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蔗糖渗透性试验在早期胃癌检测中的意义及内镜下黏膜切除术后渗透性的变化

Significance of sucrose permeability test in detecting early gastric cancer and changes of permeability after endoscopic mucosal resection.

作者信息

Yamaguchi Taketo, Shishido Tadayuki, Hara Tarou, Ohyama Nami, Sudo Kentaro, Nakamura Kazuyoshi, Denda Tadamichi, Ishihara Takeshi, Yokosuka Osamu, Nomura Fumio

机构信息

Division of Gastroenterology, Chiba Cancer Center, Chiba, Japan.

出版信息

Hepatogastroenterology. 2009 Mar-Apr;56(90):561-4.

Abstract

BACKGROUND/AIMS: To evaluate the diagnostic value of sucrose permeability test (SPT) with special reference to early gastric cancer (EGC), and to assess the changes of urinary sucrose level after treatment of gastric damage: gastric ulcer (GU) or EGC.

METHODOLOGY

Ninety subjects were included in this study, that is; 18 patients with GU, 25 EGC, 17 advance gastric cancer (AGC), and 30 healthy volunteers (HV). SPT was conducted before treatment in all the subjects, and in 6 patients each with GU and EGC after treatment- proton pump inhibitor for GU and endoscopic mucosal resection for EGC. Diagnostic values were calculated based on cut-off values estimated from the ROC curves.

RESULTS

The mean amount of sucrose excreted into urine in HV, GU, EGC, and AGC was 50.8 +/- 28.0 mg, 225.9 +/- 201.1 mg, 170.2 +/- 86.4 mg, and 426.2 +/- 155.0 mg, respectively, showing significant differences between HV and gastric disease groups (p < 0.01). The sensitivity for detecting GU, EGC, and AGC was 94.4%, 88.0%, and 100%, respectively. Sucrose excretion in GU and EGC was significantly decreased after treatment (262.4 +/- 121.2 to 80.6 +/- 42.1, and 246.0 +/- 136.9 to 139.1 +/- 69.2, p < 0.05 and p < 0.001, respectively).

CONCLUSIONS

SPT was considered useful to detect not only GU or AGC but also EGC with a high sensitivity. A significant decrease of sucrose excretion was observed after treatment in EGC.

摘要

背景/目的:评估蔗糖渗透性试验(SPT)对早期胃癌(EGC)的诊断价值,并评估胃溃疡(GU)或EGC所致胃损伤治疗后尿蔗糖水平的变化。

方法

本研究纳入90名受试者,即18例GU患者、25例EGC患者、17例进展期胃癌(AGC)患者和30名健康志愿者(HV)。所有受试者在治疗前均进行SPT,6例GU患者和6例EGC患者在治疗后进行SPT——GU患者接受质子泵抑制剂治疗,EGC患者接受内镜下黏膜切除术。根据ROC曲线估计的临界值计算诊断价值。

结果

HV、GU、EGC和AGC组尿中蔗糖排泄的平均量分别为50.8±28.0mg、225.9±201.1mg、170.2±86.4mg和426.2±155.0mg,HV组与胃部疾病组之间存在显著差异(p<0.01)。检测GU、EGC和AGC的敏感性分别为94.4%、88.0%和100%。治疗后GU和EGC的蔗糖排泄显著降低(分别从262.4±121.2降至80.6±42.1,以及从246.0±136.9降至139.1±69.2,p<0.05和p<0.001)。

结论

SPT被认为不仅对检测GU或AGC有用,对检测EGC也具有高敏感性。EGC治疗后观察到蔗糖排泄显著降低。

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