Westerveld B D, Pals G, Lamers C B, Defize J, Pronk J C, Frants R R, Ooms E C, Kreuning J, Kostense P J, Eriksson A W
Cancer. 1987 Mar 1;59(5):952-8. doi: 10.1002/1097-0142(19870301)59:5<952::aid-cncr2820590517>3.0.co;2-g.
Gastric mucosal pepsinogen A phenotype, serum pepsinogen A level, serum pepsinogen C level, serum pepsinogen A/pepsinogen C ratio, and serum gastrin level were evaluated as potential markers for gastric cancer or its precursors in 19 healthy volunteers and 341 patients from the gastroscopy program. Gastric cancer, atrophic gastritis, and intestinal metaplasia of the stomach were associated with pepsinogen A phenotypes, characterized by an intense fraction 5, and with a low serum pepsinogen A level (less than 25 micrograms/l), a low serum pepsinogen A/pepsinogen C ratio (less than 1.5), and a high serum gastrin level (greater than 79 ng/l). The specificity of pepsinogen A phenotypes with an intense fraction 5 for gastric cancer or its precursors was 95.1% with a sensitivity of 20.4%. The sensitivity and specificity of the noninvasive tests were evaluated with the receiver operating characteristic. For clinical purposes, a serum pepsinogen A/pepsinogen C ratio less than 1.8 is the most suitable test, with a sensitivity of 74% and a specificity of 76% for gastric cancer or its precursors, with a reference population of patients with benign gastric disorders. However, the sensitivity and specificity of the single or combined tests are too low for population screening purposes.
对19名健康志愿者和341名来自胃镜检查项目的患者，评估了胃黏膜胃蛋白酶原A表型、血清胃蛋白酶原A水平、血清胃蛋白酶原C水平、血清胃蛋白酶原A/胃蛋白酶原C比值和血清胃泌素水平，将其作为胃癌或其癌前病变的潜在标志物。胃癌、萎缩性胃炎和胃肠化生与胃蛋白酶原A表型相关，其特征为第5组分强烈，且血清胃蛋白酶原A水平低（低于25微克/升）、血清胃蛋白酶原A/胃蛋白酶原C比值低（低于1.5）以及血清胃泌素水平高（高于79纳克/升）。第5组分强烈的胃蛋白酶原A表型对胃癌或其癌前病变的特异性为95.1%，敏感性为20.4%。采用受试者工作特征曲线评估了这些非侵入性检测的敏感性和特异性。对于临床目的，血清胃蛋白酶原A/胃蛋白酶原C比值低于1.8是最合适的检测，对于胃癌或其癌前病变，以患有良性胃部疾病的患者作为参考人群时，其敏感性为74%，特异性为76%。然而，单项检测或联合检测的敏感性和特异性对于人群筛查目的而言过低。
