| Objective 1.To evaluate the predictive value of various gastric cancer risk scoring systems based on the detection of pepsinogen and gastrin 17 for the risk of developing gastric cancer.2.To explore the diagnostic value of volatile organic compounds(VOCs)in the detection of gastric cancer.Methods 1.One hundred and forty four patients were enrolled into the study from the First Affiliated Hospital to Anhui Medical University between April 2018 and October 2018.Among them,seventy four patients were diagnosed with early gastric cancer and seventy patients were diagnosed with non-gastric cancer.The levels of serum pepsinogen I(PG I)/ pepsinogen II(PG II),gastrin-17(G-17)and H.pylori antibody levels were measured.Patients were scored according to the Japanese ABC method,the modified ABC method,and the Chinese new gastric cancer risk scoring system.Compare the accuracy of the three methods for predicting the risk of developing gastric cancer.2.Breath samples were collected from 39 patients with gastric cancer.All patients underwent gastroscopy before the breath test.Exhaled air samples from each patient's family were used as controls.Breath samples were collected by a breath collecting cylinder,while the surrounding air was collected to remove any influence on the exhalation results.After concentration with solid phase microextraction,volatile organic compounds in the breath were detected by gas chromatography mass spectrometry.The Mann-Whitney U test was used for statistical analysis.Results 1.Compared with the control group,there was no significant difference in PG levels between the two groups,the serum G-17 levels were lower in gastric cancer patients then those in control patients(p<0.05).According to the ABC method,the incidence rates of gastric cancer in the four groups of ABCD were 48.6%,59.4%,0.0% and 100% respectively;the incidence rates of gastric cancer in the three groups of modified ABC method were 57.6%,35.9 % and 50% respectively.The cut-off value of new gastric cancer risk scoring system to diagnose gastric cancer was 11 score.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value were 64.8%,71.4%,68.1%,70.6 and 65.8% respectively.But in the low risk group,26 cases(35.1%)were gastric cancer patients.Compared with those with low risk and middle-high risk gastric cancer,there were more females in the low risk group.2.Twenty-one patients with early gastric cancer and 18 patients with advanced gastric cancer were enrolled.A total of 25 VOCs were detected by the gas chromatography mass spectrometry(GCMS)instrument.The concentration of 2-ethylhexanol in the gastric cancer group was significantly lower than that in the control group(P<0.05).Further stratified analysis found that the concentration of 2-ethylhexanol was also significantly lower in the advanced gastric cancer group than that in the control group,and the difference was significant(p<0.05).In the early gastric cancer group,the concentration of 2-ethylhexanol in patients with gastric cancer was lower than that in the control group,but there was no statistically significant difference(p>0.05).Conclusion 1.The Japanese ABC method and the modified ABC method had limited screening value for gastric cancer and were not suitable for China's national conditions.The screening efficacy of the new gastric cancer scoring system for gastric cancer was significantly higher than the other two methods.But it should be vigilant for women with low risk.2.2-ethylhexanol can be used as a potential volatile marker in the diagnosis of gastric cancer. |
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