Diagnostic Value Of Pepsinogen In Atrophic Gsatritis And Gastric Cancer Evaluation

Objective:To evaluate the significance of PG I,PGⅡ and PGR in atrophic gastritis and gastric cancer using chemiluminesent immunoassay assay(CLIA)and enzyme linked immunosorbent assay(ELISA),and to analyze the consistency of the two methods.Methods:1.3ml serum samples were collected from our hospital patients and health examination professionals,then centrifuged with 4000r/min for 6min(serum samples were taken before surgery in gastric cancer cases).The collected serum must be determined immediately(if these serum can’t timely be detected,stored at-20℃ for long-time detection).2.CLIA and ELISA were used to determine the expressions of serum PG Ⅰ,PGⅡ and PG Ⅰ/Ⅱ(PGR)in gastric cancer cases(n=135),atrophic gastritis cases(n=407),non-atrophic gastritis cases(n=173)and healthy cases(n=95).3.The most suitable cut-off values of PG of two methods were determined by ROC.Their diagnostic efficiencies.were evaluated,and the consistency of CLIA and ELISA in detecting PG was analyzed by SPSS 17.0.Results:1.We found that there was no statistical difference of the expression of PG I among healthy controls,non-atrophic gastritis,atrophic gastritis and gastric cancer group detecting by both CLIA and ELISA(CLIA:P=0.6292,0.1530,0.9929,0.1387,0.1177,0.1609;ELISA:P=0.1282,0.2100,0.0841,0.9193,0.5536,0.6743).2.The expression of PGⅡ in gastric cancer group was higher than in atrophic gastritis group,non-atrophic gastritis group and healthy controls(CLIA:P=0.027,0.002,<0.001;ELISA:P=0.008,<0.001,<0.001).PG Ⅱ level in atrophic gastritis group was higher than in non-atrophic gastritis and healthy control group(CLIA:P=0.037,<0.001;ELISA:P=0.046,0.024).There was no significant difference of PG II between non-atrophic gastritis group and healthy controls(P=0.136,0.466).3.PGR in gastric cancer group was lower than in atrophic gastritis group,non-atrophic gastritis group and healthy controls(CLIA:P<0.001,<0.001,<0.001;ELISA:P<0.O001,<0.001,0.001).PGR level in atrophic gastritis group was lower than in non-atrophic gastritis and healthy control group(CLIA:P<0.001,<0.001;ELISA:P=0.014,0.020).There was no significant difference of PGR between non-atrophic gastritis group and healthy controls(P=0.564,0.758).4.PGⅡ>13.20 and PGR≤6.67 were considered the most suitable cut-off value for diagnosing gastric cancer using CLIA,and the sensitivity and specificity were 80.88%and 71.64%,respectively.PG Ⅱ>18.10 and PGR≤6.18were considered the most suitable cut-off value for diagnosing gastric cancer using ELISA,and the sensitivity and specificity were 80,14%and 62.72%.5.PG Ⅱ>6.7 and PGRS≤6.8 was considered the most suitable cut-off value for diagnosing atrophic gastritis using CLIA,and the sensitivity and specificity were 70.50%and 62.22%,respectively.PG II>10.92 and PGR<8.8 was considered as the most suitable cut-off value for diagnosing atrophic gastritis using ELISA,and the sensitivity and specificity were 57.73%and 65.19%,respectively.6.The concidence rate of CLIA and ELISA with gastroscopy in diagnosing gastric cancer and atrophic gastritis was 73.70%,66.30%and 68.74%,61.48%,respectively.Further analysis showed that the concidence rate of two methods of CLIA and ELISA in diagnosing gastric cancer and atrophic gastritis was 85.31%,81.04%and Kappa index was 0.706 and 0.569,respectively.Conclusion:Pepsinogen has certain value in the diagnosis of gastric cancer and atrophic gastritis.PGⅡ and PGR can be used as useful biomarkers for the diagnosis of gastric cancer and atrophic gastritis using ROC.The combination of PG Ⅱ and PGR has considerable diagnostic value of gastric cancer and atrophic gastritis with higher sensitivity and specificity.CLIA and ELISA have a good consistency in detecting PG.