| Objective:Analyze and compare the dietary habits of residents of Fuan,Tongan,and Changle districts along the coast of Fujian Province,and the related serological markers of gastric cancer,Helicobacter pylori(H.pylori)infection,and Cytotoxin associated protein A(Cag A).)The distribution of antibodies and the distribution of Pepsinogen I(PGI)and Pepsinogen II(PGII)levels were used to investigate the causes of the difference in gastric cancer incidence in Fujian Province and its relationship with serological markers;The distribution of pylori antibody,Cag A antibody,PGI,PGII,and gastric cancer-associated antigen(MG7-Ag)in different gastric diseases are different,and their correlation with gastric cancer is explored to find serological suitable for gastric cancer screening in Fujian Province.Indicators to determine their best cutoffs.Mehods: 1.Influencing factors and serological studies of gastric cancer in high,middle and low incidence areas of gastric cancer in Fujian Province.A comparative study of ecology was used to select eligible subjects from Changle District,Fuzhou City,Tong’an District,Xiamen City and Fu’an City,Ningde City,using a multi-stage random sampling method.A total of 974 people were interviewed to collect relevant information and collect blood samples.Serum H.pylori antibodies,Cag A antibodies,PGI,and PGII were measured by enzyme linked immunosorbent assay(ELISA).The demographics of the survey subjects,family history of gastric diseases,past history of gastric diseases,dietary habits,and H were compared.Pylori antibody infection,Cag A antibody distribution,serum PGI,PGII,PGR(PGI/PGII)levels of distribution differences.2.The diagnostic value of serum H.pylori,Cag A,PG and MG7-Ag in gastric cancer.Based on the hospital,collect newly diagnosed patients with gastric cancer and precancerous lesions from August 2014 to September 2017 in the Fuzhou General Hospital and Fujian Provincial Hospital of the Nanjing Military Region,and the physical examination center of the Fuzhou General Hospital of the Nanjing Military District The physical examination subjects consisted of 632 persons.The frequency and gender of the subjects were the same.They were included in the normal control group(281 cases),atrophic gastritis group(150 cases),and gastric cancer group(201 cases).The basic information was collected,blood was collected,and the related serological markers were detected by ELISA.The differences of serum H.pylori antibody,Cag A antibody,PGI,PGII,and MG7-Ag levels in each group were compared,and the receiver operating characteristic curve(ROC curve)was plotted.Determine the best cut-off value and calculate the sensitivity,specificity,and Youden index.Results:1.This study investigated Fuan,Tongan and Changle,a total of 974 people.There were 416 males(42.71%)and 558 females(57.29%),with an average age of 53.0±10.9 years old.Fuan City,Tongan District,and Changle District investigated subjects with upper digestive system tumors,chronic gastritis,family history of other digestive system tumors,chronic gastritis,other stomach diseases,previous history of other tumors,and maintained eight-point full meals,often ate in restaurants,and did not The proportion of meals,taking into account nutritionally balanced conditions,intake of green vegetables,fruits,spicy products,blanched foods,fried foods,pickles,dried potatoes,ginger,milk,soy products,nuts,lean meat,fish products,The frequency of fish sauce products,tea drinking rate and drinking rate were statistically significant(P<0.05).Based on the multi-category Logistic regression model of three places,taking Fu’an City as a reference,Tongan District’s research results showed that: the frequency of Tongan workers,eating and eating,eating fried foods,pickles,milk,nuts,and the positive rate of Cag A antibody The levels of serum PGI and PGII were higher than those in Fu’an City.The OR values were 6.06,2.529,5.580,1.919,2.112,1.725,2.410,1.012,and 3.668,respectively.Labor intensity,consumption of green vegetables,fruits,spicy food,ginger and soy products The frequency of PGR was lower than that of Fu’an City,and the OR values were 0.570,0.302,0.511,0.193,0.551,0.428,and 0.041,respectively.According to the Fu’an City,Changle District’s findings show that workers in Changle District eat in the restaurant,eat and eat,eat fried foods,pickles,milk,nuts,fish sauce products,have a family history of digestive system cancer,positive Cag A antibodies,and serum PGI levels were higher than those in Fu’an City.The OR values were 2.889,1.599,1.627,4.89,1.899,2.455,3.379,1.834,2.354,8.425,respectively.Labor intensity,consumption of green vegetables,fruits,the pungent foods,ginger,soy products,tea,and serum PGR were lower than those in Fu’an City.The OR values were 0.313,0.288,0.581,0.568,0.551,0.517 and 0.959,respectively.The total infection rate of H.pylori was 51.64% in Fu’an City,Tongan District and Changle District,and the total positive rate of Cag A antibody was 40.66%.The infection rate of serum H.pylori antibody,positive rate of Cag A antibody,and PGI and PGII levels from low to high were: Fuan City,Tongan District and Changle District,and the differences were statistically significant(P<0.05).Serum PGR levels from low to high: Changle District,Tongan District,Fu’an City,were statistically significant differences(P <0.05).2.The distribution of serum PGI levels from low to high were: atrophic gastritis group,normal control group,gastric cancer group;serum PGII,MG7-Ag levels were from low to high: normal control group,atrophic gastritis group,gastric cancer The serum PGR levels were from low to high in the gastric cancer group,atrophic gastritis group,and normal control group.The above indicators were compared between groups and the differences were statistically significant(P<0.05).The serum PGII levels in advanced gastric cancer were higher than those in early gastric cancer;the serum PGR levels in advanced gastric cancer were lower than those in early gastric cancer,and the differences were statistically significant(P<0.05).The serum levels of PGI,PGII and MG7-Ag in patients with positive H.pylori infection were higher than those in patients with negative H.pylori infection.The serum PGR levels were lower than those with negative H.pylori infection,and the differences were statistically significant(P<0.05).The serum levels of PGI,PGII and MG7-Ag in patients with positive Cag A antibodies were higher than those with negative Cag A antibodies,and serum PGR levels were lower than those with negative Cag A infections.The differences were statistically significant(P<0.001).The best cut-off values of gastric cancer screening in Fujian Province: PGII≥12.101ug/L(sensitivity 75.6%,specificity 64.4%,Youden index 0.400);PGR≤8.127(sensitivity 70.5%,specificity 70.3%,Youden index 0.408);MG7-Ag≥1.090 U/ml(sensitivity 71.2%,specificity 75%,Youden index 0.462).Conclusion:1.Family history of upper digestive tract cancer,family history of chronic gastritis,family history of other digestive tract cancers,previous history of chronic gastritis,occupation of workers’ occupations,food and food intake,irregular eating times,frequent intake of fried foods,and pickles,milk,nuts,lean meat,fish products,fish sauce products,etc.increase the risk of gastric cancer in Fujian Province;survey workers with high labor intensity,frequent intake of green vegetables,fruits,ginger,soy products is beneficial to gastric cancer in Fujian Province Prevention and control.2.Serum H.pylori,Cag A antibody,PGI,PGII,and PGR levels were different in Fuan,Tongan,and Changle.It is suggested that serum H.pylori infection,Cag A antibody,PGI and PGII levels are positively correlated with the incidence of gastric cancer,and serum PGR levels are negatively correlated with the incidence of gastric cancer.3.The levels of serum H.pylori,Cag A antibodies,PGI,PGII,PGR,and MG7-Ag levels in the normal control group,atrophic gastritis group,and gastric cancer group were all different.However,the distribution of serum PGI levels from low to high were: atrophic gastritis group,normal control group,and gastric cancer group.It is suggested that H.pylori infection,Cag A antibody,PGII,PGR,and MG7-Ag levels are related to the incidence of gastric cancer and can be used as a screening index for gastric cancer.4.Serum PGI has no diagnostic value,serum PGII,PGR,and MG7-Ag have significant significance in screening for abnormal gastric mucosa,and have diagnostic value for screening gastric cancer.The best cut-off values for gastric cancer screening in Fujian Province: PGII≥12.101ug/L;PGR≤8.127;MG7-Ag≥1.090U/ml. |
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