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山东大学学报（医学版） ›› 2016, Vol. 54 ›› Issue (12): 46-52.doi: 10.6040/j.issn.1671-7554.0.2016.1146

• 临床医学 • 上一篇    下一篇

两种方法评估胃蛋白酶原在萎缩性胃炎和胃癌中的诊断价值

张守彩1,高玉2,郑桂喜1,杨咏梅1,刘延红1,高杨1,王传新1   

  1. 1.山东大学齐鲁医院检验科, 山东 济南 250012;2.青岛市市北区妇幼保健计划生育服务中心, 山东 青岛 266032
  • 收稿日期:2016-09-11 出版日期:2016-12-10 发布日期:2016-12-10
  • 通讯作者: 王传新. E-mail:cxwang@sdu.edu.cn E-mail:cxwang@sdu.edu.cn
  • 基金资助:
    国家自然科学基金(81472025)

Diagnostic value of pepsinogen in atrophic gastritis and gastric cancer evaluation

ZHANG Shoucai1, GAO Yu2, ZHENG Guixi1, YANG Yongmei1, LIU Yanhong1, GAO Yang1, WANG Chuanxin1   

  1. 1. Department of Clinical Laboratory, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China;
    2. Maternal and Child Health Care of Family Planning Service Center of Shibei District, Qingdao 266032, Shandong, China
  • Received:2016-09-11 Online:2016-12-10 Published:2016-12-10

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摘要： 目的 评估以化学发光微粒子免疫分析法(CLIA)和酶联免疫吸附法(ELISA)检测胃蛋白酶原用于萎缩性胃炎和胃癌辅助诊断的价值,并探讨两种方法检测的一致性。 方法 采用CLIA和ELISA分别检测胃蛋白酶原(PG)在健康对照组(95例)、非萎缩性胃炎组(173例)、萎缩性胃炎组(407例)和胃癌组(135例)患者的表达,检测PGⅠ、PGⅡ水平,计算PGⅠ/PGⅡ的比值(PGR),分别建立两种方法诊断的cut-off值,评估其诊断价值,并分析两种方法检测的一致性。 结果 胃癌组PGⅡ高于萎缩性胃炎组、非萎缩性胃炎组和健康对照组(CLIA: P=0.027, 0.002, <0.001; ELISA: P=0.008, <0.001, <0.001),PGR低于萎缩性胃炎组、非萎缩性胃炎组和健康对照组(CLIA: P<0.001, <0.001, <0.001; ELISA: P<0.001, <0.001, 0.001)。CLIA法以PGⅡ>13.20且PGR≤6.67作为诊断胃癌的cut-off值,其敏感性和特异性为80.88%、71.64%;ELISA法以PGⅡ>18.10且PGR≤6.18作为诊断胃癌的cut-off值,其敏感性和特异性为80.14%、62.72%。两种方法诊断胃癌和萎缩性胃炎的一致性Kappa指数分别为0.706、0.569。 结论 PGⅡ和PGR可以作为胃癌诊断标志物,PGⅡ+PGR联合诊断萎缩性胃炎和胃癌敏感性和特异性较高,且CLIA和ELISA两种方法检测结果一致性良好。

关键词: 萎缩性胃炎, 酶联免疫吸附试验, 胃蛋白酶原Ⅰ, 胃蛋白酶原Ⅱ, 胃癌, 化学发光微粒子免疫分析法

Abstract: Objective To evaluate the significance of pepsinogen in atrophic gastritis and gastric cancer using chemiluminesent immunoassay assay(CLIA)and enzyme linked immunosorbent assay(ELISA), and to analyze the consistency of the two methods. Methods CLIA and ELISA were used to determine the expressions of serum PG Ⅰ, PGⅡ and PG Ⅰ/Ⅱ(PGR)in healthy controls(n=95), non-atrophic gastritis cases(n=173), atrophic gastritis cases(n=407)and gastric cancer cases(n=135). The most suitable cut-off values of PG of the two methods were determined. Their diagnostic efficiencies were evaluated, and the consistency of CLIA and ELISA in detecting PG was analyzed. Results The expression of PG Ⅱ in gastric cancer group was higher than in atrophic gastritis group, non-atrophic gastritis group, and healthy controls(CLIA: P=0.027, 0.002, <0.001; ELISA: P=0.008, <0.001, <0.001). PGR in gastric cancer group was lower than in atrophic gastritis group, non-atrophic gastritis group, and healthy controls(CLIA: P<0.001, <0.001, <0.001; ELISA: P<0.001, <0.001, 0.001). PG Ⅱ>13.20 and PGR≤6.67 were considered the most suitable cut-off value for diagnosing gastric cancer using CLIA, and the sensitivity 山 东 大 学 学 报 (医 学 版)54卷12期 -张守彩,等.两种方法评估胃蛋白酶原在萎缩性胃炎和胃癌中的诊断价值 \=-and specificity were 80.88% and 71.64%, respectively. PG Ⅱ>18.10 and PGR≤6.18 were considered the most suitable cut-off value for diagnosing gastric cancer using ELISA, and the sensitivity and specificity were 80.14% and 62.72%, respectively. Further analysis showed that Kappa index of CLIA and ELISA in diagnosing gastric cancer and atrophic gastritis were 0.706 and 0.569, respectively. Conclusion PG Ⅱ and PGR can be used as useful biomarkers for the diagnosis of gastric cancer. The combination of PG Ⅱ and PGR has considerable diagnostic value of atrophic gastritis and gastric cancer with higher sensitivity and specificity. CLIA and ELISA have a good consistency in detecting PG.

Key words: Gastric cancer, Atrophic gastritis, Pepsinogen Ⅱ, Chemiluminesent immunoassay assay, Pepsinogen Ⅰ, Enzyme linked immunosorbent assay

中图分类号: 

  • R735.2
[1] Chen W, Zheng R, Zhang S, et al. The incidences and mortalities of major cancers in China, 2009[J]. Chin J Cancer, 2013, 32(3): 106-112.
[2] 张俊旺,甄俊红,师水生,等.血清胃蛋白酶原对胃癌癌前病变的诊断价值研究[J]. 国际肿瘤学杂志,2014,41(7): 541-545. ZHANG Junwang, ZHEN Junhong, SHI Shuisheng, et al. The study on the diagnostic value of serum pepsinogens to gastric precancerous lesions[J]. J Int Oncol, 2014, 41(7): 541-545.
[3] 张澍田, 李鹏. 如何提高上消化道早期癌的内镜诊断率[J]. 中华内科杂志, 2014,53(7): 511-512. ZHANG Shutian, LI Peng. How to improve the endoscopic diagnosis rate of early uppergastrointestinal cancer[J]. Chin J intern Med, 2014, 53(7): 511-512.
[4] 江堤,苏剑东,张莉,等. 血清胃蛋白酶原对胃癌筛查价值的探讨[J].广州医药,2016,47(1): 24-27. JIANG Di, SU Jiandong, ZHANG Li, et al. The value of serum pepsinogen for gastric cancer screening[J]. Guangzhou Medical Journal, 2016, 47(1): 24-27.
[5] Tanaka T, Arai M, Minemura S, et al. Expression level of sonic hedgehog correlated with the speed of gastric mucosa regeneration in artificial gastric ulcers[J]. J Gastroenterol Hepatol, 2014, 29(4): 736-741.
[6] 何忠发,骆安德,卢彦蕙,等.胃蛋白酶原的定量检测方法及其临床应用的研究进展[J].广西医学,2016,38(3): 398-401. HE Zhongfa, LUO Ande, LU Yanhui, et al. Pepsinogen quantitative detection method and the research progress of clinical application[J]. Guangxi Medical Journal, 2016, 38(3): 398-401.
[7] 李庆新, 张振坤, 李向莉, 等. FICE内镜、胃蛋白酶原Ⅰ、胃蛋白酶原Ⅱ水平检测对胃癌及萎缩性胃炎的诊断价值[J]. 标记免疫分析与临床, 2015, 22(8): 765-768. LI Qingxin, ZHANG Zhenkun, LI Xiangli, et al. Value of FICE endoscope, detection of pepsinogen Ⅰ and pepsinogen Ⅱ levels on diagnosis of gastric cancer and atrophic gastritis[J]. Labeled Immunoassays & Clin Med, 2015, 22(8): 765-768.
[8] 梁瑞威,侯俊良,廖江涛.不同胃黏膜病变患者的血清胃蛋白酶原变化[J].临床与病理杂志, 2016,36(3): 215-219. LIANG Ruiwei, HOU Junliang, LIAO jiangtao. Change of the serum pepsinogen in patients with different gastric mucosal lesions[J]. Journal of Clinical and Pathological Research, 2016, 36(3): 215-219.
[9] 王珏,刘邦伦,易楠,等.血清胃蛋白酶原检测结合美蓝-靛胭脂双重染色法对胃癌及胃癌前病变的诊断价值[J].重庆医科大学学报,2011,36(9): 1084-1086. WANG Jue, LIU Banglun, YI Nan, et al. The clinical value of combined determination of serum PG and double staining in diagnosis of gastric carcinoma and gastric precancerous lesions[J]. Journal of Chongqing Medical University, 2011, 36(9): 1084-1086.
[10] 石贞玉, 厉永强, 吴铭, 等. 血清PG检测在胃癌早期筛查及术后检测中的应用[J]. 河南大学学报(医学版), 2014, 33(3): 188-189, 194. SHI Zhenyu, LI Yongqiang, WU Ming, et al. The application of serum pepsinogen in the early gastric cancer screening and postoperative monitoring[J]. Journal of Henan University(Medical Science), 2014, 33(3): 188-189, 194.
[11] 邢瑞青, 吴永昌, 邹海, 等.不同血清肿瘤标志物对胃癌诊断价值的临床研究[J].现代检验医学杂志, 2014, 29(6): 102-106. XING Ruiqing, WU Yongchang, ZOU Hai, et al. Diagnostic value of different serum tumor markers in gastric cancer[J]. J Mod Lab Med, 2014, 29(6): 102-106.
[12] 王兵,李鼎,张光明,等.上海地区健康体检人群血清胃蛋白酶原水平研究[J]. 检验医学与临床, 2016, 13(2): 210-211. WANG Bing, LI Ding, ZHANG Guangming, et al. Study on serum pepsinogen level among population of healthy physical examination in Shanghai area[J]. Lab Med Clin, 2016, 13(2): 210-211.
[13] 乐嫣,项明洁,张华.血清胃蛋白酶原检测在胃相关疾病中的诊断价值[J]. 标记免疫分析与临床, 2016,23(1): 12-14. LE Yan, XIANG Mingjie, ZHANG Hua. The Value of serum pepsinogen in diagnosis of various gastric diseases[J]. Labeled Immunoassays & Clin Med, 2016, 23(1): 12-14.
[14] 李凤,蒲泽晏,梁艳丽,等.胃疾病患者血清胃蛋白酶原的水平变化及其临床意义[J].实用医院临床杂志,2015,12(5): 125-126. LI Feng, PU Zeyan, LIANG Yanli, et al. The changes of serum pepsinogen levels and its clinical significance in patients with gastric diseases[J]. Practrical Journal of Clinical Medicine, 2015, 12(5): 125-126.
[15] 吴冠楠,姚学权,刘福坤,等.血清胃蛋白酶原对早期胃癌检测的研究进展[J].检验医学与临床, 2015, 12(14): 2126-2128. WU Guannan, YAO Xuequan, LIU Fukun, et al. Research advance of serum pepsinogen in early gastric cancer detection[J]. Lab Med Clin, 2015, 12(14): 2126-2128.
[16] Massarrat S, Haj-Sheykholeslami A, Mohamadkhani A, et al. Pepsinogen Ⅱ Can Be a Potential surrogate marker of morphological changes in corpus before and after H. pylori eradication[J]. Biomed Res Int, 2014, 2014: 481607. doi: 10.1155/2014/481607. Epub 2014 Jun 17.
[17] Cao XY, Jia ZF, Jin MS, et al. Serum pepsinogen Ⅱ is a better diagnostic marker in gastric cancer[J]. World J Gastroenterol, 2012, 18(48): 7357-7361.
[18] Miki K. Gastric cancer screening using the serum pepsinogen test method[J]. Gastric Cancer, 2006, 9(4): 245-253.
[19] 鲁伟, 俞瑾, 谈潘莉, 等. 胃蛋白酶原在胃癌诊断中的临床价值[J]. 浙江实用医学, 2015, 20(3): 175-176, 190. LU Wei, YU Jin, TAN Panli, et al. The clinical value of pepsinogen in diagnosing gastric cancer[J]. Zhejiang Practical Medicine, 2015, 20(3): 175-176, 190.
[20] Kang JM, Kim N, Yoo JY, et al. The role of serum pepsinogen and gastrin test for the detection of gastric cancer in Korea[J]. Helicobacter, 2008, 13(2): 146-156.
[21] di Mario F, Cavallaro LG. Non-invasive tests in gastric disease[J]. Digestive and Liver Disease, 2008, 40(7): 523-530.
[22] 陈湘林, 朱净. 胃蛋白酶原Ⅰ联合胃蛋白酶原Ⅱ检测在胃病中的临床应用价值分析[J]. 医学综述, 2016, 22(10): 2006-2008. CHEN Xianglin, ZHU Jing. Analysis of the Clinical Application Value of Combined Detection of Pepsinogen Ⅰ and Pepsinogen Ⅱ in Gastric Disease[J]. Medical Recapitulate, 2016, 22(10): 2006-2008.
[23] 朱虹. 血清CA 199、CA125、CEA和胃蛋白酶原联合检测对早期胃癌的诊断价值[J]. 微创医学, 2014, 9(6): 778-780. ZHU Hong. The value of combination of serum CA199, CA 125, CEA and pepsinogen in early diagnosis of gastric cancer[J]. Journal of Minimally Invasive Medicine, 2014, 9(6): 778-780.
[24] Massarrat S, Stolte M. Development of gastric cancer and its prevention[J]. Arch Iran Med, 2014, 17(7): 514-520.
[25] Miki K, Morita M, Sasajima M, et al. Usefulness of gastric cancer screening using the serum pepsinogen test method[J]. Am J Gastroenterol, 2003, 98(4): 735-739.
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