Shishido Tadayuki, Yamaguchi Taketo, Odaka Takeo, Seimiya Masanori, Saisho Hiromitsu, Nomura Fumio
Department of Medicine and Clinical Oncology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-city, Chiba 260-8677, Japan.
World J Gastroenterol. 2005 Nov 28;11(44):6905-9. doi: 10.3748/wjg.v11.i44.6905.
To investigate the usefulness of sucrose permeability test using serum in the diagnosis of gastric diseases, with special reference to early gastric cancer (EGC).
A total of 63 subjects, including 11 patients with gastric ulcer, 20 patients with gastric cancer (13, early; 7, advanced) and 32 healthy controls, were studied. Blood and urine samples were collected repeatedly for 5 h before and after the sucrose loading. Sucrose levels were measured by a newly developed enzymatic method.
Serum sucrose levels started to increase 15 min after loading, and peaked at 60 min in the gastric disease groups. The levels for gastric ulcer, EGC and advanced gastric cancer (AGC) at 60 min were significantly higher than that in the healthy controls (26.9+/-2.4, 34.4+/-5.0, and 71.8+/-15.6 vs 7.9+/-0.7 mol/L, respectively, P<0.01). The cut-off level set at 15.4 mol/L (60 min) offered the best distinction between EGC patients and healthy controls; and the sensitivity and specificity were 92.3% and 93.8%, respectively, while those of the urine method were 76.9% and 93.8%, respectively.
The gastric permeability test using serum is reliable for the detection of EGC, and this test can provide results much earlier than the conventional urine method. This test may offer a useful alternative to more invasive tests for EGC.
探讨血清蔗糖渗透性试验在胃部疾病诊断中的作用,尤其是早期胃癌(EGC)。
共研究了63名受试者,包括11名胃溃疡患者、20名胃癌患者(13例早期;7例晚期)和32名健康对照者。在蔗糖负荷前后5小时反复采集血液和尿液样本。采用新开发的酶法测量蔗糖水平。
胃部疾病组在负荷后15分钟血清蔗糖水平开始升高,并在60分钟时达到峰值。胃溃疡、EGC和晚期胃癌(AGC)在60分钟时的水平显著高于健康对照组(分别为26.9±2.4、34.4±5.0和71.8±15.6对7.9±0.7mol/L,P<0.01)。设定为15.4mol/L(60分钟)的临界值能最好地区分EGC患者和健康对照者;敏感性和特异性分别为92.3%和93.8%,而尿液法的敏感性和特异性分别为76.9%和93.8%。
血清胃部渗透性试验对EGC的检测可靠,且该试验比传统尿液法能更早得出结果。该试验可能为EGC的侵入性更强的检测提供一种有用的替代方法。