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Received:September 25, 2022 Published Online:February 20, 2023
Received:September 25, 2022 Published Online:February 20, 2023
中文摘要: 目的 分析胃黏膜“血清学活检”，即血清胃蛋白酶原Ⅰ（PGⅠ）、胃蛋白酶原Ⅱ（PGⅡ）、PGⅠ/PGⅡ比值（PGR）、胃泌素-17(G-17)和幽门螺杆菌抗体（HP-IgG），与组织学慢性胃炎分级评估系统（OLGA/OLGIM）的相关性，评价其对胃癌前疾病筛查的效力。方法 选取2019年1月至2021年12月中国人民解放军海军第971医院因消化不良症状行胃镜检查的417例患者，根据OLGA/OLGIM胃炎评估系统对其进行分组评估，对各组患者血清PG及G-17、HP-IgG进行检测及比较。结果 在OLGA/OLGIM分组中，PGⅠ和PGR随分组等级升高呈降低趋势（P＜0.01），而G-17和HP感染率随分组等级升高呈升高趋势（P＜0.01）。Kendall相关性分析显示联合评分法与OLGA分期、OLGIM分期之间均呈正相关（r=0.44、0.43，P<0.01）。此外，HP-IgG阳性组PGⅡ、G-17水平显著高于阴性组，PGⅠ、PGR水平显著低于阴性组，差异有统计学意义（P＜0.01）。结论 胃黏膜“血清学活检”与组织学OLGA/OLGIM胃炎评价标准密切相关，在胃癌前疾病的筛查评估展现出极大的潜力。
Abstract:ObjectiveTo analyze the correlation between gastric mucosa serological biopsy ［serum pepsinogen Ⅰ（PGⅠ）, pepsinogen Ⅱ（PGⅡ）, ratio of PGⅠ/PGⅡ(PGR), gastrin-17 and helicobacter pyloriantibody（HP-IgG）］ and histological gastritis evaluation criteria （OLGA/OLGIM）, and to evaluate the efficacy of these indicators in the screening of gastric precancerous disease. MethodsA total of 417 patients underwent gastroscopy for dyspepsia were selected in the 971st Hospital of the PLA Navy from January 2019 to December 2021 were selected. They were evaluated in groups according to the OLGA/OLGIM staging system, and the serum PGⅠ, PGⅡ, PGR, G-17 and HP-IgG were detected and analyzed. ResultsIn OLGA/OLGIM group, PGⅠ and PGR decreased with the increase of group grade(P＜0.01), while the infection rates of G-17 and HP increased with the increase of group grade(P＜0.01). Kendall correlation analysis showed that there was a positive correlation between the combined scoring method and OLGA stage and OLGIM stage (r=0.44, 0.43,P<0.01). In addition, the levels of PGⅡ and G-17 in HP-IgG positive group were significantly higher than those in the negative group, and the levels of PGⅠ and PGR were significantly lower than those in the negative group (P＜0.01). ConclusionSerological gastric biopsy is closely related to OLGA/OLGIM stage, which shows great potential in the screening and evaluation of gastric precancerous disease.
keywords: Pepsinogen Gastrin Helicobacter pylori antibody Gastric precancerous disease Screening Serological biopsy
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基金项目:青岛市医药科研指导计划（2020-WJZD200）；青岛市市南区科技计划项目（2020-2-009-YY）
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