国际肿瘤学杂志
國際腫瘤學雜誌
국제종류학잡지
JOURNAL OF INTERNATIONAL ONCOLOGY
2014年
7期
541-545
,共5页
张俊旺%甄俊红%师水生%毓珊%王守桃%齐莹
張俊旺%甄俊紅%師水生%毓珊%王守桃%齊瑩
장준왕%견준홍%사수생%육산%왕수도%제형
胃蛋白酶原类%萎缩%癌前状态%荧光免疫测定
胃蛋白酶原類%萎縮%癌前狀態%熒光免疫測定
위단백매원류%위축%암전상태%형광면역측정
Pepsinogens%Atrophic%Precancerousconditions%Fluoroimmunoassay
目的：通过检测血清胃蛋白酶原在胃黏膜不同病理状态下的表达水平，探讨其作为临床筛查胃癌标志物的可能性及定量范围。方法用时间分辨荧光免疫分析（TRFIA）法检测63例胃黏膜非典型增生、64例慢性萎缩性胃炎、67例胃癌患者和20例健康志愿者血清胃蛋白酶原（PG）Ⅰ、Ⅱ的含量，计算PGⅠ/PGⅡ比值（PGR），并对3类病变进行等级分组，比较PG水平在组间和组内差异。结果①与健康对照组（152．00μg/L）比较，萎缩性胃炎、非典型增生和胃癌患者PGⅠ水平中位数值分别为124．01、91．23和71．23μg/L，差异有统计学意义（Z＝-2．52，P＝0．0170；Z＝-3．42，P＝0．0014；Z＝-3．57，P＝0．0009）。PGR水平M值分别为7．61、5．21和4．32，低于健康组（15．38），差异有统计学意义（Z＝-2．98，P＝0．0029；Z＝-3．17，P＝0．0002；Z＝-2．89，P＝0．0001）；PGⅡ与健康组比较差异无统计学意义（P＞0．05）。②非典型增生和胃癌组血清PGⅠ水平与萎缩组比较差异有统计学意义（Z＝-2．42，P＝0．0024；Z＝-3．62，P＝0．0009）；PGⅡ和PGR水平差异无统计学意义（P＞0．05）。③血清PGⅠ水平在萎缩性胃炎和胃癌组3个级别小组内比较差异无统计学意义（χ2＝2．86，P＝0．4143；χ2＝1．67，P＝0．1368）；而PGⅠ在非典型增生组，轻中度呈下降趋势，重度升高，差异有统计学意义（χ2＝0．83，P＝0．0430），PGⅡ水平和PGR差异无统计学意义（P＞0．05）。④以正常组和胃黏膜非典型增生组的血清PGⅠ和PGR所作的受试者工作特征（ROC）曲线下的面积分别为0．782和0．831；以血清PGI≤72．12μg/L和PGR≤4．32作为临界值筛查胃黏膜非典型增生的敏感性和特异性分别为89．48％和76．31％。结论①随胃黏膜病变严重程度增加，PGⅠ水平和PGR呈下降趋势，PG有可能作为胃黏膜恶性变的筛查标记物。②血清PG水平与胃黏膜病变密切相关，以血清PGI≤72．12μg/L联合PGR≤4．32作为临界值筛查胃黏膜非典型增生在本地区可能具有较好的敏感性和特异性。
目的：通過檢測血清胃蛋白酶原在胃黏膜不同病理狀態下的錶達水平，探討其作為臨床篩查胃癌標誌物的可能性及定量範圍。方法用時間分辨熒光免疫分析（TRFIA）法檢測63例胃黏膜非典型增生、64例慢性萎縮性胃炎、67例胃癌患者和20例健康誌願者血清胃蛋白酶原（PG）Ⅰ、Ⅱ的含量，計算PGⅠ/PGⅡ比值（PGR），併對3類病變進行等級分組，比較PG水平在組間和組內差異。結果①與健康對照組（152．00μg/L）比較，萎縮性胃炎、非典型增生和胃癌患者PGⅠ水平中位數值分彆為124．01、91．23和71．23μg/L，差異有統計學意義（Z＝-2．52，P＝0．0170；Z＝-3．42，P＝0．0014；Z＝-3．57，P＝0．0009）。PGR水平M值分彆為7．61、5．21和4．32，低于健康組（15．38），差異有統計學意義（Z＝-2．98，P＝0．0029；Z＝-3．17，P＝0．0002；Z＝-2．89，P＝0．0001）；PGⅡ與健康組比較差異無統計學意義（P＞0．05）。②非典型增生和胃癌組血清PGⅠ水平與萎縮組比較差異有統計學意義（Z＝-2．42，P＝0．0024；Z＝-3．62，P＝0．0009）；PGⅡ和PGR水平差異無統計學意義（P＞0．05）。③血清PGⅠ水平在萎縮性胃炎和胃癌組3箇級彆小組內比較差異無統計學意義（χ2＝2．86，P＝0．4143；χ2＝1．67，P＝0．1368）；而PGⅠ在非典型增生組，輕中度呈下降趨勢，重度升高，差異有統計學意義（χ2＝0．83，P＝0．0430），PGⅡ水平和PGR差異無統計學意義（P＞0．05）。④以正常組和胃黏膜非典型增生組的血清PGⅠ和PGR所作的受試者工作特徵（ROC）麯線下的麵積分彆為0．782和0．831；以血清PGI≤72．12μg/L和PGR≤4．32作為臨界值篩查胃黏膜非典型增生的敏感性和特異性分彆為89．48％和76．31％。結論①隨胃黏膜病變嚴重程度增加，PGⅠ水平和PGR呈下降趨勢，PG有可能作為胃黏膜噁性變的篩查標記物。②血清PG水平與胃黏膜病變密切相關，以血清PGI≤72．12μg/L聯閤PGR≤4．32作為臨界值篩查胃黏膜非典型增生在本地區可能具有較好的敏感性和特異性。
목적：통과검측혈청위단백매원재위점막불동병리상태하적표체수평，탐토기작위림상사사위암표지물적가능성급정량범위。방법용시간분변형광면역분석（TRFIA）법검측63례위점막비전형증생、64례만성위축성위염、67례위암환자화20례건강지원자혈청위단백매원（PG）Ⅰ、Ⅱ적함량，계산PGⅠ/PGⅡ비치（PGR），병대3류병변진행등급분조，비교PG수평재조간화조내차이。결과①여건강대조조（152．00μg/L）비교，위축성위염、비전형증생화위암환자PGⅠ수평중위수치분별위124．01、91．23화71．23μg/L，차이유통계학의의（Z＝-2．52，P＝0．0170；Z＝-3．42，P＝0．0014；Z＝-3．57，P＝0．0009）。PGR수평M치분별위7．61、5．21화4．32，저우건강조（15．38），차이유통계학의의（Z＝-2．98，P＝0．0029；Z＝-3．17，P＝0．0002；Z＝-2．89，P＝0．0001）；PGⅡ여건강조비교차이무통계학의의（P＞0．05）。②비전형증생화위암조혈청PGⅠ수평여위축조비교차이유통계학의의（Z＝-2．42，P＝0．0024；Z＝-3．62，P＝0．0009）；PGⅡ화PGR수평차이무통계학의의（P＞0．05）。③혈청PGⅠ수평재위축성위염화위암조3개급별소조내비교차이무통계학의의（χ2＝2．86，P＝0．4143；χ2＝1．67，P＝0．1368）；이PGⅠ재비전형증생조，경중도정하강추세，중도승고，차이유통계학의의（χ2＝0．83，P＝0．0430），PGⅡ수평화PGR차이무통계학의의（P＞0．05）。④이정상조화위점막비전형증생조적혈청PGⅠ화PGR소작적수시자공작특정（ROC）곡선하적면적분별위0．782화0．831；이혈청PGI≤72．12μg/L화PGR≤4．32작위림계치사사위점막비전형증생적민감성화특이성분별위89．48％화76．31％。결론①수위점막병변엄중정도증가，PGⅠ수평화PGR정하강추세，PG유가능작위위점막악성변적사사표기물。②혈청PG수평여위점막병변밀절상관，이혈청PGI≤72．12μg/L연합PGR≤4．32작위림계치사사위점막비전형증생재본지구가능구유교호적민감성화특이성。
Objective Toinvestigatethepossibilityandquantitativerangeofpepsinogen(PG)usedas the screening marker of gastric cancer by detecting serum pepsinogen level in different gastric mucous pathologic status.Method ThelevelofserumpepsinogenⅠ(PGⅠ)andpepsinogenⅡ(PGⅡ)bytimeresolvedfluoro-immunoassay(TRFIA)in 64 chronic atrophic gastritis patients,63 gastric mucous atypical hyperplasia patients, 67 gastric cancer patients and 20 healthy volunteers were defeeted ,and the ratio of PGR(PGⅠ/PGⅡ)was calculated.Then the three kinds of diseases were graded.The data was analyzed between groups and sub-groups.Result ①Compared with normal control group,the median PGⅠvalues were 1 24.01 ,91 .23 and 71 .23 respectively,which were all lower than that of healthy group (1 52.00).There were significant differ-ences(Z=-2.52,P=0.01 7 0;Z=-3.42,P=0.001 4;Z=-3.57,P=0.000 9).The median PGR values were 7.61 ,5.21 and 4.32 respectively,which were also lower than that of healthy group,the differences were significant(Z=-2.98,P=0.002 9;Z=-3.1 7,P=0.000 2;Z=-2.89,P=0.000 1 ).The PGⅡlevel of these diseases were not significantly different with control group.②The serum PGⅠlevel of gastric mucous atypical hyperplasia and gastric cancer were reduced significantly in contrast with atrophic gastritis (Z =-3.42,P =0.001 4;Z=-3.62,P=0.000 9);the levels of PGⅡand PGR were varied without significance (P>0.05 );③The levels of PGⅠamong atrophy gastritis and gastric cancer subgroup have no significant difference(χ2 =2.86,P=0.41 4 3;χ2 =1 .67,P=0.1 36 8).But the level of PGⅠwas significantly different in gastric atypical hyperplasia(χ2 =0.83,P=0.043 0).It decreased in light and medium grade dysplasia and went up in severe grade dysplasia.The levels of PGⅡ and PGR were varied without significance(P>0.05).④The areas under the ROC curves performed by the PGⅠ and PGR from normal control group and atypical hyperplasia group were 0.782 and 0.831 respectively;The sensitivity and specificity of PGⅠ≤72.1 2 μg/L and PGR≤4.32 for gastric dysplasia were 89.48%and 76.31%respectively.Conclusion ①The level of PGⅠand PGR were decreased along with the seriousness of gastric pathological changes and probably regarded as the screening markers of gastric mucous malignant transformation.②Serum pepsinogen level is closely correlated with gastric precancerous lesion,PGI≤72.1 2 μg/L and PGR≤4.32 has better specificity and sensitivity for gastric atypical hyperplasia in this area.
