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目的探讨血清胃蛋白酶原PGⅠ、PGⅡ与老年胃癌及癌前病变的关系。方法对已行常规胃镜检查和病理活检确诊的118例老年患者(其中慢性非萎缩性胃炎31例,慢性萎缩性胃炎33例,胃溃疡糜烂24例,胃癌30例)。用ELISA法定量检测血清PGⅠ和PGⅡ水平,并计算PGR(PGⅠ/PGⅡ)值。结果慢性萎缩性胃炎及胃癌组血清PGⅠ、PGR水平同慢性非萎缩性胃炎组相比差异有统计学意义(P<0.05)。但PGⅠ水平及PGR值在慢性萎缩性胃炎组与胃癌组之间差异无统计学意义(P>0.05)。胃癌组中以PGⅠ<70μg/L、PGR<3作为阳性指标,同时符合这两项的确诊率为23.3%,特异性为93.3%。而如以PGⅠ<70μg/L或PGR<3作为阳性指标,确诊率和特异性分别为73.3%、76.7%。结论血清PGⅠ、PGR水平与老年患者萎缩性胃炎和胃癌有关,可以作为老年高危患者胃黏膜萎缩、癌变的一项血清学筛查指标。
Objective To investigate the relationship between serum pepsinogen PGⅠ, PGⅡ and gastric cancer and precancerous lesions in elderly patients. Methods 118 elderly patients (including 31 cases of chronic non-atrophic gastritis, 33 cases of chronic atrophic gastritis, 24 cases of gastric ulcer erosion and 30 cases of gastric cancer) were diagnosed by routine gastroscopy and biopsy. Serum levels of PGⅠand PGⅡwere detected by ELISA, and PGR (PGⅠ / PGⅡ) values were calculated. Results The serum levels of PGⅠ and PGR in chronic atrophic gastritis and gastric cancer group were significantly different from those in chronic non-atrophic gastritis group (P <0.05). However, there was no significant difference in PGⅠ level and PGR between chronic atrophic gastritis group and gastric cancer group (P> 0.05). PGI <70μg / L and PGR <3 in gastric cancer group as positive indicators, while the coincidence of the two diagnosis rate was 23.3%, the specificity was 93.3%. As PGI <70μg / L or PGR <3 as a positive indicator, the diagnosis rate and specificity were 73.3%, 76.7%. Conclusions The serum levels of PGⅠ and PGR are related to atrophic gastritis and gastric cancer in elderly patients and may be used as a serological marker for gastric mucosal atrophy and carcinogenesis in elderly patients at high risk.