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血清胃蛋白酶原联合肿瘤坏死因子α检测在幽门螺杆菌相关性胃疾病诊断中的意义
边春红,梁乐,王永刚,尚杰,郭胜香,潘玥
0
(北京市海淀医院检验科)
摘要:
【摘要】目的 检测幽门螺杆菌(Hp)相关性胃疾病患者血清中胃蛋白酶原(PG)与肿瘤坏死因子(TNFα),并探讨PG与TNFα在Hp相关性胃疾病诊断中的意义。方法 选取2018年1月~2019年3月于本院接受治疗的237例Hp相关性胃疾病患者为研究对象作为Hp相关性胃疾病组,其中73例为非萎缩性胃炎,66例为萎缩性胃炎,68例为消化性溃疡,30例为胃癌;同期选取195例健康体检者作为对照组(CG组)。采用乳胶免疫比浊法检测各组血清中的PGⅠ、PGⅡ以及酶联免疫吸附法(ELISA)TNFα水平,同时检测各组患者Hp感染情况;分析PGⅠ、PGⅡ及PGR和TNFα对Hp相关性胃疾病的诊断价值。结果 Hp相关性胃疾病组血清中TNFα、PGⅠ、PGⅡ水平均显著高于CG组,PGR水平显著低于CG组(P<005);萎缩性胃炎患者血清中PGⅠ、PGR水平显著低于非萎缩性胃炎(P<005);消化性溃疡患者血清中TNFα、PGⅡ水平显著高于非萎缩性胃炎和萎缩性胃炎,PGⅠ水平显著高于萎缩性胃炎,PGR水平低于非萎缩性胃炎高于萎缩性胃炎(P<005);胃癌患者血清中PGⅠ、PGR水平显著低于非萎缩性胃炎、萎缩性胃炎及消化性溃疡,TNFα、PGⅡ水平高于非萎缩性胃炎和萎缩性胃炎(P<005);Hp阳性的非萎缩性胃炎、萎缩性胃炎患者血清中TNFα水平均显著高于Hp阴性组(P<005);Hp阳性的萎缩性胃炎、消化性溃疡、胃癌患者血清中PGⅠ水平均显著高于Hp阴性组(P<005);Hp阳性的非萎缩性胃炎、萎缩性胃炎、消化性溃疡、胃癌患者患者血清中PGⅡ、PGR水平均显著高于Hp阴性组(P<005);TNFα、PGⅠ、PGⅡ、PGR诊断Hp相关性胃疾病患者的AUC分别为0842(95%CI:0807~0877)、0.844(95%CI:0808~0879)、0864(95%CI:0831~0896)、0874(95%CI:0789~0906),截断值分别为14563、114404、25483、4710,特异性分别为645%、698%、755%、657%,敏感度分别为897%、877%、862%、959%;PGⅠ、PGⅡ、PGR分别与TNFα联合诊断Hp相关性胃疾病患者的AUC分别为0922(95%CI:0898~0945)、0925(95%CI:0902~0948)、0937(95%CI:0916~0951),特异性分别为792%、857%、804%,敏感度为933%、851%、938%。结论 PGⅠ、PGⅡ、PGR联合TNFα可作为诊断Hp相关性胃疾病的参考指标,对Hp感染胃疾病的癌前病变及早期胃癌诊断有重要意义。
关键词:  幽门螺杆菌  消化性溃疡;萎缩性胃炎;非萎缩性胃炎;胃蛋白酶原;肿瘤坏死因子 α
DOI:
基金项目:北京市海淀医院青年项目院级课题(KYQ2018007)
Significance of serum pepsinogen combined with tumor necrosis factor α in the diagnosis of Helicobacter pylori related gastric diseases
BIAN Chunhong,LIANG Le,WANG Yonggang,SHANG Jie,GUO Shengxiang,PAN Yue
(Department of Laboratory, Beijing Haidian Hospital)
Abstract:
【Abstract】Objective To detect serum pepsinogen (PG) and tumor necrosis factorα (TNFα) in patients with Helicobacter pylori (Hp) related gastric diseases, and to explore the significances of PG and TNFα in the diagnosis of Hprelated gastric diseases. Methods From January 2016 to March 2019, 237 patients with Hprelated gastric diseases treated in our hospital were selected as the study subjects. During the same period, 195 healthy people (CG group) were selected as the control group. The levels of serum PGⅠ, PGⅡ and TNFα were detected by ELISA, and the infection of Hp in each group was also detected, and the diagnostic values of PGⅠ, PG Ⅱ and TNFα in Hprelated gastric diseases were analyzed.Results The levels of serum TNFα, PGⅠ and PGⅡ in Hprelated gastric diseases group were significantly higher than those in CG group (P<005). The levels of serum PGⅠ and PGⅡ in patients with atrophic gastritis were significantly lower than those in patients with superficial gastritis (P<005). The levels of serum TNFα and PGⅡ in patients with peptic ulcer were significantly higher than those in patients with superficial gastritis and atrophic gastritis, and the level of PG Ⅰ was higher than that in patients with atrophic gastritis (P<005). The level of serum PGⅡ in patients with gastric cancer was significantly lower than that of superficial gastritis, atrophic gastritis and peptic ulcer, TNFα level was higher than that of superficial gastritis and atrophic gastritis, PGⅠ level was lower than that of superficial gastritis and peptic ulcer, and PGR level was higher than that of superficial gastritis and peptic ulcer (P<005). The levels of serum TNFα in patients with superficial gastritis and atrophic gastritis with positive Hp were significantly higher than those in patients with negative Hp (P<005). The levels of serum PGⅠ in patients with Hppositive atrophic gastritis, peptic ulcer and gastric cancer were significantly higher than those in patients with Hpnegative (P<005). The level of serum PGⅡ in patients with atrophic gastritis with positive Hp was significantly higher than that in patients with negative Hp (P<005). The AUCs of TNFα, PGⅠ and PGⅡ in the diagnosis of Hprelated gastric diseases were 0858 (95% CI: 08110905), 0824 (95% CI: 07790869) and 0748 (95% CI: 06890806). The truncation values were 12444, 128648 and 28113, respectively. The specificities were 808%, 653% and 502%, and the sensitivities were 792%, 989% and 943%, respectively. The AUCs of PGⅠ and PGⅡ combined with TNFα respectively in patients with Hprelated gastric diseases were 0924 (95% CI: 08910957) and 0901 (95% CI: 08660936). The specificities were 811% and 785%, and the sensitivitties were 981% and 887%, respectively. ConclusionPGⅠ, PGⅡ and TNFα can be used as a reference index for the diagnosis of gastric diseases associated with Hp, and have important significances for the diagnosis of precancerous lesions and early gastric cancer caused by Hp infection. 
Key words:  Helicobacter pylori  Peptic ulcer  Atrophicgastritis  Non atropnic gastritis  Pepsinogen  Tumor necrosis factor α

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