血清胃蛋白酶原、胃泌素-17聯(lián)合幽門(mén)螺桿菌定量檢測(cè)對(duì)胃良惡性疾病診斷的臨床研究

血清胃蛋白酶原、胃泌素-17聯(lián)合幽門(mén)螺桿菌定量檢測(cè)對(duì)胃良惡性疾病診斷的臨床研究血清胃蛋白酶原、胃泌素-17聯(lián)合幽門(mén)螺桿菌定量檢測(cè)對(duì)胃良惡性疾病診斷的臨床研究

摘要：目的：探討血清胃蛋白酶原（PG）、胃泌素-17（G17）聯(lián)合幽門(mén)螺桿菌定量檢測(cè)對(duì)胃良惡性疾病的診斷價(jià)值。方法：選取2015年1月至2018年12月我院收治的胃病患者120例，其中胃癌組60例，胃潰瘍組60例。另選取40名非胃病人群作為對(duì)照組，根據(jù)病理學(xué)結(jié)果分組，采用ELISA法檢測(cè)PG、G17水平，同時(shí)采用實(shí)時(shí)熒光定量PCR檢測(cè)幽門(mén)螺桿菌負(fù)載量。結(jié)果：胃癌組PG、G17水平顯著高于對(duì)照組及胃潰瘍組，差異均有統(tǒng)計(jì)學(xué)意義（P<0.05）。胃癌組幽門(mén)螺桿菌陽(yáng)性率高于胃潰瘍組（P<0.05），而且幽門(mén)螺桿菌在PG、G17水平高組比低組陽(yáng)性率更高。PG、G17聯(lián)合檢測(cè)的靈敏度為68.3%，特異度為77.9%，在胃癌和胃潰瘍的診斷中差異均有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論：血清PG、G17聯(lián)合幽門(mén)螺桿菌定量檢測(cè)可提高胃良惡性疾病的診斷準(zhǔn)確性，為早期診斷和治療提供參考。

關(guān)鍵詞：胃癌；胃潰瘍；胃蛋白酶原；胃泌素-17；幽門(mén)螺桿菌

Abstract:Objective:Toexplorethediagnosticvalueofserumpepsinogen(PG),gastrin-17(G17)combinedwithHelicobacterpyloriquantitativedetectioningastricbenignandmalignantdiseases.Methods:120gastricpatientsadmittedtoourhospitalfromJanuary2015toDecember2018wereselected,including60casesofgastriccancerand60casesofgastriculcer.Inaddition,40non-gastricdiseasepopulationswereselectedascontrolgroup.Accordingtothepathologicalresults,ELISAwasusedtodetectthelevelsofPGandG17andreal-timefluorescencequantitativePCRwasusedtodetecttheloadofHelicobacterpylori.Results:ThelevelsofPGandG17inthegastriccancergroupweresignificantlyhigherthanthoseinthecontrolandgastriculcergroup,andthedifferenceswerestatisticallysignificant(P<0.05).ThepositiverateofHelicobacterpyloriinthegastriccancergroupwashigherthanthatinthegastriculcergroup(P<0.05),andthepositiverateofHelicobacterpyloriwashigherinthehighgroupofPGandG17levelsthaninthelowgroup.ThesensitivityandspecificityofPGandG17combineddetectionwere68.3%and77.9%,respectively,andthedifferencesinthediagnosisofgastriccancerandgastriculcerwerestatisticallysignificant(P<0.05).Conclusion:SerumPGandG17combinedwithHelicobacterpyloriquantitativedetectioncanimprovethediagnosticaccuracyofgastricbenignandmalignantdiseases,andprovidereferenceforearlydiagnosisandtreatment.

Keywords:gastriccancer;gastriculcer;pepsinogen;gastrin-17;HelicobacterpyloriGastriccancerandgastriculceraresignificanthealthproblemsaffectingmillionsofpeopleworldwide.Earlydiagnosisandtreatmentarecriticalforimprovingpatientoutcomesandreducingmorbidityandmortality.Inrecentyears,serumbiomarkerssuchaspepsinogen(PG)andgastrin-17(G17)havebeenshowntohavediagnosticpotentialforgastricbenignandmalignantdiseases.

Inthisstudy,wecombinedthedetectionofserumPGandG17withHelicobacterpyloriquantitativedetectiontoevaluatetheirdiagnosticaccuracyforgastriccancerandgastriculcer.OurresultsshowedthatthecombineddetectionofPGandG17hadhighersensitivityandspecificitycomparedwitheitherbiomarkeralone.Furthermore,thedifferencesinthediagnosisofgastriccancerandgastriculcerbetweenthetwobiomarkerswerestatisticallysignificant.

ThesefindingssuggestthatthecombinationofserumPGandG17withHelicobacterpyloriquantitativedetectioncanimprovethediagnosticaccuracyofgastricbenignandmalignantdiseases.Routinescreeningforthesebiomarkersinhigh-riskpopulationsmayfacilitateearlydiagnosisandtreatment,ultimatelyleadingtobetterpatientoutcomes.FurtherstudiesarewarrantedtovalidateourfindingsandexploretheclinicalutilityofthesebiomarkersinthemanagementofgastricdiseasesInadditiontothepotentialdiagnosticbenefitsofserumPGandG17incombinationwithHelicobacterpyloriquantitativedetection,thesebiomarkersmayalsohaveprognosticvalueingastriccancerpatients.SeveralstudieshavereportedthatlowserumPGlevelsareassociatedwithaworseprognosisinpatientswithgastriccancer,indicatingthatitmaybeausefulprognosticmarkerinthispopulation.Similarly,highserumG17levelshavebeenlinkedtoamoreaggressivetumorphenotypeandworsesurvivaloutcomesingastriccancerpatients.

Moreover,serumPGandG17mayalsohavearoleinmonitoringtreatmentresponseanddiseaserecurrenceingastriccancerpatients.Forexample,adecreaseinserumPGlevelsfollowingHelicobacterpylorieradicationtherapyhasbeenshowntobepredictiveofhistologicalimprovementandareducedriskofdevelopinggastriccancer,suggestingthatthisbiomarkercouldbeusedtomonitortreatmentefficacyanddiseaseprogression.Similarly,serialmeasurementsofserumG17levelsmayprovideearlyindicationsofrecurrentdiseaseingastriccancerpatientsfollowingsurgeryorchemotherapytreatment.

Inconclusion,serumPGandG17arepromisingbiomarkersforthediagnosis,prognosis,andmonitoringofgastricbenignandmalignantdiseases.ThecombinationofthesebiomarkerswithHelicobacterpyloriquantitativedetectioncouldsignificantlyimprovetheaccuracyofgastricdiseasediagnosis,particularlyinhigh-riskpopulations.Furtherresearchisneededtovalidatethesefindingsandtodeterminetheclinicalutilityofthesebiomarkersinthemanagementofgastricdiseases.Ultimately,theintegrationofserumPGandG17assaysintoroutineclinicalpracticemayhelptoimproveoutcomesforpatientswithgastriccancerandothergastricdiseasesGastricdiseaseremainsasignificanthealthburdenglobally,withgastriccancerbeingthefifthmostcommonmalignancyandthethirdmostcommoncauseofcancer-relateddeathsworldwide.Timelydiagnosisandtreatmentofgastricdiseasesarecrucialforimprovingpatientoutcomes,whichhighlightstheneedforeffectivediagnostictools.

Helicobacterpyloriinfectionistheprimaryriskfactorforthedevelopmentofgastricdiseases,includinggastritis,pepticulcerdisease,andgastriccancer.Therefore,accurateandreliabledetectionofH.pyloriinfectionisessentialforthediagnosisandtreatmentofgastricdiseases.

Serumbiomarkers,suchaspepsinogenandgastrin-17,havebeenstudiedaspotentialdiagnostictoolsforgastricdiseases.Pepsinogenisagroupofproteolyticenzymessecretedbythegastricmucosa,whilegastrin-17isahormoneproducedbythegastricantralG-cells.BothofthesebiomarkersarealteredinthepresenceofH.pyloriinfectionandgastricatrophy.

Recentstudieshaveshownthatthecombinationofserumpepsinogenandgastrin-17assayscouldimprovetheaccuracyofH.pyloridetectionandpredicttheriskofgastriccancer.Forinstance,astudyconductedinChinafoundthattheuseofserumPGandG17assayshadhighersensitivityandspecificitythanH.pyloriantibodydetectioninpredictinggastriccancerrisk.Similarly,aKoreanstudyshowedthatthecombineduseofthesebiomarkershadasensitivityof90.7%andaspecificityof83.0%forthediagnosisofgastriccancer.

TheuseofserumPGandG17assaysforgastricdiseasediagnosis,particularlyinhigh-riskpopulations,couldimprovepatientoutcomesbyenablingearlierdetectionandintervention.However,furtherresearchisneededtovalidatethesefindingsanddeterminetheclinicalutilityofthesebiomarkersinroutineclinicalpractice.

Inconclusion,thecombinationofserumpepsinogenandgastrin-17assayscouldserveasausefuldiagnostictoolforH.pylorid