| Part 1 Analysis of influencing factors of PG and G-17 levelObjective:To investigate the influence of gender,age,living habits,and Helicobacter pylori on serum PG and G-17 levels by detecting the serum PG and G-17 levels in healthy people.Methods:The study selected 989 healthy people who were screened for upper gastrointestinal diseases in rural areas of Yangzhou from January 2019 to December 2019 as the research objects.The subjects who met the screening criteria were included in the electronic system to conduct the questionnaire survey.The content of the questionnaire includes personal basic information,living habits,etc.The 14C-urea Breath Test was used to detect the Hp infection.The serological PGI,PGII,and G-17 detection of all subjects used the ELISA method,to obtain PGI/PGII ratios(PGR)and compared the change characteristics of PG and G-17 levels in different genders,ages,Hp infection status,smoking,and drinking.P<0.05 indicates that the difference is statistically significant.Results:(1)The serum levels of PGI,PGII,and G-17 in people with Hp positive were higher,while PGR level was significantly decreased.(P<0.01).(2)Serum PGI a nd PGII levels were significantly higher in the men group than in the women group(P<0.01).(3)As the age increases,the higher the serum PGI,the opposite is the rati o PGR,and the G-17 level shows an upward trend(P<0.05).(4)By comparing the PGI,PGII,and PGR levels of the three groups of smokers,former smokers,and non smokers,it was found that PGI,PGII,and PGR were higher in the smoking group t han in the other two groups,PGR was higher in the former smoking group than in t he nonsmoking group,and G-17 was lower in the smoking group than in the nonsm okers.(P<0.01).(5)Comparing PGI and PGⅡ in the drinking group and the non-drin king group found that PGI and PGⅡ in the drinking group were higher than those i n the non-drinking group.Conclusion:1.The level of serum PG was affected by gender,age and Hp infection,smoking and drinking habits of the subjects.2.Serum gastrin-17 might have some relations with Hp infection,age and smoking.Part 2 The application value of serum pepsinogen and gastrin17 in gastric cancer and precancerous lesions screeningObjective:To investigate the changes of serum pepsinogen and gastrin 17 levels in patients with different gastric diseases,and to evaluate the efficacy of serum PG and G-17 for screening gastric cancer and precancerous lesions,as well as to assess the application value of the "new screening scoring system of gastric cancer" in Yangzhou.Methods:The residents who underwent upper gastrointestinal diseases screening in Yangzhou rural areas from January 2019 to December 2019 were included as study subjects.Morever the corresponding serological testing processes,14C urea breath test,gastroscopy and pathological examination,were performed on all study subjects.Based on gastroscopy and pathology results,they were divided into different groups,and comparison of changes in serum PG and G-17 levels with different gastric mucosal lesions.The ROC curve was drawn to evaluate the screening efficiency of PG and G-17 on gastric cancer and gastric precancerous lesions.According to the new gastric cancer screening scoring system,the risk population was divided into low-risk(0-11),medium-risk(12-16)or high-risk(17-25)group.Then compare the detection rates of precancerous lesions and gastric cancer in each group.Results:(1)A total of 1376 subjects,including 382 males and 994 females,were enrolled in this study and were divided into six groups based on gastroscopic and biopsy histopathology,including 611 cases of the superficial gastritis group(SG),30 cases of the gastric ulcer(GU)group,467 cases of the chronic atrophic gastritis(CAG)group,215 cases of the intestinal epithelial metaplasia(IM)group,39 cases of the intraepithelial neoplasia(IN)group,and 14 cases of gastric cancer(GC)group.(2)Compared with the SG group,the PGI level in the CAG,IM and IN groups showed a gradual decrease.The PGR level showed a gradual decline.Serum G-17 showed no significant difference in the CAG and IM groups,but the serum G-17 in the IN group showed a significant increase compared with the CAG and IM groups.G-17 levels were significantly higher in the GC group than the rest of the groups(P<0.01).(3)According to the ROC curve changes,the optimal cut-off values for PGI、PGR and G-17 to diagnose pre-cancerous lesions and gastric cancer were 70.04 ng/ml、8.27、9.86 pmol/L,and its sensitivity was 52.8%,60.4%,and 83.0%,the specificity was 88.5%,77.4%,74.1%,respectively.The areas under the curve(AUC)for PG I,PGR,and G-17 were 0.713,0.718,and 0.778,respectively.(4)IN’s detection rates in the high-risk,medium-risk and low-risk groups were 9.4%,3.3%and 2.3%,respectively.There was a difference in IN among the three groups(x2=5.641,P=0.008).There was a difference in the detection rate of precancerous lesions between the high-risk group and medium-risk group or between the high-risk group and the low-risk group(P=0.035、0.002).Screening showed that the detection rate of gastric cancer:high-risk group(7.55%)>medium-risk group(1.92%)>low-risk group(0.31%),the difference was statistically significant(P<0.01).There were significant differences in the detection rate of gastric cancer between the high-risk group and low-risk group,medium risk group and low-risk group(P<0.01).Moreover,there was no significant difference between the high-risk group and the medium-risk group(P=0.054).Conclusion:1.When the gastric mucosa was found to be atrophy,the intestinal metaplasia,the intraepithelial neoplasia,or the canceration,the levels of PGI and PGR were significantly decreased;Low serum PGI and PGR possibly indicate the existence of gastric cancer and precancerous lesions,and the high level of serum G-17 is the high-risk factor of gastric cancer and precancerous lesions.2.Serum PGI,PGR and G-17 can be used as valuable reference indicators for gastric cancer and precancerous lesion screening.Low level of PGI and PGR have a good value in predicting gastric cancer and precancerous lesions.3.The new screening scoring system of gastric cancer can be applied to the screening of gastric cancer in the populations at risk of gastric cancer in Yangzhou,improving the detection rate of gastric cancer. |
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