| Objective The purpose of this study was to provide a feasible basis for evaluating the degree of inflammation of gastric mucosa in chronic gastritis by combining PG and IL-8.Comparing with chronic gastritis OLGIM staging systems,we evaluate the consistency of the test results and pathological diagnosis,provide objective basis for the endoscopic diagnosis monitoring follow-up cases and the auxiliary method,and through a simple,noninvasive technology to reduce medical cost and time cost,reduce the risk of biopsy in patients with trauma and complications.Methods This topic for cross-sectional observational studies,since January 1,2017 to December 31,2017,944 patients with endoscopic examination and 228 patients chronic were diagnosed gastritis and agreed to participate in research subjects.Before carrying out this study,we have obtained the argumentation and approval of the ethics committee of our hospital.Meet the following one is out of study: stomach surgery history,history of cancer of the stomach,pyloric obstruction caused by gastric retention,such as surgical acute abdomen,gastrointestinal bleeding,activity,and history or definite diagnosis tumor disease,unable to cooperate or tolerance gastroscopy,anticoagulation and antiplatelet medications are not stopped 1 weeks or have a blood coagulation function disorder,pregnancy,refused to subjects.Prepared by digestive diseases of chronic gastritis patients clinical data collection table,approved by the hospital ethics committee argumentation and at the same time,the collection and analysis of the clinical medical records of patients(including: the patient's general information,clinical manifestation,serologic test results(PG I/II,IL8)endoscopy results and pathological results)The characteristics of gastric mucosal injury were observed and evaluated using endoscopy,and the diagnosis results of pathological examination and endoscopic examination were compared.The diagnostic criteria were based on gastroscopy and histopathological examination.Endoscopic examination and postoperative pathological diagnosis were performed by physicians with extensive clinical experience in the department of gastroenterology and pathology,to ensure the accuracy of the results.SPSS 19.0 package was used for data processing and statistical analysis.The counting data was checked by chi-square test,and the measurement data was based on rank and test,and the difference was statistically significant with P<0.05.Result(1)Among 228 chronic gastritis patients,128 cases with intestinal metaplasia,68 were male and 60 were female.There were 72 cases of age >50 years,and 56 cases of age< 50 years;38 patients with clinical symptoms;Endoscopic examination revealed 96 cases of intestinal metaplasia;There were 38 cases of stage I,27 cases of stage II,35 cases of stage III and 28 cases of stage IV.PG I content averaged 49.66±5.21ug/L,PG II content averaged 15.60 ± 4.61 ug/L,PG I/PG II ratio of 2.31 ±1.30,The content of IL-8 was 110.10 ± 40.16 pg/ml.(2)Intestinal metaplasia endoscopic classification,mild 65 cases,moderate 44 cases,severe 19 cases;under endoscopy,there were 18 cases of pale yellow nodules,42 cases of porcelain white nodular type,22 cases of fish scales,and 46 cases of diffuse type.(3)The stage were performed according to the staging criteria of OLGIM(gastric mucosal intestinal metaplasia).In I stage,the content of PG I was 57.55±5.01ug/L,the content of PG II was13.33±5.03ug/L,PGR was4.61±1.93,the content of IL-8 was58.85±10.97pg/ml.In II stage,the content of PG I was 60.21±5.27ug/L,the content of PG II was 16.05±4.71ug/L,PGR was 4.01±1.72,the content of IL-8 was89.27±12.68pg/ml;In III stage,the content of PG I was 43.16±4.57ug/L,the content of PG II was18.21±4.85ug/L,PGR was2.91±0.82,the content of IL-8 was117.31±21.25pg/ml;In IV stage,the content of PG I was 35.21±3.25 ug/L,the content of PG II was21.57±5.09 ug/L,PGR was1.72±0.68,the content of IL-8 was 169.77±23.89pg/ml;(4)In 228 cases of chronic gastritis,128 cases of intestinal metaplasia were diagnosed by biopsy.According to endoscopic morphology,110 cases of intestinal metaplasia were considered in endoscopic examination,96 of which were consistent with the final pathological diagnosis.According to PGR < 3,there were 100 intestinal metaplasia,72 of which were consistent with the final pathological diagnosis.According to the evaluation of IL-8 > 120,98 cases of intestinal metaplasia were considered,of which 68 were in accordance with the final pathological diagnosis.According to PGR < 3 and IL-8 >120,90 cases of intestinal metaplasia were considered,(5)Using four table chi-square,efficiency compared to the diagnosis of 4 methods,the sensitivity of endoscopy in the diagnosis of intestinal metaplasia was 75.00%,specificity of 86.00%,positive predictive value was 87.27%,the coincidence rate is 79.82%;The sensitivity of PGR value to intestinal metaplasia was 56.13% and specificity was 72.00%.The positive predictive value was 72.00%,and the coincidence rate was 63.16%.The sensitivity of il-8 value in the diagnosis of intestinal metaplasia was 53.13%,specificity was 70.00%,positive predictive value was 69.39%,and the coincidence rate was 60.53%.The sensitivity of PGR value +IL-8 value to the diagnosis of intestinal metaplasia was 62.50%,the specificity was90.00%,the positive predictive value was 88.89%,and the coincidence rate was74.56%.Conclusion The levels of PG I,PG II,PGR,IL-8 were closely associated with in pathological staging,PG I ? level and PGR value were reduced with reduced intestinal metaplasia gradually,PGII and IL-8 were increased;(2)PGR < 3 and IL-8 > 120 may be considered as the critical value,which has guiding significance for the diagnosis of intestinal metaplasia.(3)In the diagnosis of intestinal metaplasia,the sensitivity and coincidence rate of endoscopic diagnosis was the highest,and the specificity and positive predictive value of PGR+IL-8 was the highest,and PGR+IL-8was significantly superior to PGR and IL-8.(4)The combination of PGR+IL-8 and intestinal metaplasia were consistent,which played an important role in the clinical diagnosis of intestinal metaplasia. |
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