血清胃蛋白酶原 II 是胃癌的更好诊断标志物。
Serum pepsinogen II is a better diagnostic marker in gastric cancer.
机构信息
Department of Gastrointestinal Surgery, Jilin University First Hospital, Changchun 130021, Jilin Province, China.
出版信息
World J Gastroenterol. 2012 Dec 28;18(48):7357-61. doi: 10.3748/wjg.v18.i48.7357.
AIM
To investigate screening makers for gastric cancer, we assessed the association between gastric cancer and serum pepsinogens (PGs).
METHODS
The subjects comprised 450 patients with gastric cancer, 111 individuals with gastric atrophy, and 961 healthy controls. Serum anti-Helicobacter pylori (H. pylori) immunoglobulin G (IgG), PGI and PG II were detected by enzyme-linked immunosorbent assay. Gastric atrophy and gastric cancer were diagnosed by endoscopy and histopathological examinations. Odds ratios and 95%CIs were calculated using multivariate logistic regression.
RESULTS
Rates of H. pylori infection remained high in Northeastern China. Rates of H. pylori IgG positivity were greater in the gastric cancer and gastric atrophy groups compared to the control group (69.1% and 75.7% vs 49.7%, P < 0.001). Higher levels of PG II (15.9 μg/L and 13.9 μg/L vs 11.5 μg/L, P < 0.001) and lower PGI/PG II ratio (5.4 and 4.6 vs 8.4, P < 0.001) were found in patients with gastric cancer or gastric atrophy compared to healthy controls, whereas no correlation was found between the plasma PGI concentration and risk of gastric cancer (P = 0.537). In addition, multivariate logistic analysis indicated that H. pylori infection and atrophic gastritis were independent risk factors for gastric cancer. Lower plasma PGI/PG II ratio was associated with higher risks of atrophy and gastric cancer. Furthermore, plasma PG II level significantly correlated with H. pylori-infected gastric cancer.
CONCLUSION
Serum PG II concentration and PGI/PG II ratio are potential biomarkers for H. pylori-infected gastric disease. PG II is independently associated with risk of gastric cancer.
目的
为了探究胃癌的筛查标志物，我们评估了胃癌与血清胃蛋白酶原（PG）之间的关系。
方法
本研究纳入了 450 例胃癌患者、111 例胃萎缩患者和 961 例健康对照者。采用酶联免疫吸附试验检测血清抗幽门螺杆菌（H. pylori）免疫球蛋白 G（IgG）、PGI 和 PG II。通过内镜和组织病理学检查诊断胃萎缩和胃癌。采用多变量 logistic 回归计算比值比（OR）及其 95%可信区间（CI）。
结果
东北地区 H. pylori 感染率居高不下。胃癌和胃萎缩组的 H. pylori IgG 阳性率高于对照组（69.1%和 75.7%比 49.7%，P<0.001）。与健康对照组相比，胃癌和胃萎缩患者的 PG II 水平更高（15.9 μg/L 和 13.9 μg/L 比 11.5 μg/L，P<0.001），PGI/PG II 比值更低（5.4 和 4.6 比 8.4，P<0.001），但血浆 PGI 浓度与胃癌风险之间无相关性（P=0.537）。此外，多变量 logistic 分析表明，H. pylori 感染和萎缩性胃炎是胃癌的独立危险因素。较低的血浆 PGI/PG II 比值与萎缩和胃癌的风险增加相关。此外，血浆 PG II 水平与 H. pylori 感染的胃癌显著相关。
结论
血清 PG II 浓度和 PGI/PG II 比值可能是 H. pylori 感染性胃病的潜在生物标志物。PG II 与胃癌风险独立相关。
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