摘要
目的观察并分析慢性萎缩性胃炎(CAG)患者的血清胃功能指标[胃蛋白酶原(PG)Ⅰ、PGⅡ、胃蛋白酶原比值(PGR)、胃泌素-17(G-17)]水平、萎缩范围评估分型结果和1型胃神经内分泌肿瘤(G-NET)检出率。方法回顾性分析95例胃癌高危患者的资料,将44例慢性非萎缩性胃炎患者纳入慢性非萎缩性胃炎组,并根据萎缩范围评估结果(内镜检查和病理组织学表现)将51例CAG患者分为远端CAG组30例和广泛CAG组21例。比较3组患者的基线资料、血清胃功能指标水平、幽门螺杆菌(Hp)感染率和1型G-NET检出率。结果远端CAG组、广泛CAG组血清PGⅠ水平均低于慢性非萎缩性胃炎组,且广泛CAG组低于远端CAG组,差异有统计学意义(P<0.001);广泛CAG组血清PGR低于另外2组,血清G-17水平高于另外2组,差异有统计学意义(P<0.001);3组血清PGⅡ水平比较,差异无统计学意义(P>0.05)。广泛CAG组的1型G-NET检出率为14.29%(3/21),高于慢性非萎缩性胃炎组、远端CAG组的0%,差异有统计学意义(P<0.05)。结论血清PG联合G-17对CAG的诊断价值较高。G-17水平显著升高并伴有血清PGⅠ、PGR水平显著降低,提示可能是以胃体萎缩为主的广泛CAG。广泛CAG患者发生1型G-NET的风险较高,胃镜检查时需进行萎缩范围评估,从而提高1型G-NET检出率。
Objective To observe and analyze serum gastric function indexes [pepsinogen(PG) Ⅰ,PG Ⅱ,pepsinogen Ⅰ to pepsinogen Ⅱ ratio(PGR),gastrin-17(G-17)],atrophy range evaluation classification results and the detection rate of type 1 gastric neuroendocrine tumor(G-NET) in patients with chronic atrophic gastritis(CAG). Methods Data of 95 high-risk patients with gastric cancer were retrospectively analyzed,44 patients with chronic non-atrophic gastritis were included in chronic non-atrophic gastritis group,and 51 patients with CAG were divided into distal CAG group(n=30) and extensive CAG group(n=21) according to the atrophic range assessment results(endoscopy and histopathological findings). Baseline data,serum gastric function index levels,Helicobacter pylori(Hp) infection rate and detection rate of patients with type 1 G-NET in three groups were compared. Results The serum PGⅠ levels of the distal CAG group and the extensive CAG group were lower than those of the chronic non-atrophic gastritis group,and the serum PGⅠ level of the extensive CAG group was lower than that of the distal CAG group(P<0.001). In the extensive atrophic gastritis group,the serum PGⅠ level was significantly decreased,while the serum G-17 level was increased compared with the non-atrophic gastritis group and the distal atrophic gastritis group( P < 0. 001). There was no significant difference in serum PGⅡ level among the three groups( P > 0. 05). The detection rate of type 1 G-NET in the extensive CAG group was 14. 29%( 3/21),which was higher than 0% in the chronic non-atrophic gastritis group and the distal CAG group( P < 0. 05). Conclusion Serum PG combined with G-17has significant diagnostic value for CAG. Patients with increase of G-17 accompanying by significant decrease in serum PGⅠ and PGR indicate that they occur extensive CAG mainly characterized by gastric atrophy. Patients with extensive CAG have a higher risk of developing type 1 G-NET,and the atrophy area should be evaluated during gastroscopy to improve the detection rate of type 1 G-NET.
作者
吴慧博
郭雅丽
姚玉霞
宋丽
辛莘
高春霞
郐大余
曹翠云
徐宝宏
WU Huibo;GUO Yali;YAO Yuxia;SONG Li;XIN Shen;GAO Chunxia;KUAI Dayu;CAO Cuiyun;XU Baohong(Department of Gastroenterology,Beijing Luhe Hospital Affiliated to Capital Medical University,Beijing,101149)
出处
《实用临床医药杂志》
CAS
2022年第12期80-83,90,共5页
Journal of Clinical Medicine in Practice
基金
北京市通州区科技计划-临床特色研究专项(KJ2018CX009-17)。
