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背景:慢性萎缩性胃炎(CAG)是胃癌的癌前病变。血清胃泌素-17(G-17)诊断CAG的研究结果差异较大,推测幽门螺杆菌(Hp)感染在其中起重要作用。目的:探讨Hp感染对血清G-17水平的影响,以及在不同Hp感染状态下血清G-17诊断CAG的价值。方法:纳入2014年5月—2015年5月三家不同医院的204例非萎缩性胃炎患者和81例CAG患者。行胃镜检查,以ELISA法检测空腹血清G-17、餐后血清G-17和幽门螺杆菌抗体Ig G(Hp-Ig G)。结果:Hp阳性组空腹血清G-17水平显著高于Hp阴性组(P=0.001),CAG组餐后血清G-17水平显著低于非萎缩组(P=0.002)。空腹血清G-17诊断Hp阳性和Hp阴性CAG的AUC分别为0.634(95%CI:0.537~0.732)和0.576(95%CI:0.478~0.675),准确率分别为62.6%和54.9%。餐后血清G-17诊断Hp阳性和Hp阴性CAG的AUC分别为0.675(95%CI:0.581~0.769)和0.595(95%CI:0.495~0.694),准确率分别为61.8%和53.1%。结论:Hp感染对血清G-17水平有一定影响,因而在不同Hp感染状态下血清G-17诊断CAG的价值存在差异。空腹和餐后血清G-17诊断Hp阳性CAG的价值高于Hp阴性CAG。
Background: Chronic atrophic gastritis (CAG) is a precancerous lesion of gastric cancer. Serum gastrin-17 (G-17) diagnosis of CAG results vary widely, speculated that Helicobacter pylori (Hp) infection plays an important role. Objective: To investigate the effect of Hp infection on serum G-17 level and the value of serum G-17 diagnosis of CAG under different Hp infection status. METHODS: Totally 204 non-atrophic gastritis patients and 81 CAG patients were enrolled in three different hospitals from May 2014 to May 2015. Gastroscopy was performed to detect fasting serum G-17, postprandial serum G-17 and H. pylori antibody Ig G (Hp-Ig G) by ELISA. Results: The fasting serum G-17 level in Hp positive group was significantly higher than that in Hp negative group (P = 0.001). The postprandial serum G-17 level in CAG group was significantly lower than that in non-atrophic group (P = 0.002). The AUC of fasting serum G-17 in diagnosis of Hp-positive and Hp-negative CAG were 0.634 (95% CI: 0.537-0.732) and 0.576 (95% CI: 0.478-0.675), respectively, with accuracy of 62.6% and 54.9%, respectively. The AUC of postprandial serum G-17 diagnosis of Hp-positive and Hp-negative CAG were 0.675 (95% CI: 0.581-0.769) and 0.595 (95% CI: 0.495-0.694), respectively, with 61.8% and 53.1% accuracy respectively. Conclusion: The infection of Hp has some influence on serum G-17 level, so the diagnostic value of serum G-17 in different Hp infection status is different. The value of fasting and postprandial serum G-17 diagnosis of Hp-positive CAG is higher than that of Hp-negative CAG.