The Clinical Research Of Pepsinogen Combined With Intelligent Chromo Endoscopy Diagnosing Early Gastric Carcinoma

Objective：Gastric cancer is one of the most common malignant tumors that endangerhuman health. The onset time is not easy to be found. Most patients after abdominalpain, vomiting blood, black stools and other gastrointestinal symptoms, has beendeveloped for advanced treatment. The survival rate of the suffering from advancedgastric cancer five years is much lower than early gastric cancer. Therefore, thediagnosis of early gastric cancer is particularly important. This study established anearly screening for gastric cancer. Intended to explore the pepsinogen PG Ⅰ, PG Ⅱserum values that are measured with time-resolved fluoroimmunoassay method and PGⅠ/PG Ⅱ ratio as the first step screening method, and combined with intelligentchromo endoscopy (i-Scan) screening early gastric carcinoma’dignostic values.Methods：1. Randomly collected the patients that in Medical centers, outpatient and inpatient inour hospital from March2011to August2012. To pepsinogen detected under thepermission of the subjects. The pepsinogen detected by time-resolved fluorescenceimmunoassay method for the determination. This approach reduces the interferenceof the sample analysis system, shorter analysis times, has higher sensitivity, theminimum detectable amount of O.05ug/L [1-2].2. The subjects that pepsinogen abnormal will be checked with the method ofIntelligent chromo endoscopy (i-Scan). In this study, high-definition intelligentelectronic chromo endoscopy (i-Scan), in addition to containing the traditionalcontrast enhancement and surface enhanced the two basic emphasized mode, thebiggest feature is the tone enhancements. It can be easy to observe the lesions withvirtual staining techniques. Compared with conventional endoscopy, It is easier toidentify the disease and identify the edge of the lesion, to improve the detection rateof lesions. 3. The i-Scan guide targeted biopsy based on pathology results clear lesions will beused to the smart staining endoscopic suspicious lesions. And clear lesions based onpathology results.4. According to the benign gastric lesions of PG I, PG II, PG I/PG II ratio referencevalue range reported in literature, we can analyze and compare the changes of thePGⅠ、PGⅡ、PGⅠ/PGⅡ belong to the patients that have Chronic gastritis(chronic non atrophic gastritis, chronic atrophic gastritis), gastric ulcer and earlygastric cancer and advanced gastric cancer.Results:1. Pepsinogen test results: a total of262cases of subjects, of which46were normal,216cases of exceptions.2. Endoscopy and pathology results: in the216cases of pepsinogen anomalies detected96cases of chronic non-atrophic gastritis,34cases of benign gastric ulcer,10casesof early gastric cancer,22cases of advanced gastric cancer.3. Benign gastric ulcer patients’ PG I and PG II above normal, PG I/PG II ratiodecreased (P <005).4. Patients’ with chronic atrophic gastritis PG I lower than normal, PG I/PG II ratiodecreased.5. Patients’with gastric cancer PG I and PG I/PG II ratio are significantly lower thanPatients with normal and chronic non atrophic gastritis. Compared the patients withearly gastric cancer with the patients with advanced gastric cancer, there was nosignificant difference in the ratio of PG I and PG I/PG II.(P>0.05).6. Compared with non-atrophic gastritis and normal patients, the patients’ withatrophic gastritis and gastric cancer PG I <60ug/L and PG I/PG II ratio≤6probability of occurrence increased.(P>0.05).Conclusion:1. Serum PG I, PG II numerical and PG I/PG II ratio decreased is related to theoccurrence of early gastric cancer.2. The time-resolved fluorescence immunoassay serum PG can be used as a means ofgastric cancer screening, which has the advantages of simple non-invasive.3. Intelligent chromo endoscopy (i-Scan), compared with other intelligent chromoendoscopy (NBI FACE), can be better to observe the lesions with the virtual staining techniques. Easier to identify lesions and identify the edge of the lesion and improvethe detection rate of early gastric cancer.4. Intelligent chromo endoscopy (i-Scan) can improve the diagnosis rate of earlygastric cancer.