标题：胃蛋白酶原、胃泌素-17和幽门螺杆菌定量检测在胃癌早期筛查中的应用

      作者：汤欣源 1，刘航 2，乔文 3    汤欣源 1，刘航 2，乔文 31.西安交通大学医学部，陕西 西安 710048；2.西安医学院附属宝鸡医院消化内科老年病科，陕西 宝鸡 721006；3.西安交通大学第一附属医院消化内科，陕西 西安 710065

      卷次： 2023年34卷22期

      【摘要】 目的 探究胃蛋白酶原(PG)、胃泌素-17 (GAS-17)及幽门螺杆菌(Hp)定量检测在胃癌早期筛查中的应用价值。方法 选取2018年10月至2022年10月期间西安医学院附属宝鸡医院收治的94例疑似胃癌患者作为研究对象，所有患者均接受PG (PGⅠ、PGⅡ)、GAS-17及Hp定量检测；以病理学检查作为胃癌诊断的金标准，将患者分为胃癌组(n=39)和非胃癌组(n=55)，绘制受试者工作特征曲线(ROC)分析PG、GAS-17及Hp定量检测评估原发性胃癌的曲线下面积(AUC)、灵敏度和特异度。结果 胃癌组患者的PGⅠ水平为(78.34±12.68) ng/mL，明显低于非胃癌组的(106.37±18.27) ng/mL，PGⅡ、GAS-17及Hp定量检测水平分别为(21.34±4.56) ng/mL、(23.51±6.84) pmol/L、(286.39±51.36) dmp，明显高于非胃癌组的(17.26±3.77) ng/mL、(13.44±4.25) pmol/L、(185.47±46.32) dmp，差异均有统计学意义(P<0.05)；经ROC分析结果显示，PGⅠ、PGⅡ、GAS-17及Hp定量检测应用于早期胃癌筛查的AUC分别为0.926、0.711、0.918、0.919，灵敏度分别为 92.31%、74.36%、84.62%、92.31%，特异度分别为 81.82%、58.18%、83.64%、76.36%。结论 PG、GAS-17以及Hp定量检测应用于胃癌早期筛查均具有一定的参考价值，值得临床工作者借鉴。
      【关键词】 原发性胃癌；早期筛查；胃蛋白酶原；胃泌素-17；幽门螺杆菌
      【中图分类号】 R735.2 【文献标识码】 A 【文章编号】 1003—6350（2023）22—3275—04

Application of quantitative detection of pepsinogen, gastrin-17, and Helicobacter pylori in early screening ofgastric cancer.
TANG Xin-yuan 1, LIU Hang 2, QIAO Wen 3. 1. Health Science Center, Xi'an Jiaotong University, Xi'an710048, Shaanxi, CHINA; 2. Department of Gastroenterology and Geriatrics, Baoji Hospital Affiliated to Xi'an MedicalCollege, Baoji 721006, Shaanxi, CHINA; 3. Department of Gastroenterology, the First Affiliated Hospital of Xi'an JiaotongUniversity, Xi'an 710065, Shaanxi, CHINA
【Abstract】 Objective To explore the application value of pepsinogen (PG), gastrin-17 (GAS-17), and Helico-bacter pylori (Hp) in the early screening of gastric cancer. Methods A total of 94 patients with suspected gastric canceradmitted to Baoji Hospital Affiliated to Xi'an Medical College from October 2018 to October 2022 were selected as theresearch objects. All patients received quantitative detection of PG (PGⅠ, PGⅡ), GAS-17, and Hp. The pathological ex-amination was used as the gold standard for the diagnosis of gastric cancer. The patients were divided into gastric cancergroup (n=39) and non-gastric cancer group (n=55). The receiver operating characteristic curve (ROC) was drawn to ana-lyze the area under the curve (AUC), sensitivity, and specificity of PG, GAS-17, and Hp quantitative detection in evalu-ating primary gastric cancer. Results The level of PGⅠ in the gastric cancer group was (78.34±12.68) ng/mL, whichwas significantly lower than (106.37±18.27) ng/mL in the non-gastric cancer group; the quantitative detection levels ofPGⅡ, GAS-17, and Hp were (21.34±4.56) ng/mL, (23.51±6.84) pmol/L, (286.39±51.36) dmp, respectively, which weresignificantly higher than (17.26 ± 3.77) ng/mL, (13.44 ± 4.25) pmol/L, (185.47 ± 46.32) dmp in the non-gastric cancergroup; the differences were statistically significant (P<0.05). The results of ROC analysis showed that the AUC of PGⅠ,PGⅡ, GAS-17, and Hp quantitative detection in early gastric cancer screening was 0.926, 0.711, 0.918, and 0.919; thesensitivity was 92.31%, 74.36%, 84.62%, and 92.31%, respectively; the specificity was 81.82%, 58.18%, 83.64%, and76.36%. Conclusion The quantitative detection of PG, GAS-17, and Hp has certain reference value in the early screen-ing of gastric cancer, which is worthy of reference for clinical workers.
      【Key words】 Primary gastric cancer; Early screening; Pepsinogen; Gastrin-17; Helicobacter pylori