血清胃蛋白酶原检测与胃镜检查对慢性萎缩性胃炎临床诊断价值的比较

doi:10.3969/j.issn.1673-8640.2017.03.003

摘要/Abstract

摘要：

目的比较血清胃蛋白酶原（PG）Ⅰ、PGⅡ水平及PGⅠ/PGⅡ比值（PGR）与胃镜检查对慢性萎缩性胃炎（CAG）的临床诊断价值。方法以病理诊断为金标准,将205例患者分为CAG组（103例）和慢性非萎缩性胃炎组（对照组,102例）。所有患者均进行血清PG检测及胃镜检查,计算PG和胃镜诊断CAG的敏感性、特异性、阳性预测值、阴性预测值。结果 CAG组血清PGⅠ [（74.43±39.62）μg/L]、PGR（2.70±1.05）明显低于对照组[PGⅠ 为（94.89±36.30）μg/L、PGR为3.55±0.90,P<0.01],而PGⅡ2个组之间差异无统计学意义（P>0.05）。血清PGⅠ、PGR、胃镜诊断CAG的敏感性分别为66.0%、67.0%、74.8%,特异性分别为62.7%、77.5%、80.4%,阳性预测值分别为64.2%、75.0%、79.4%,阴性预测值分别为64.6%、70.0%、75.9%;PGR诊断CAG的敏感性、特异性、阳性预测值、阴性预测值与胃镜检查比较,差异均无统计学意义（P>0.05）,PGⅠ诊断CAG的特异性和阳性预测值明显低于PGR及胃镜检查（P<0.05）。结论血清PGR与胃镜检查对CAG的临床诊断价值相当。在大量筛查CAG时或对于不适用胃镜检查的患者,PG检测有望替代胃镜检查用于对CAG的临床辅助诊断。

关键词: 胃蛋白酶原Ⅰ, 胃蛋白酶原Ⅱ, 胃蛋白酶原Ⅰ/胃蛋白酶原Ⅱ比值, 胃镜检查, 慢性萎缩性胃炎

Abstract:

Objective To evaluate serum pepsinogen（PG）Ⅰ,PGⅡ,PGⅠ/PGⅡ ratio（PGR） determinations and endoscopy for the diagnosis of chronic atrophic gastritis（CAG）. Methods According to the results of pathological analysis,205 patients were enrolled and classified into CAG group （103 cases） and non-CAG group （control group,102 cases）. PGⅠ,PGⅡ,PGR determinations and endoscopy were performed. The sensitivities,specificities,positive predictive values and negative predictive values of PGⅠ,PGⅡ,PGR determinations and endoscopy were evaluated. Results The levels of serum PGⅠ [（74.43±39.62）μg/L] and PGR（2.70±1.05） in CAG group were lower than those in control group [（94.89±36.30）μg/L and 3.55±0.90,P<0.01],and there was no statistical significance for PGⅡ level（P>0.05）. For serum PGⅠ,PGR determinations and endoscopy,the sensitivities were 66.0%,67.0% and 74.8%,the specificities were 62.7%,77.5% and 80.4%,the positive predictive values were 64.2%,75.0% and 79.4 %,and the negative predictive values were 64.6%,70.0% and 75.9%. Compared to endoscopy,there was no statistical significance of PGR determination for the diagnosis of CAG（P>0.05）. For the diagnosis of CAG,the specificity and positive predictive value of PGⅠ determination were lower than those of PGR determination and endoscopy （P<0.05）. Conclusions The performance of serum PGR determination and endoscopy for the diagnosis of CAG is similar. For screening CAG and for patients who are not suitable for endoscopy,serum PG determinations may be potential for replacing endoscopy for the diagnosis of CAG.

Key words: Pepsinogen Ⅰ, Pepsinogen Ⅱ, Pepsinogen Ⅰ/pepsinogen Ⅱ ratio, Endoscopy, Chronic atrophic gastritis

中图分类号:

R446.1

惠文佳, 周春艳, 刘卫东, 蒋琦, 高峰. 血清胃蛋白酶原检测与胃镜检查对慢性萎缩性胃炎临床诊断价值的比较[J]. 检验医学, 2017, 32(3): 169-172.

HUI Wenjia, ZHOU Chunyan, LIU Weidong, JIANG Qi, GAO Feng. Comparison of serum pepsinogen determinations and endoscopy for the diagnosis of chronic atrophic gastritis[J]. Laboratory Medicine, 2017, 32(3): 169-172.

图/表 2

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组别	例数	PGⅠ（μg/L ）	PGⅡ（μg/L ）	PGR
CAG组	103	74.43±39.62	27.64±12.89	2.70±1.05
对照组	102	94.89±36.30	27.15±9.99	3.55±0.90
t值		3.584	0.304	6.220
P值		<0.001	0.761	<0.001

组别	例数	PGⅠ（μg/L ）	PGⅡ（μg/L ）	PGR
CAG组	103	74.43±39.62	27.64±12.89	2.70±1.05
对照组	102	94.89±36.30	27.15±9.99	3.55±0.90
t值		3.584	0.304	6.220
P值		<0.001	0.761	<0.001