The Value Of Serum Pepsinogen Combined With Gastrin 17 In The Diagnosis Of Atrophic Gastritis

Objective: To evaluate the diagnostic value of serum pepsinogen(PG ?,PG ?)and pepsinogen ratio(PGR)and gastrin 17 in the diagnosis of atrophic gastritis.And the assessment of serum PG?,PG?,PGR and gastrin 17,with two markers diagnosis of atrophic gastritis,to strengthen the serum pepsinogen and gastrin 17 awareness for early detection of chronic atrophic gastritis.Methods: Form March 2016 to May 2017,the patients in the department of Gastroenterology,Shanxi Provincial People's Hospital Affiliated to Shanxi Medical University received the treatment of stomach upset was conducted.The patient was examined serum PG? and PG? and gastrin 17 by enzyme-linked immunosorbent assay(ELISA),calculated PGR(the ratio of PG?to PG?)before performing gastroscopy;according to gastroscopy and pathological report results,evaluation of diagnosis effect of the above indexes in gastric precancerous diseases.The diagnostic results of single index,dual index and multiple indicators for the diagnosis of atrophic gastritis were evaluated by sensitivity,specificity,accuracy,positive and negative predictive value,receiver operating characteristic curve(ROC curve)and Logistic regression method.Results: Based on the results of the pathological diagnosis,cases were enrolled and divided into chronic atrophic gastritis group(cases),chronic non-atrophic gastritis group(cases).Serum PG?,PG?,G-17 levels significant decreased(P<0.05)in chronic atrophic gastritis groups.There was no significant difference in PGR level among the two groups.The sensitivity of PG? to the diagnosis of atrophic gastritis was 69.92%,the specificity was 69.05%,the accuracy was 69.48%,the positive predictive value was 68.80% and the negative predictive value was 70.16%.The sensitivity of PG? to the diagnosis of atrophic gastritis was 66.67%,the specificity was 52.38%,the accuracy was 59.44%,the positive predictive value was 57.75% and the negative predictive value was 61.68%.The sensitivity of gastrin 17 to the diagnosis of atrophic gastritis is 78.05%,specificity is 50%,accuracy is 63.86%,positive predictive value is 60.38%,and negative predictive value is 70%.The sensitivity of PG? combined with gastrin 17 in the diagnosis of atrophic gastritis is 60.16%,specificity is 79.37%,accuracy is 69.88%,positive predictive value is 74%,and negative predictive value is 67.11%.The sensitivity of PG? combined with gastrin 17 in the diagnosis of atrophic gastritis is 60.16%,specificity is 70.63%,accuracy is 65.46%,positive predictive value is 66.67%,and negative predictive value is 64.49%.The sensitivity of PG? combined with PG? in the diagnosis of atrophic gastritis was 58.54%,the specificity was 49.21%,the accuracy was 53.82%,the positive predictive value was 52.94% and the negative predictive value was 54.87%.According to the Logistic regression analysis,the OR of PG? low value(< 117.805?g/L)and gastrin 17(< 9.125pmol/L)were 5.349,2.612,and PG? low value atrophic gastritis was the highest.Conclusion: The combination of serum PG and gastrin 17 in the screening of chronic atrophic gastritis is helpful for the early detection of chronic atrophic gastritis.When serum PG?,PG? and gastrin 17 were used for the diagnosis of atrophic gastritis,the specificity of the combined diagnosis was higher,and the best diagnosis was serum PG? and gastrin 17.PG? has the highest risk of low value atrophic gastritis.