王定保

【摘要】 目的：探讨血清G-17、PG表达水平在胃癌中的诊断价值。方法：选取2015年8月-2017年8月在笔者所在医院消化内科行胃镜和病理学检查的门诊及住院患者280例，根据胃镜及病检结果分为：非萎缩性胃炎组80例，萎缩性胃炎组90例，胃癌组110例，并选同期胃镜检查正常者60例作为对照组。比较各组血清PGⅠ、PGⅡ、G-17水平及PGR（PGⅠ/PGⅡ）值，并对胃癌组进展期患者与非进展期患者进行上述指标水平比较。结果：胃癌组患者血清PGⅠ水平及PGR值均显著低于其他三组，PGⅡ及G-17水平均显著高于其他三组（P<0.05）;萎缩性胃炎组患者血清PGⅠ及G-17水平和PGR值均显著低于对照组及非萎缩性胃炎组，PGⅡ水平显著高于对照组（P<0.05），PGⅡ水平与非萎缩性胃炎组比较差异无统计学意义（P>0.05）;非萎缩性胃炎组患者血清PGⅠ、PGⅡ、G-17水平及PGR值与对照组比较差异均无统计学意义（P>0.05）。进展期胃癌组PGⅠ水平及PGR值均明显低于早期胃癌组，G-17水平显著高于早期胃癌组（P<0.05），而两组PGⅡ水平比较差异无统计学意义（P>0.05）。结论：血清PG、G-17對于胃癌及癌前病变的诊断有一定意义，可作为筛查胃癌的重要指标。

【关键词】 胃癌; G-17; PG; 诊断价值

doi：10.14033/j.cnki.cfmr.2019.15.030 文献标识码 B 文章编号 1674-6805（2019）15-00-03

【Abstract】 Objective：To investigate the expression levels and diagnostic value of serum G-17 and PG in patients with gastric cancer.Method：A total of 280 outpatients and inpatients who underwent gastroscopy and pathological examination in department of gastroenterology of the hospital from August 2015 to August 2017 were selected.According to the results of gastroscopy and pathological examination，the patients were divided into non-atrophic gastritis group（80 cases），atrophic gastritis group（90 cases） and gastric cancer group（110 cases）.60 cases with normal results of gastroscopy were selected as the control group.The levels of serum PGⅠ，PGⅡ and G-17 and PGR（PGⅠ/PGⅡ） were compared among groups.The levels of above indicators were compared between patients in advanced stage and those in non-progressive stage in gastric cancer group.Result：The level of PGⅠand PGR were significantly lower in the gastric cancer group than in the other three groups，while levels of PGⅡ and G-17 were significantly higher than the other three groups（P<0.05）.Levels of PGⅠ and G-17 and PGR were significantly lower in the atrophic gastritis group than in the control group and the non-atrophic gastritis group，while the level of PGⅡ was higher than the control group （P<0.05），there was no significant difference in the level of PGⅡ between the non-atrophic gastritis group and the non-atrophic gastritis group（P>0.05）.There was no significant difference in levels of PG I，PG II and G-17 or PGR between the non-atrophic gastritis group and the control group（P>0.05）.The level of PGⅠand PGR in gastric cancer group were significantly lower in advanced stage than early stage while the level of G-17 was significantly higher than early stage （P<0.05），there was no significant difference in the level of PGⅡ between the two groups（P>0.05）.Conclusion：Serum PG and G-17 are of certain significance for the diagnosis of gastric cancer and precancerous lesions，and they can be used as important indexes for screening gastric cancer.

【Key words】 Gastric cancer; G-17; PG; Diagnostic value

胃癌是临床常见的消化道恶性肿瘤，其病死率居全球恶性肿瘤第2位，胃癌在我国发病率较高，据统计，胃癌在我国恶性肿瘤发病率中位列第二，死亡率居第三位[1]。研究表明早期胃癌治疗后5年生存率可达90%，因此提高胃癌的早期诊断率对降低胃癌的病死率有至关重要的作用[2]。目前胃镜和病理学检查仍然是胃癌诊断主要的检测方法，但其作为一种有创检查，患者依从性较差，难以应用于胃癌普遍筛查[3]。近年来有研究表明血清胃蛋白酶原（PG）及胃泌素（G-17）表达水平与胃癌有密切关系[4]，为进一步验证血清PG和G-17水平与胃癌的关联，本研究拟通过对我院收治的胃癌患者进行血清PG和G-17检测，旨在探讨PG和G-17在胃癌诊断中的价值，现报告如下。