幽门螺杆菌及胃蛋白酶原、胃泌素17水平在胃癌前病变诊断中的应用价值

doi:10.3969/j.issn.1004-583X.2021.03.009

摘要/Abstract

摘要：

目的探讨幽门螺杆菌(H.pylori)与胃蛋白酶原(PG)、胃泌素17(G17)与胃癌前病变的相关性。方法选取在我院行胃镜检查的患者856例,其中471例病理检出癌前病变的患者为病例组,385例未检出癌前病变的患者为对照组。病例组按病理诊断结果分为慢性萎缩性胃炎(CAG)组157例,肠化(IM)组153例,低级别上皮内瘤变(LGIN)组82例,高级别上皮内瘤变(HGIN)组79例。检测各组H.pylori感染分型及PG、G17水平。结果 CAG组Ⅰ型感染率高于对照组(P<0.05);CAG组PGⅠ 低于对照组(P<0.05);IM组、LGIN组、HGIN组PGⅡ高于对照组(P<0.05);CAG组、IM组、LGIN组、HGIN组PGⅠ/PGⅡ(PGR)均低于对照组(P<0.05);LGIN组、HGIN组G17均高于对照组(P<0.05);PGⅠ、PGⅡ、G17与H.pylori感染阳性存在正相关,PGR与H.pylori感染阳性存在负相关(P<0.05)。结论 H.pylori感染分型、PG、G17水平与胃癌前病变密切相关,检测H.pylori感染分型、PG、G17对于早期筛查胃癌前病变具有重要价值。

关键词: 幽门螺杆菌, 胃蛋白酶原, 胃泌素, 胃肿瘤, 癌前病变

Abstract:

Objective To explore the correlation among Helicobacter pylori(H.pylori), pepsinogen(PG), and gastrin 17(G17) in precancerous lesions of gastric cancer(PLGC). Methods 856 patients who underwent gastroscopy in our hospital were selectively divided into the case group (n=471, patients with PLGC detected by the pathology) and the control group (n=385, patients with no PLGC detected by the pathology). In the case group, patients were assigned into the chronic atrophic gastritis (CAG) group (n=157), the intestinal metaplasia (IM) group (n=153), the low-grade intraepithelial neoplasia(LGIN) group (n=82), and the high-grade intraepithelial neoplasia(HGIN) group (n=79). The H.pylori infection type and the PG and G17 levels were detected in each group. Results The rate of H.pylori infection type I in the CAG group was higher than that of the control group (P<0.05). PGⅠ in the CAG group was lower than that of the control group (P<0.05). PGⅡ in the IM group, LGIN group and the HGIN group were higher than those of the control group (P<0.05). PGⅠ/PGⅡ(PGR) in the CAG group, the IM group, the LGIN group and the HGIN group were lower than those of the control group (P<0.05). G17 in the LGIN group and the HGIN group were higher than that of the control group (P<0.05). PGⅠ, PGⅡ, and G17 were positively correlated with the positive H.pylori infection. PGR level was negatively correlated with the positive H.pylori infection (P<0.05). Conclusion The H.pylori infection type and the levels of PG and G17 are closely related to PLGC. Detecting of the H.pylori infection type, PG and G17 is of great value for early screening of PLGC.

Key words: helicobacter pylori, pepsinogen, gastrin, gastric neoplasms, precancerous lesions

中图分类号:

R735.2

晋颖, 汪湃, 冯世兵. 幽门螺杆菌及胃蛋白酶原、胃泌素17水平在胃癌前病变诊断中的应用价值[J]. 临床荟萃, 2021, 36(3): 233-237.

Jin Ying, Wang Pai, Feng Shibing. Application value of Helicobacter pylori, PG and G17 in diagnosing precancerous lesions of gastric cancer[J]. Clinical Focus, 2021, 36(3): 233-237.

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链接本文: https://huicui.hebmu.edu.cn/CN/10.3969/j.issn.1004-583X.2021.03.009

https://huicui.hebmu.edu.cn/CN/Y2021/V36/I3/233

图/表 4

参考文献 21

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组别	例数	性别[例(%)]		年龄(岁)	吸烟史[例(%)]	饮酒史[例(%)]
组别	例数	男	女	年龄(岁)	吸烟史[例(%)]	饮酒史[例(%)]
对照组	385	257(66.75)	128(33.25)	43.72±4.52	188(48.83)	134(34.81)
CAG组	157	66(42.04)^a	91(57.96)	44.25±4.96	79(50.32)	41(26.11)
IM组	153	74(48.37)^a	79(51.63)	49.96±5.64^ab	81(52.94)	42(27.45)
LGIN组	82	43(52.44)^a	39(47.56)	50.13±5.82^ab	45(54.88)	29(35.37)
HGIN组	79	41(51.90)^a	38(48.10)	50.75±5.23^ab	42(53.16)	31(39.24)
统计值		17.293	14.923	0.822	1.185	17.293
P值		<0.01	<0.01	0.623	0.492	<0.01

组别	例数	性别[例(%)]		年龄(岁)	吸烟史[例(%)]	饮酒史[例(%)]
组别	例数	男	女	年龄(岁)	吸烟史[例(%)]	饮酒史[例(%)]
对照组	385	257(66.75)	128(33.25)	43.72±4.52	188(48.83)	134(34.81)
CAG组	157	66(42.04)^a	91(57.96)	44.25±4.96	79(50.32)	41(26.11)
IM组	153	74(48.37)^a	79(51.63)	49.96±5.64^ab	81(52.94)	42(27.45)
LGIN组	82	43(52.44)^a	39(47.56)	50.13±5.82^ab	45(54.88)	29(35.37)
HGIN组	79	41(51.90)^a	38(48.10)	50.75±5.23^ab	42(53.16)	31(39.24)
统计值		17.293	14.923	0.822	1.185	17.293
P值		<0.01	<0.01	0.623	0.492	<0.01

组别	例数	感染率	H.pylori
组别	例数	感染率	Ⅰ型感染	Ⅱ型感染
对照组	385	187(48.57)	146(78.07)	41(21.93)
CAG组	157	84(53.50)	80(95.24)^a	4(4.76)
IM组	153	77(50.33)	67(87.01)	10(12.99)
LGIN组	82	43(52.44)	38(88.37)	5(11.63)
HGIN组	79	41(51.90)	37(90.24)	4(9.76)
χ²值	1.034	3.346	0.924	1.034
P值	0.521	0.013	0.583	0.521

组别	例数	感染率	H.pylori
组别	例数	感染率	Ⅰ型感染	Ⅱ型感染
对照组	385	187(48.57)	146(78.07)	41(21.93)
CAG组	157	84(53.50)	80(95.24)^a	4(4.76)
IM组	153	77(50.33)	67(87.01)	10(12.99)
LGIN组	82	43(52.44)	38(88.37)	5(11.63)
HGIN组	79	41(51.90)	37(90.24)	4(9.76)
χ²值	1.034	3.346	0.924	1.034
P值	0.521	0.013	0.583	0.521

组别	例数	PGⅠ(μg/L)	PGⅡ(μg/L)	PGR	G17(pmol/L)
对照组	385	99.84(73.84~134.82)	9.13(5.97~16.89)	9.87(6.92~14.27)	3.57(1.15~8.47)
CAG组	157	79.76(65.72~108.78)^a	7.78(5.17~19.74)	9.13(5.42~13.27)^a	3.34(1.25~10.89)
IM组	153	97.69(71.48~133.89)	10.42(6.13~17.33)^ab	8.84(6.27~13.82)^ab	3.27(1.47~9.75)
LGIN组	82	104.87(74.79~157.25)	11.94(6.75~17.98)^abc	8.54(6.15~13.78)^abc	4.72(1.04~8.83)^abc
HGIN组	79	109.48(87.68~176.90)	19.67(12.68~28.95)^abcd	8.03(5.12~13.72)^abcd	11.12(1.42~15.82)^abcd
Z值		3.644	15.923	17.724	11.383
P值		0.029	<0.01	<0.01	<0.01