| Background and ObjectiveGastric cancer(GC)is a common tumor of digestive system.Its development follows the pattern of "chronic gastritis gastric mucosa atrophy intestinal metaplasia dysplasia intestinal cancer".Therefore,chronic atrophic gastritis(CAG)is considered as an important precancerous disease of gastric cancer.The 5-year survival rate of most patients with early gastric cancer(EGC)is more than 90%,while that of patients with advanced gastric cancer is less than 30%[1].Therefore,screening,diagnosis and treatment of chronic atrophic gastritis and early gastric cancer can improve the survival rate and reduce the mortality rate of gastric cancer patients.It is found that serum pepsinogen(PG)and gastrin-17(G-17)can better reflect the structure,function and change of gastric mucosa.They have been widely used in early screening and diagnosis of gastric cancer in Japan and other countries.The purpose of this study was to investigate the difference and regularity of serum PG and G-17 levels in non atrophic gastritis,chronic atrophic gastritis and early gastric cancer,as well as the change characteristics of their contents in different lesions,analyze the independent risk factors of atrophic gastritis and early gastric cancer,evaluate the diagnostic efficacy of PG and G-17 in atrophic gastritis and early gastric cancer.MethodsAccording to the inclusion criteria and exclusion criteria,72 patients with early gastric cancer(cancer cells are only limited to mucosa and submucosa)and 78 patients with atrophic gastritis(including chronic atrophic gastritis with or without intestinal metaplasia)were selected from the Department of Gastroenterology,the First Affiliated Hospital of Zhengzhou University from January 2016 to January 2019,and 80 patients with chronic nor atrophic gastritis at the same period were selected as the control group.General data(including age,gender,family history of gastric cancer,Helicobacter pylori infection),PG ?,PG ?,PGR and G-17 were collected and compared.SPSS 21.0 was used for statistical analysis.The measurement data were in accordance with the normal distribution by Shapiro Wilk test,expressed by mean ±standard deviation(x±s),single factor analysis of variance was used for the comparison between groups,LSD-t test was used for the comparison between two groups,and ?2 test was used for the comparison between groups.Logistic regression was used to analyze the independent risk factors of atrophic gastritis and early gastric cancer.Draw the receiver operating characteristic curve(ROC curve)of PG and G-17 in the diagnosis of chronic atrophic gastritis and early gastric cancer,evaluate the diagnosis efficiency according to the area under the curve,and calculate the sensitivity,specificity and optimal critical value.P<0.05 was statistically significant.Results1.Compared with the control group,the mean age,male proportion and HP positive rate of the atrophic gastritis group and the early gastric cancer group were significantly higher(P<0.05);compared with the atrophic gastritis group,the mean age,male proportion and HP positive rate of the early gastric cancer group were higher,but the difference was not statistically significant(P>0.05).There was no significant difference in family history of gastric cancer among the three groups(P>0.05).2.Compared with the control group,the serum PG ? and PGR levels of the atrophic gastritis group and the early gastric cancer group were significantly lower and the G-17 levels were significantly higher(P<0.05);compared with the atrophic gastritis group,the serum PG ? and PGR levels of the early gastric cancer group were significantly lower and the G-17 levels were significantly higher(P<0.05).There was no significant difference in serum PG ? among the three groups(P>0.05).3.In chronic atrophic gastritis group,the level of serum PG ? in patients with gastric atrophy was significantly lower than that in patients with antral atrophy,while the level of serum G-17 in patients with antral atrophy was significantly higher than that in patients with antral atrophy and multifocal atrophy,the difference was statistically significant(P<0.05).In the early gastric cancer group,the serum levels of PG ?,PG ?,PGR and G-17 had no significant difference among the three groups(P>0.05).4.PGR(OR=0.889,P=0.011)and gender(OR=3.321,P=0.001)were independent risk factors of chronic atrophic gastritis.PGR(OR=0.692,P=0.000),G-17(OR=1.094,P=0.001),gender(OR=5.751,P=0.000),age(OR=1.051,P=0.019)are independent risk factors for early gastric cancer.5.The area under the curve of serum diagnosis of chronic atrophic gastritis by PG ?,PGR and G-17 were 0.611,0.715 and 0.638,respectively.The area under the curve of PGR was the largest,the best critical value was 6.82,the sensitivity was 67.9%,and the specificity was 68.7%.The area under the curve of serum diagnosis of early gastric cancer by PG ?,PGR and G-17 were 0.679,0.871 and 0.704,respectively.The area under the curve of PGR was the largest,the best critical value was 4.75,the sensitivity was 79.2%,and the specificity was 82.5%.Conclusion1.Serum PG and G-17 have certain diagnostic value for chronic atrophic gastritis and early gastric cancer.With the development of chronic atrophic gastritis into early gastric cancer,the level of serum PG? and PGR decreased,and the level of serum G-17 increased.2.Serum PGI and G-17 have certain diagnostic value for atrophic sites of gastric mucosa.When the gastric antrum atrophied,the level of serum G-17 decreased significantly;when the gastric body atrophied,the level of PG I decreased significantly.3.The decrease of PGR and male were independent risk factors of chronic atrophic gastritis.The decrease of PGR,the increase of G-17,the male and the aged were the independent risk factors of early gastric cancer.4.PGR has a high value in the diagnosis of chronic atrophic gastritis and early gastric cancer,especially in early gastric cancer. |
PDF Full Text Request