| Objective:By observing the changes of serological levels of pepsinogen I,pepsinogen II,pepsinogen I / II and gastrin-17,the clinical value of dynamic reaction of gastric mucosal function and morphology by serological markers was evaluated.And to evaluate the ability to screen high-risk people with gastric cancer using a new gastric cancer scoring system.Follow-up of patients with chronic atrophic gastritis infected by Helicobacter pylori.Changes of serum pepsinogen,gastrin-17 and histopathological examination after successful eradication of Helicobacter pyloriMethods:1.The subjects of early gastric cancer screening were collected from May.2017 to Dec.2018.Age,sex,family history of gastric cancer,smoking history,drinking history and other relevant personal information were obtained by questionnaire.Serological indexes,14 C breath test,gastroscopy and histopathological biopsy were collected and analyzed.The results showed that pepsinogen and gastrin-17 could reflect gastric mucosal atrophy and intestinal metaplasia and predict the occurrence of gastric cancer.2.All subjects were grouped according to the new gastric cancer scoring screening system.To evaluate the clinical value of a new type of gastric cancer scoring screening system.3.For the patients with precancerous lesions(atrophic gastritis,intestinal gastritis,gastric ulcer)and early cancer with Hp positive,the patients with gastroscopy and biopsy indicated that PPI combined with bismuth two antibiotics could be used for14 days eradication therapy.After 4 weeks of withdrawal,the results of 14 C breath test were used to determine whether the eradication was successful.After successful eradication of Helicobacter pylori,peripheral blood samples were taken to determine pepsinogen,gastrin 17,gastroscopy and histopathology after 6 months of follow-up.The changes of serological indexes and histopathology before and after eradication were analyzed statistically.Results:1.A total of 145 subjects were included,including 96 males and 49 females.There were 50 cases of chronic superficial gastritis,11 cases of atrophic gastritis,31 cases of intestinal metaplasia gastritis,25 cases of gastric ulcer,7 cases of low grade intraepithelial neoplasia,11 cases of early gastric cancer and 10 cases of advanced gastric cancer.There was no significant difference in age,gender,smoking history,drinking history and family history of gastric cancer.2.There were 56 cases(38.62%)without obvious symptoms,78 cases(53.79%)with dyspepsia,3 cases(2.07%)with hematemesis and black stool,8 cases(5.51%)with wasting and weak.3.The PG ? and PGR of chronic superficial gastritis,precancerous lesion group and gastric cancer group were decreased gradually,and there was significant difference between each group(P < 0.05).The G-17 of chronic superficial gastritis,precancerous lesion group and gastric cancer group was increased gradually(P <0.05).The levels of PG ? and PGR in gastric ulcer group were significantly different from those in atrophic gastritis group,intestinal metaplastic gastritis group and low grade intraepithelial neoplasia group(P < 0.05).The levels of PG ? and PGR in atrophic gastritis group,intestinal metaplastic gastritis group and low grade intraepithelial neoplasia group were significantly different(P < 0.05).There was no significant difference in G-17 levels between gastric ulcer group and atrophic gastritis group,intestinal metaplastic gastritis group and low grade intraepithelial neoplasia group.There was no significant difference in PG ?,PRG,PG ?,G-17 between early gastric cancer group and advanced gastric cancer group.4.New gastric cancer screening system: 80 cases of low-risk population of gastric cancer,including 6 cases of gastric cancer group,the detection rate of gastric cancer was 7.5%.Among 56 cases of gastric cancer,11 cases were gastric cancer group,and the detection rate of gastric cancer was 19.6%.9 cases of high risk population of gastric cancer,4 cases of gastric cancer group,the detection rate of gastric cancer was 44.4%.The positive rate of low risk group of gastric cancer was lower than that of middle risk group of gastric cancer,and the difference was statistically significant(P = 0.035 ?0.006).5.There were 14 cases of Helicobacter pylori eradicated and followed up for 6 months,including 8 males,4 females,6 patients with chronic atrophic gastritis,5 patients with intestinal metaplasia gastritis,5 patients with chronic atrophic gastritis.There was no significant difference in PG ?,PG ? and PGR between 14 patients with low grade intraepithelial neoplasia before and after eradication of Helicobacter pylori(P = 0.901,0.966 n 0.827).There was significant difference in G-17 levels before and after eradication of Helicobacter pylori(P = 0.037).Conclusion:1.When the gastric mucosa was found to be atrophy,the intestinal metaplasia,the intraepithelial neoplasia,or the canceration,the secretion of PG I in the gastric mucosa was reduced,and the serum PG I and PGR were negatively correlated with the atrophy of the gastric mucosa,the intestinal metaplasia and the intraepithelial neoplasia,and the serum PG I and PGR were significantly reduced as one of the serological manifestations of gastric cancer.2.The G-17 level is positively correlated with the atrophy of the gastric mucosa,the intestinal metaplasia,the intraepithelial neoplasia and the canceration,and the high level of serum G-17 is the high risk factor of the gastric cancer.3.Serum PGI,PGR,G-17 can be used as a predictor of early gastric cancer,and can improve the detection rate of gastric cancer,achieve early detection,early treatment,and reduce the mortality of gastric cancer.4.Hp infection is closely related to gastric mucosal atrophy,intestinal metaplasia,atypical hyperplasia and carcinogenesis.Eradication of Hp has important clinical significance in reducing the incidence of gastric cancer.5.The new gastric cancer screening system has important clinical value for the population at risk of gastric cancer. |
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