| Objective:To study the changes of serum Pepsinogen(PG)content in patients with gastric cancer and atrophic gastritis,and to explore the clinical value of serum PG detection in the diagnosis,staging and prognosis of gastric cancer.Methods:117 patients confirmed by gastroscopy and histopathology were selected as the gastric cancer group,including 13 patients in the stage Ⅰ group,47 patients in the stageⅡ group,41 patients in the stage Ⅲ group and 16 patients in the stage Ⅳ group.122 patients with atrophic gastritis were selected to be included in the atrophic gastritis group,and 120 healthy subjects in the same period were selected to be included in the healthy control group.Abbott automatic chemiluminescence instrument was used to detect PG content in peripheral blood.Thirty-seven patients in the gastric cancer group between 7 and 15 months after surgery(according to CT scan,gastroscopy review,tumor markers and other relevant examination results to comprehensively determine whether there is recurrence,divided into the postoperative stability group of 26 cases,postoperative recurrence group of 11 cases),their serum PG content was tested again.To explore the relationship between serum PG content and the diagnosis,staging and prognosis of gastric cancer,to evaluate the clinical value of PG in the staging and prognosis of gastric cancer,and to evaluate the efficacy of PG in the diagnosis of gastric cancer by ROC curve.Results:In the healthy control group,PGI was(89.24±39.42)ng/ml,PGⅡ was(17.64±12.70)ng/ml,PGR(PGⅠ/PGⅡ)was(6.07±2.57).The PGⅠ,PGⅡ and PGR of the atrophic gastritis group were(75.40±32.79)ng/ml,(15.84±9.02)ng/ml and(5.25±1.86)respectively.In the gastric cancer group PGⅠ was(47.74±20.18)ng/ml,PGⅡ was(14.87±10.99)ng/ml and PGR was(3.85±1.70).In the stomach cancer stage Ⅰ group,PGⅠ results for(66.74±16.64)ng/ml,PGⅡ results for(20.53±17.10)ng/ml,PGR results for(4.20±1.79);The PGⅠ,PGⅡ and PGR of the stomach cancer stage Ⅱ group were(50.07±15.76)ng/ml,(14.20±12.46)ng/ml,(4.38±1.46)respectively.In the stomach cancer stage Ⅲ group,PGⅠ results for(42.96±21.12)ng/ml,PGⅡ results for(15.05±6.93)ng/ml,PGR results for(3.24±1.60);The PGⅠ,PGⅡ and PGR of the stomach cancer stage Ⅳ group were(37.72±20.33)ng/ml,(11.78±5.46)ng/ml,(3.54±1.92)respectively.Gastric cancer postoperative stable group of PGⅠ results for(35.44±18.51)ng/ml,PGⅡ results for(11.75±7.03)ng/ml,PGR results for(3.25±1.60);Gastric cancer postoperative recurrence group of PGⅠ results for(117.47±53.96)ng/ml,PGⅡ results for(29.83±18.64)ng/ml,PGR results for(4.51±1.99);The PGⅠ content of healthy control group,atrophic gastritis group,gastric cancer stage Ⅰ group,gastric cancer stage Ⅱ group,gastric cancer stage Ⅲ group and gastric cancer stage Ⅳ group decreased successively.Compared with the healthy control group,the results of PGⅠ and PGR in serum of the gastric cancer group were significantly decreased,with statistically significant differences(P<0.01),and no statistically significant differences in PGⅡ(P>0.05).Compared with the atrophic gastritis group,the results of PGⅠ and PGR in the serum of the gastric cancer group were significantly decreased,and the differences were statistically significant(P<0.01),while the differences in PGⅡ were not statistically significant(P>0.05).Compared with the healthy control group,serum PGⅠand PGR results in the atrophic gastritis group were significantly decreased,and the differences were statistically significant(P<0.01),while PGⅡ results were not statistically significant(P>0.05).Compared with the postoperative stable group,the results of PGⅠ and PGⅡ in the postoperative recurrence group was significantly higher than that in the postoperative stable group,with statistically significant difference(P<0.01)and no statistically significant difference in PGR(P>0.05).The area under the ROC curve of PGⅠfor the diagnosis of gastric cancer was 0.834,the cut-off value(clinical defection value)was 51.2ng/ml,the sensitivity was 81.7%,and the specificity was 68.4%.The area under the ROC curve of PGⅡ was 0.587,the cut-off value was 13.05ng/ml,the sensitivity was 65.8%,and the specificity was 53.8%.The area under ROC curve of PGR was 0.752,cut-off value was 5.65,sensitivity was 54.2%,and specificity was 87.2%.Conclusions:The decrease of serum PGⅠ has certain clinical value in the diagnosis and staging of gastric cancer.Postoperative serum PGⅠ and PGⅡ results increased again,suggesting a risk of gastric cancer recurrence.PGⅠ,PGⅡ and PGR combined detection has important clinical value in the screening,prevention,diagnosis and prognosis of gastric cancer,and is helpful for the early detection,diagnosis and treatment of gastric cancer. |
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