胃蛋白酶原联合智能染色内镜诊断早期胃癌的临床研究

摘要

目的：观察和分析胃蛋白酶原（PG）联合智能染色内镜（i-San）诊断早期胃癌的临床价值。方法：选取258例老年胃黏膜病变患者作为病例组，选取50例健康人作为对照组，对两组研究对象的血清 PGⅠ水平、血清 PGⅡ水平及血清 PGⅠ／PGⅡ值进行观察和比较；对病例组患者进行 i-Scan 检查。结果：病例组患者的血清 PGⅠ水平和血清 PGⅠ／PGⅡ值均显著低于对照组而血清 PGⅡ水平显著高于对照组（P ＜0．05）；早期胃癌组（EGC 组）、进展期胃癌组（AGC 组）患者的血清 PGⅠ水平显著低于其它各组（P ＜0．05）；浅表性胃炎组（CSG 组）、EGC 组、AGC 组、胃溃疡组（GU）组患者的血清 PGⅡ水平显著高于其它各组（P ＜0．05），EGC 组、AGC 组患者的血清 PGⅠ／PGⅡ值显著低于其它各组（P ＜0．05）；单独应用血清 PG 检测与 i-Scan 检查的敏感度差异无统计学意义（χ2＝1．343，P ＞0．05），而联合检测的敏感度显著高于两种单独检测（χ2＝1 1．733、5．779，P ＜0．05）。结论：血清 PG 水平的变化可提示胃黏膜病变的进展和胃癌的发生，血清 PG 检测可作为早期胃癌的辅助诊断手段，与 i-Scan 检查联合时，可提高针对早期胃癌的诊断敏感度。%Objective:To observe and analyze the value of pepsinogen (PG)combined with intelligent chromoendoscopy (i-San)in the diagnosis of early gastric cancer.Methods:258 cases of elderly patients with gastric mucosal lesions were selected as the case group.50 cases of healthy people were selected as the control group.The serum PG I level,the serum PG II level and the serum PG I /PG II value of the objects in the two groups were observed and compared.The i-Scan detection were employed to the patients in the case group.Results:The serum PG I level and the serum PG I /PG II value were significantly lower than those in the control group and the serum PG II level was significantly higher than that in the control group (t =8.167,9.064,10.073,P <0.05 ).The serum PG I level of the patients in the early gastric cancer group (the EGC group),the advanced gastric carcinoma group (the AGC group)was significantly lower than that in the other groups (P <0.05).The serum PG II level of the patients in the superficial gastritis group (the CSG group),the EGC group,the AGC group,or the gastric ulcer group (GU)was significantly higher than that in the other groups (P<0.05).The serum PG I /PG II value of the patients in the EGC group,the AGC group was significantly lower than that in the other groups (P <0.05).There was no significant difference of sensitivity between single application of serum PG detection and i-Scan detec-tion (χ2 =1 .343,P >0.05)and the sensitivity of combined detection was significantly higher than that of the single detection (χ2 =1 1 .733,5.779,P <0.05).Conclusion:The changes of the serum PG level can provide clues to the progression of gastric mucosal le-sion and the occurrence of gastric cancer.The serum PG detection can be used as the auxiliary in the diagnosis of early gastric cancer, and the combined application of i-Scan detection can improve the sensitivity in diagnosis of early gastric cancer.