The Value Of Detection Of Serum Pepsinogen And Gastrin 17 Combined With Gastroscopy In The Diagnosis And Treatment Of Early Gastric Cancer

Objective?1?.To investigate whether the incidence of gastric cancer is related to gender,age,and Hp;?2?.The serum pepsinogen and gastrin 17 were detected to evaluate whether pepsinogen and gastrin 17 could be used as effective serological markers for early diagnosis of gastric cancer;?3?.To explore the screening ability of the new gastric cancer screening scoring system for the population at risk of gastric cancer;?4?.The subjects were scored according to the new gastric cancer screening scoring system,and then gastroscopy was performed in high-risk populations to evaluate whether the diagnosis of gastric cancer is more accurate and reliable.Methods218 patients who were admitted to our hospital due to abdominal discomfort from July,2018 to July,2019 were collected as research objects,including 30 cases of gastric cancer,72 cases of chronic atrophic gastritis,50 cases of chronic atrophic gastritis with intestinal,42 cases of chronic atrophic gastritis with intraepithelial neoplasia,24 cases of gastric ulcer.The basic information of patients?age,gender?,Hp infection,family history of first-degree relatives with gastric cancer,long-term smoking and drinking history were obtained by questionnaire.Serum pepsinogen and gastrin 17 of all subjects were detected,and gastroscopy and pathological biopsy were conducted.Meanwhile,the status of Hp infection was determined.The patients were divided into gastric cancer group?30cases?and non-gastric cancer group?188 cases?according to the disease detection results.Differences in age,gender,family history of gastric cancer,smoking history,drinking history and serum gastric function were compared between the two groups,and the diagnostic efficacy of PG and G-17 in gastric cancer was evaluated..According to the new gastric cancer screening scoring system,the subjects were divided into 107 patients in the low-risk group,81 patients in the medium-risk group and 30 patients in the high-risk group.The detection rate of gastric cancer in the three groups was compared.Gastroscopy was performed in the high-risk group to evaluate whether the diagnosis of gastric cancer was more accurate and reliable.Results?1?.Among 218 subjects,there were 30 patients in the gastric cancer group,including3 patients with a family history of gastric cancer,4 patients with a history of smoking and2 patients with a history of drinking.There were 188 patients in the non-gastric group,among which 27 patients had a family history of gastric cancer,26 patients had a history of smoking and 28 patients had a history of drinking.There were no significant differences in family history of gastric cancer,smoking history and drinking history between the two groups?P>0.05?,but there were significant differences in age,sex and Hp between the two groups?P<0.05?;?2?.Among the 218 cases,there were 58 patients were aged 40-49 years,of which the detection rate of gastric cancer was 1.7%.Among the 57 patients aged 50-59 years,the detection rate of gastric cancer was 12.3%.There were 50 patients aged 60-69 years,of which the detection rate of gastric cancer was 18.0%.The detection rate of gastric cancer was 24.5%in 53 patients over 69 years old.With the growth of age,the detection rate of gastric cancer increased significantly,and the difference was statistically significant(?²_??=12.774,P<0.001);?3?.Among the 218 cases,there were 111 males and 107 females.The detection rate of gastric cancer was 20.7%in males and 6.5%in females.The detection rate of gastric cancer in males was significantly higher than that in females??²=9.229,P<0.05?;?4?.Among the 218 subjects,90 were Hp-negative,and 128 were Hp-positive.The detection rate of gastric cancer in Hp-negative patients was 5.6%,and in Hp-positive patients was 19.5%.The detection rate of Hp-negative gastric cancer was significantly lower than that of Hp-positive gastric cancer?5.6%vs 19.5%,?²=8.697,P<0.05?.?5?.Among the 218 cases,there were 30 cases in the gastric cancer group and188 cases in the non-gastric cancer group.PGI and PGR in the gastric cancer gr oup were lower than those in the non-gastric cancer group,while PGII and G-17were higher than those in the non-gastric cancer group.PGI,PGII,PGR,and G-17 in the gastric cancer group and non-gastric cancer group were different?Z=-4.036,-2.226,-3.765,-2.836,P<0.05??6?.According to the new gastric cancer screening scoring system,218 subjects were divided into 107 patients in the low-risk group,81 patients in the medium-risk group and30 patients in the high-risk group.The detection rate of gastric cancer in the low-risk group was 0.9%,the detection rate of gastric cancer in the medium-risk group was14.8%,and the detection rate of gastric cancer in the high-risk group was 56.7%.With the increase of the score,the detection rate of gastric cancer increased significantly,and the difference was statistically significant(?²_??=54.043,P<0.001).?7?.In this study,218 cases of gastric cancer were detected by direct endoscopic examination and endoscopic precision examination based on early gastric cancer screening scoring system.Both methods detected 14 cases of gastric cancer and 188 cases of non-gastric cancer.In 2 cases,gastric cancer was detected by direct endoscopic examination,while non-gastric cancer was detected by endoscopic precision examination based on the early gastric cancer screening scoring system.In 14 cases,direct endoscopic examination showed non-gastric cancer,while endoscopic fine examination based on the early gastric cancer screening scoring system showed gastric cancer.Paired chi-square test showed that P=0.004?P<0.05?,while the Kappa consistency coefficient was0.599,P=0.000?P<0.05?,indicating that the detection results of the two methods were basically the same,but the detection accuracy of the two methods was different.Endoscopic screening based on the early gastric cancer screening scoring system was more accurate.Conclusion:1.The incidence of gastric cancer is related to gender,age and Hp;2.Serum pepsinogen and gastrin 17 can be used as effective serological markers for early diagnosis of gastric cancer;3.The new gastric cancer screening scoring system has a high screening capacity for the population at risk of gastric cancer;4.On the basis of the new gastric cancer screening scoring system,gastroscopy was performed in high-risk groups for accurate and reliable diagnosis of gastric cancer.