| Background and PurposeGastric cancer is a common gastrointestinal tumor,and its prognosis is closely related to the diagnosis and treatment period.Helicobacter pylori(Hp)infection is the major cause of chronic gastritis,peptic ulcers,gastric cancer.Cytotoxin CagA and VacA proteins are the main virulence factors for Hp,and Hp strains that carrying cagPAI with CagA-,VacA-positive cause severe gastric inflammation,which are high-risk strains for gastric cancer.Serum gastrin-17(G-17)and pepsinogen(PG)are commonly used in the screening and risk assessment of atrophic gastritis and early gastric cancer,but the effectiveness of screening is controversial.Joint detection can improve the diagnostic value of gastric cancer.In this study,through the study of hospital population data,to evaluate the diagnostic value of Hp typing combined with serum G-17 and PG detection in early gastric cancer,which will help to explore a preliminary screening strategy for gastric cancer.Materials and MethodsData of hospital admitted patients were collected,including patient's general condition,smoking history,drinking history and family history.All subjects were tested for Hp antibody typing,serum G-17,PG ?,PG ?,PG ?/PG ? ratio on an empty stomach by ELISA,and then examined by upper-endoscopy and tissue biopsy.Based on the pathological diagnosis as the gold standard,1699 cases were enrolled in this study,including 1256 cases non-atrophic gastritis,292 chronic atrophic gastritis and 151 cases of gastric cancer.Comparing the general situation of patients in gastric cancer group and non-gastric cancer group,and the diagnostic value and risk assessment of serum G-17,PG and Hp typing for gastric cancer.Result1.Among 1699 enrolled patients,921 were males and 778 were females,with an average age of(54.4±11.9)years.Senior age,men,smoking and drinking patients have a high risk factors of gastric cancer.Compared with type ? Hp positive and Hp negative patients,type ? Hp positive patients have a higher risk of gastric cancer.2.As disease progress,Hp positive rate was gradually increased in non-atrophic gastritis,atrophic gastritis groups and gastric cancer group,and it was mainly type ?Hp positive;compared with type ? Hp positive and Hp negative patients,type ? Hp positive patients have a higher risk of developing gastric cancer.3.The levels of serum G-17,PG ? and PG ? in gastric cancer group were significantly increased,while PG ?/PG ? ratio was significantly lower when compared with non-atrophic gastritis and atrophic gastritis groups;serum G-17,PG ?and PG ? levels were significantly increased,and PG ?/PG ? ratio were decreased in patients with type ? Hp positive when compared with type ? and Hp-negative patients.4.Compared with non-gastric cancer group,serum G-17 and PG ? values were higher,and PG ?/PG ? ratio was lower in gastric cancer group,while PG ? levels showed no difference in these two groups.The areas under the ROC curve for G-17,PGII,and PG ?/PG ? ratio screening gastric cancer were 0.64(95%CI:0.58-0.69),0.67(95%CI:0.62-0.71)and 0.70(95%CI:0.66-0.75),the optimal cut-off was 5.9 pmol/L,13.0 ?g/L and 8.9,the sensitivity were 60.3%,64.9%and 69.5%,and the specificity were 66.1%,64.8%and 62.8%,respectively.5.When serum G-17 combined with PG detection to diagnose gastric cancer,the sensitivity,specificity,accuracy,positive predictive value and negative predictive value were 38.41%(58/151),81.68%(1409/1725),78.20%(1467/1876),15.51%(58/374)and 93.81%(1409/1502).while PG ? combined with PG ?/PG ? detection,the sensitivity,specificity,accuracy,positive predictive value and negative predictive value were 48.3%(73/151),78.5%(1215/1548),75.8%(1288/1699),17.98%(73/406),94.0%(121/1293),respectively.G-17 combined with PG ?/PG ? detection had the best diagnostic efficacy,and its sensitivity,specificity,accuracy,positive predictive value and negative predictive value were 41.06%(62/151),86.09%(1485/1725),82.46%(1547/1876),20.53%(62/302)and 94.35%(1485/1574).Conclusion1.Senior age,men,smoking and drinking patients have a high risk factors of gastric cancer.2.Type ? Hp infection is closely related to the occurrence and progression of gastric cancer,and can cause the increase of serum G-17,PG ?,PG ? levels and the decrease of PG ?/PG ? ratio.3.Hp typing combined with serum G-17 and PG detection is helpful for screening people at high risk of gastric cancer,among them,Type ? Hp positive combined with serum G-17 and PG has better accuracy for gastric cancer,but the sensitivity is more low. |
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