血清PGI、PGII、PGR、G-17水平与Hp-IgG联合检测对胃癌早期诊断的临床价值分析

Abstract

Objective To investigate the clinical value of combined detection of serum pepsinogen (PG)Ⅰ, PGⅡ, PGⅠ/PGⅡ (PGR), gastrin-17 (G-17) and IgG anti-Helicobacter Pylori (IgG anti-Hp) in the diagnosis of early gastric cancer. Methods One hundred and twenty patients with gastric cancer (early gastric cancer group), 60 patients with atrophic gastritis (atrophic gastritis group) and 120 healthy volunteers (control group) who were examined or treated in our hospital from January 2018 to June 2019 were selected as the subjects. The levels of serum PGⅠ, PGⅡ, PGR, G-17 and IgG anti-Hp were compared among the three groups. The indicators and combined diagnostic value were analyzed by receiver operating characteristic (ROC) curve. Results The levels of PGⅠ in early gastric cancer group, atrophic gastritis group and control group were (59.85±8.59)ng/ml, (72.19±9.89)ng/ml, (96.83±8.66)ng/ml, with statistically significant difference (F=530.504, P<0.001). The levels of PGⅡ in the three groups were (23.19±2.45)ng/ml, (20.60±4.19)ng/ml, (16.52±3.34)ng/ml, with statistically significant difference (F=130.085, P<0.001). The levels of PGR in three groups were 2.78±0.69, 4.33±0.95, 6.21±1.46, with statistically significant difference (F=288.801, P<0.001). The levels of G-17 in the three groups were (77.04±10.09)ng/ml, (64.69±7.22)ng/ml, (55.91±8.32)ng/ml, with statistically significant difference (F=170.770, P<0.001). The levels of IgG anti-Hp in the three groups were (70.23±8.11)IU, (58.30±9.37)IU, (33.00±5.24)IU, with statistically significant difference (F=778.431, P<0.001). The levels of serum PGⅠand PGR in early gastric cancer group and atrophic gastritis group were significantly lower than those in control group (all P<0.05). The levels of serum PGⅠand PGR in early gastric cancer group were significantly lower than those in atrophic gastritis group (both P<0.05). While serum PGⅡ, G-17 and IgG anti-Hp in early gastric cancer group and atrophic gastritis group were significantly higher than those in control group (all P<0.05). The levels of PGⅡ, G-17 and IgG anti-Hp in gastric cancer group were significantly higher than those in atrophic gastritis group (all P<0.05). According to the ROC curve, the critical value of serum PGⅠ diagnosis was 73.11 ng/ml, the sensitivity was 63.33%, the specificity was 83.33%, and the area under the curve (AUC) was 0.801. The critical value of serum PGⅡ diagnosis was 19.55 ng/ml, the sensitivity was 75.83%, the specificity was 72.22%, and the AUC was 0.760. The critical value of serum PGR diagnosis was 4.60, the sensitivity was 82.50%, the specificity was 77.22%, and the AUC was 0.816. The critical value of serum G-17 diagnosis was 64.33 ng/ml, the sensitivity was 64.17%, the specificity was 65.56%, and the AUC was 0.631. The critical value of IgG anti-Hp diagnosis was 53.80 IU, the sensitivity was 59.17%, the specificity was 75.00%, and the AUC was 0.708. At the critical tangent point, the sensitivity, specificity and AUC of PG I + IgG anti-Hp were 69.17%, 76.67% and 0.754 respectively; the sensitivity, specificity and AUC of PGR + IgG anti-Hp were 88.33%, 74.44% and 0.798 respectively; the sensitivity, specificity and AUC of G-17 + IgG anti-Hp were 71.67%, 65.56% and 0.718 respectively. The sensitivity of joint detection of the five indexes was 92.50%, the specificity was 72.22%, and the AUC was 0.869. The sensitivity of joint detection was significantly higher than that of individual detection (all P<0.05), and the AUC of joint detection was significantly higher than that of individual indexes (Z=1.848, P=0.032; Z=3.145, P=0.001; Z=1.688, P=0.046; Z=7.726, P<0.001; Z=4.931, P<0.001; Z=3.188, P=0.001; Z=1.783, P=0.037; Z=4.534, P<0.001). Conclusion The combined detection of serum PGⅠ, PGⅡ, PGR, G-17 and IgG anti-Hp can improve the sensitivity of gastric cancer diagnosis and it is of great significance and value for early diagnosis of gastric cancer. Key words: Stomach neoplasms; Pepsinogens; Helicobacter Pylori; Gastrin-17