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慢性萎缩性胃炎患者血清胃功能、胃神经内分泌肿瘤的临床研究

Clinical study of serum gastric function and gastric neuroendocrine tumor in patients with chronic atrophic gastritis

    摘要
  • 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。

     

    Abstract:
    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-17 has 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.

     

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