The Influencing Factors Of Serum Pepsinogen And Gastrin-17 And Its Value In The Screening And Diagnosis Of Gastric Cancer

Part 1 The influencing factors of serum pepsinogen and gastrin-17 level and its application in gastric cancer screeningObjective: To investigate the changes of serum pepsinogen(PG?,PG?)and gastrin-17(G-17)levels and the influencing factors,and to explore the application of screening strategies for further gastroscopy in serological abnormalities.Methods: A total of 1573 patients were randomly selected to study serum levels of PG,G-17 and Hp-Ig G in serum by enzyme-linked immunosorbent assay(ELISA).To compare the changes of PG and G-17 levels in different sexes,age and Hp-infected populations,and to explore the influencing factors of PGR(PG? / PG?)and G-17 levels by single factor and multivariate analysis.And gastroscopy was performed on PG and / or G-17 abnormalities.Results:(1)Serum PG? levels were significantly higher in men than in females(P<0.01).Compared with the young group,the levels of serum PGR were significantly decreased in the middle-aged group and the elderly group(P<0.05),and the G-17 level in the elderly group was significantly higher(P<0.05).Compared with Hp negative,the levels of PG?,PG?and G-17 in Hp positive group were significantly increased,PGR level was significantly decreased(P <0.01).(2)Age(OR = 1.657,95%CI: 1.387-1.979),high-salt diet(OR = 1.450,95%CI: 1.134-1.865)?family history of gastric cancer(OR = 1.458,95%CI: 1.029-2.068),smoking(OR = 1.518,95%CI: 1.166-1.806)and Hp infection(OR = 3.937,95%CI: 3.095-5.026)were independent risk factors for PGR abnormality.Eating marinated foods(OR = 1.632,95%CI: 1.157-2.301)and Hp infection(OR = 1.821,95%CI: 1.400-2.368)were independent risk factors for G-17 abnormalities.(3)Of the 1573 subjects who received serological tests,there were 384(24.41%)PG or(and)G-17 abnormalities,of which 203(52.86%)were endoscopy.4 cases of gastric cancer,2 cases of high grade intraepithelial neoplasia,11 cases of low grade intraepithelial neoplasia,54 cases of atrophic gastritis,35 cases of intestinal metaplasia and 97 cases of superficial gastritis.Conclusions:1.Serum PG and G-17 levels were affected by sex,age,and Hp infection.2.Age,high-salt diet,family history of gastric cancer,smoking and Hp infection are independent risk factors for PGR abnormalities;eating marinated foods and Hp infection are independent risk factors for G-17 abnormalities.3.Screening strategies for further gastroscopy in high-risk populations with serological abnormalities are of great value for the early detection and early intervention of gastric cancer and precancerous lesions.Part 2 The clinical value of serum pepsinogen and gastrin-17 in the diagnosis of gastric cancerObjective: To investigate the changes of serum PG and G-17 in patients with different gastric diseases,and to evaluate the diagnostic value of PG combined with G-17 in gastric cancer.Methods: Serum levels of PG and G-17 were measured by enzyme-linked immunosorbent assay(ELISA)in 278 patients.According to endoscopy and pathological results were divided into: superficial gastritis group 67 cases,33 cases of peptic ulcer group,atrophic gastritis / intestinal group 73 cases,51 cases of intraepithelial neoplasia and gastric cancer group 54 cases.The changes of PG and G-17 levels in the serum of each group were analyzed,and the ROC curve was drawn to obtain the diagnostic value of PG?,PGR(PG? / PG?)and G-17.According to the results of serology,the patients were divided into group A: PG and G-17 were normal.Group B: PG or G-17 abnormalities;group C: PG and G-17 were abnormal.BC group for serological abnormalities,assessment of PG combined with G-17 serological detection of gastric cancer diagnosis.Results:(1)Compared with the superficial gastritis group,the levels of PGR and PGR in the peptic ulcer group were significantly increased(P <0.05),and the levels of PG? and PGR in atrophic gastritis /intestinal metaplasia,intraepithelial neoplasia and gastric cancer group were significantly decreased(P <0.01).Compared with atrophic gastritis / intestinal metaplasia,serum PG? and PGR levels in gastric cancer group were significantly decreased(P <0.01).The level of G-17 in gastric cancer group was significantly higher than that in other groups(P <0.01).The level of G-17 in intraepithelial neoplasia group was significantly higher than that in atrophic gastritis / intestinal metaplasia group.(2)According to the ROC curve,the cutoff value of PG?was 70.78 g/L(sensitivity 89.3%,specificity 79.2%),the cutoff value of PGR was 6.24(sensitivity 88.1%,specificity 74.8%),and the cutoff value of G-17 was 14.27 pmol / L(sensitivity 83.3%,specificity 76%).(3)The prevalence of gastric cancer was 3.17% in group A,28.68% in group B and 56.52% in group C.The prevalence of gastric cancer in group B and group C was significantly higher than that in group A The sensitivity of serum PG combined with G-17 in diagnosis of gastric cancer was 92.59%,the specificity was 54.46%,the false positive rate was 45.54% and the false negative rate was 7.41%.Conclusions:1,The levels of PG? and PGR in patients with gastric cancer and gastric precancerous lesions were significantly decreased,and the levels of G-17 were significantly increased.2,PG??70.78 g / L,PGR ? 6.24,G-17 ? 14.27 pmol / L in the diagnosis of gastric cancer has a good sensitivity and specificity;3,PG and G-17 abnormal levels suggest a high risk of gastric cancer,PG combined with G-17 test can be used for gastric cancer screening And diagnosis,is conducive to improving the detection rate of gastric cancer.