| Objective:The early gastric cancer screening fasting venous serological indexes were analyzed the stomach secrete element-17,pepsinogen ? and pepsin ? level detection,analysis the relationship between the serological indexes and early gastric cancer.Through the analysis of serological indicators,the high-risk patients with gastric cancer were screened out,and the high-risk patients were divided into two groups,respectively for white light endoscopy and endoscopic ultrasonography,to explore the practical value of endoscopic ultrasonography in the detection of early gastric cancer.Methods:Among the patients participating in early gastric cancer screening,2800 patients were selected for blood test for preliminary screening of early gastric cancer.The study subjects were selected on May 1,2018(solstice),December 31,2019.As a first step,to participate in 2800 patients with early gastric cancer screening extract 4 ml,fasting venous blood by centrifugal test related serological indexes,including gastric secrete element-17,pepsinogen ? and pepsin ? numerical values.Serological test results were reviewed by 2 laboratory physicians with relevant medical experience.The second step was to grade the above 2800 patients according to the test results,of which the number of low-risk patients was 1303,the number of medium-risk patients was 897,and the number of high-risk patients was 600.In the third step,two experienced physicians performed white light endoscopy on the middle risk group,biopsy was taken at the same time for the patients with gastric lesions found in the microscopic examination,and tissue biopsy was performed at the later stage.No cases of advanced gastric cancer or early gastric cancer were found.Step 4:the high-risk groups were divided into 2 groups,of which 346 were in the control group.Two experienced physicians performed white light endoscopic examination on the patients.At the same time,2 gastric antrum,2 gastric body and 1 gastric Angle biopsy were taken.There were 254 patients in the experimental group.Two experienced physicians performed endoscopic ultrasonography on the patients.Biopsies of tissue detected under an endoscopic ultrasound probe with an abnormal signal were performed.The fifth step,by two experienced pathologists at all for endoscopic biopsy tissue pathological examination:the biopsy samples through conventional slice production processing,the hematoxylin-eosin staining method for dyeing,finally microscopy with ordinary optical microscope,and some have clear biopsy tissue without pathological changes and issue a report on pathology.The samples collected by each subject were subjected to two data measurements,in which the variation coefficient of the measured data<15%was acceptable data.Results:(1)Patients were found in the high-risk group,and there was a significant difference between gastrin-17 and pepsinogen levels in each group(P<0.01).Levels of gastrin-17,pepsinogen ? and pepsinogen ? were lower in the low-risk group.Levels of gastrin-17,pepsinogen ? and pepsinogen ? were followed by those in the medium-risk group,with the highest levels in the high-risk group.(2)In the high-risk group:there was no significant difference in the detection rate of early gastric cancer between the experimental group and the control group(P>0.05),which was no statistically significant.Among them,the detection rate of egc in the experimental group was 8.27%,and that in the control group was 7.51%,that is,the detection rate of egc in the experimental group was higher than that in the control group.(3)There were differences in sensitivity,specificity,positive ratio,negative ratio and diagnostic odds ratio between endoscopic ultrasonography and white light endoscopy(P<0.05),among which there were significant differences between sensitivity,specificity and diagnostic odds ratio(P<0.01).The sensitivity,specificity,positive ratio,negative ratio and diagnostic ratio of endoscopic ultrasound were 0.57,0.86,5.56,0.23 and 56.12,respectively,while the above indexes of white light endoscopy were 0.23,0.56,4.71,0.33 and 44.78,respectively.(4)Based on multiple factors Logistic multivariate regression analysis,the dependent variable is the occurrence of early gastric cancer,independent variables for the stomach secrete element-17,pepsinogen ?,pepsinogen ? and PGR,after analysis found that independent factors associated with early gastric cancer including gastric secrete element-17(OR=2.013,P<0.01),pepsinogen ?(OR=1.986,P<0.01),pepsinogen ?(OR=1.917,P<0.01)and PGR(OR=2.643,P<0.01).Conclusion:(1)In the low,medium and high risk groups,gastrin-17 level was higher in the high risk group,so gastrin-17 level was of high value in screening for early gastric cancer.(2)In the low,medium and high risk groups,pepsinogen ? and pepsinogen ? were higher in the high risk group,so pepsinogen had higher value in screening for early gastric cancer and could provide an effective basis for clinical diagnosis of gastric cancer.(3)The examination of patients with abnormal indicators(gastrin-17,pepsinogen)by endoscopic ultrasonography is more advantageous in the detection of early gastric cancer than that by conventional endoscopic ultrasonography.The detection rate of endoscopic ultrasonography is higher and the results are more accurate.(4)Patients in the low-risk group had low PGR level.The second group was the medium risk group,and the highest level was the high risk group.Therefore,PGR level is of great significance in the screening of early gastric cancer. |
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