastritis group and gastric cancer group.The levels of PGI and PGII were lower than those of the control group.The CEA level of gastric cancer group was higher than that of atrophic gastritis group and gastric ulcer group.2.In each group,only the positive rate of the control group was lower than 85.0%,and the remaining groups were higher than 85.0%.It was suggested that H.pylori infection was an important risk factor for the occurrence and development of gastric diseases.3.The levels of gastrin 17,pepsinogen and CEA in patients with H.pylori positive group were not significantly different from those with H.pylori negative group.It suggested that the occurence and development of gastric cancer had a more complex mechanism,H.Pylori infection was not a single pathogenic factor.4.Combined detection of G-17,PGⅠ,PGⅡand Hp is of great significance for the diagnosis of early gastric cancer and can provide an effective basis for early gastric cancer screening.5.Meta analysis showed that serum G-17,PGⅠ,PGR had good clinical value in early screening of gastric cancer in Chinese residents.