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目的探讨中国胃癌高发区健康成年居民血清胃蛋白酶原(PG)水平及年龄、性别分布规律和用于慢性萎缩性胃炎(CAG)、胃癌筛查的血清PG异常的界定标准。方法 采用时间分辨荧光免疫分析法(TRFIA)检测分析河北省赞皇县胃癌高发区农村自然人群606名健康成年居民血清PG水平和分布特点；对比分析720例接受胃镜检查的当地居民血清PG水平与胃黏膜病变的关系,确定适合中国胃癌高发区居民CAG和胃癌筛查的血清PG异常界定标准。结果606名健康成年居民血清PGI、PGⅡ和PGI／PGⅡ均呈偏态分布,其中位数分别为161μg／L、14．8μg／L和10．5,无明显年龄和性别差异。720例当地成年居民血清PG水平和胃黏膜病变对比分析结果表明,血清PG水平与胃黏膜病变密切相关,用于CAG和胃癌筛查的PGⅠ、PGⅠ／PGⅡ比值的最佳异常界定值分别为PGⅠ≤60μg／L、PGⅠ／PGⅡ≤6,PGⅠ与PGⅠ／PGⅡ比值串联的灵敏度明显低于并联,而特异度却明显高于并联。结论 胃癌高发区健康成年居民血清PG水平呈偏态分布。从灵敏度和特异度综合分析,PGⅠ≤60μg／L、PGⅠ／PGⅡ≤6是中国胃癌高发区居民胃癌和CAG筛查较为合适的异常界定值。
Objective To investigate the level of serum pepsinogen (PG), age and sex distribution in healthy adult residents with high incidence of gastric cancer in China and define the criteria for serum PG abnormalities in chronic atrophic gastritis (CAG) and gastric cancer screening. Methods The time-resolved fluorescence immunoassay (TRFIA) was used to detect and analyze the level and distribution of serum PG in 606 healthy adults in rural natural areas of Zanhuang County in Hebei Province. The serum levels of PG in 720 residents undergoing gastroscopy Gastric mucosal lesions, to determine suitable for high incidence of gastric cancer in China resident CAG and gastric cancer screening PG abnormal delineation criteria. Results There were skewed distributions of PGI, PGⅡ and PGI / PGⅡ in 606 healthy adults, with median of 161μg / L, 14.8μg / L and 10.5, respectively. There were no significant differences in age and gender. The results of serum PG level and gastric mucosal lesion in 720 local adult residents showed that serum PG levels were closely related to gastric mucosal lesions. The best abnormal demarcation values of PGⅠ, PGⅠ / PGⅡ ratio for CAG and gastric cancer screening were PGⅠ ≤60μg / L, PGⅠ / PGⅡ≤6. The sensitivity of series PGⅠand PGⅠ / PGⅡ was significantly lower than that of parallel and the specificity was significantly higher than that of parallel. Conclusion Serum PG levels of healthy adult residents in high incidence of gastric cancer are skewed. From the sensitivity and specificity of comprehensive analysis, PG Ⅰ ≤ 60μg / L, PG Ⅰ / PG Ⅱ ≤ 6 in China’s high incidence of gastric cancer residents and CAG screening more appropriate abnormal delineation.