An Analysis Of The Changes And Related Influence Factors Of Serum Levels Of Gastrin-17 And Pepsinogens Of The People In Yan'an Area

Objective:This study aimed to analyze the influence of gender and age on serum levels of Gastrin-17 and pepsinogens in healthy Chinese Han nationality in Yan'an area so as to initially establish the normal medical reference range of Gastrin-17 and pepsinogen levels of those people.This study aimed to analyze the change rule of high-risk population of gastric cancer serum gastrin-17 and pepsinogen so that to define the cut-off value for screening gastric cancer.This study aimed to understand the local Helicobacter pylori infection rate so as to clear whether the serum gastrin and pepsinogen-17 clear levels were affected by Helicobacter pylori.It was based on the results above to explore the clinical value of applying Gastrin-17 and pepsinogen for screening the gastric cancer and its precancerous lesion.Methods:The healthy group consisted of 2251 healthy people who randomly selected and performed physical examination,containing G-17,PG,14C-urea breath test(HP-)and gastroscopy(gastric mucosal were not found significant abnormalities)in Affiliated Hospital of Yan'an University and Yan'an People's Hospital from 2015.10 to 2017.04.At the same period,the observation group constituted 409 people of outpatients and inpatients who checked the serum levels of G-17 and PG,14C-urea breath test(HP-/+)and endoscopic biopsy due to gastrointestinal symptoms.According to the results of pathological examination,the observation group was divided into five groups:non-atrophic chronic gastritis,gastric polyps,chronic atrophic gastritis,intraepithelialneoplasia and gastric cancer.Endoscopic and pathological diagnosis were in line with the2012 edition of “the Chinese chronic gastritis consensus opinion diagnostic criteria”.The data were analyzed by SPSS 20.0 software package,the normal test and the homogeneity test of variance were carried out.The measurement data which according with normal distribution and homogeneity was stood for(` x+ s),and comparison of data of two groups using t-test,single factor analysis of variance(SNK-test or LSD-test);The count data was stood for percentage(%),and comparison between groups using Chi-square test,P<0.05 means the statistical difference.To calculate the best threshold value for screening gastric cancer by curve of receiver operating characteristic.Results:1.There were statistical differences of Gastrin-17 and pepsinogen levels of different gender and different age groups in Chinese Han population of Yan'an area(P<0.05).2.The normal medical reference range of Gastrin-17 and pepsinogen levels in Chinese Han population of Yan'an area were as followed: 16-44 year old male group: G-17(5.69-12.37)pmol/L,PG I(111.56-139.07)ug/L,PG II(9.74-14.64)ug/L,PGR(9.25-13.76);16-44 year-old female groups: G-17(4.43-10.35)pmol/L,PGI(102.08-134.21)ug/L,PG II(9.40-13.37)ug/L,PGR(8.52-14.34);more than 45 years old male group: G-17(4.19-11.36)pmol/L,PGI(110.87-126.93)ug/L,PGII(10.01-14.79)ug/L,PGR(9.05-15.18);more than 45 years old female group: G-17(3.90-11.70)pmol/L PGI(98.7-125.83)ug/L,PGII(8.19-12.21)ug/L,PGR(6.14-14.03).3.The level of G-17: the level of G-17 of both-non atrophic chronic gastritis group and gastric cancer group were significantly higher than that of gastric polyp group,chronic atrophic gastritis and intraepithelial neoplasia group respectively(P < 0.05).The level of G-17 in gastric cancer group was significantly higher than that of non-atrophic chronic gastritis group(P < 0.05).The level of PGI: The levels of PG I in intraepithelial neoplasia group and gastric cancer group was significantly lower than that in non-atrophic chronic gastritis group,gastric polyp group and chronic atrophic gastritis group respectively(P <0.05).This in non-atrophic chronic gastritis group was statistically lower that it inchronic atrophic gastritis group and gastric cancer group respectively(P < 0.05),while there was no significantly difference of that in intraepithelial neoplasia group and gastric cancer group(P > 0.05).The level of PGII: the level of PG-II in gastric cancer group was significantly higher than that of gastric polyp group(P < 0.05).The level of PGR:Compared with the level of PGR in non-atrophic chronic gastritis group,that in intraepithelial neoplasia group and gastric cancer group was respectively significantly lower(P < 0.05).The level of PGR in gastric polyp group was significantly higher than that in gastric cancer group(P < 0.05).4.There was a certain correlation among G-17,PG and Helicobacter pylori infection in chronic gastric diseases.The level of G-17: the level of G-17 in the HP(+)group was significantly higher than that in HP(-)group,among the subgroup of gastric cancer group?chronic atrophic gastritis group?gastric cancer group respectively(P < 0.05).The level of PG-I: the level of PGI in the HP(+)group was statistically higher than that in HP(-)group of the subgroup of CAG(P < 0.05),while in the HP(+)group was statistically lower than that in HP(-)group of the subgroup of GC(P < 0.05).The level of PG II: the level of PG II in the HP(+)group was statistically higher than that in HP(-)group of the subgroup of GP(P < 0.05).The level of PGR: there were no significantly differences in the level of PGR among all the subgroup respectively(P >0.05).5.The rate of Helicobacter pylori infection in chronic atrophic gastritis was significantly higher than that of non-atrophic gastritis group and gastric cancer group respectively(P <0.05).6.The receiver operating characteristic curve was constructed by case group which was set by gastric cancer group and control group which was set by healthy people group.The G-17>17.07pmol/L and PGR<8.68 were set as the critical value of gastric cancer screening which was more accuracy,and the sensitivity was 79.5% and 74.4%,specificity 71.6% and 82.9% respectively.Conclusion:1.There were difference in Gastrin-17 and pepsinogen levels in healthy Chinese Han nationality in Yan'an area range of different gender and age groups,and a normal medical reference range for the local population was initially established.2.Both Gastrin-17 and pepsinogen were closely related with gastric mucousal lesions,which could be used to screen of gastric cancer precancerous lesions and to develop the best critical value of diagnosis of gastric cancer.3.Both Gastrin-17 and pepsinogen were associated with Helicobacter pylori,and it was significantly important for gastric cancer prevention and control by eradication the Helicobacter pylori.