Application Value Of Combined Detection Of Serum PG,G-17,IL-8 And HP In The Diagnosis Of Precancerous Diseases And Gastric Cancer

Background:Gastric cancer(GC)is one of the most common malignant tumors in the world.About 700000 people die of primary gastric cancer every year.At present,the gold standard for the diagnosis of primary gastric cancer is to carry out regular gastroscopy and gastric pathological tissue biopsy.However,endoscopy makes patients feel pain and discomfort and the limitation of fear,it is only suitable for patients with symptoms.It is difficult to carry out large-scale gastroscopy screening in China However,due to the lack of diagnostic and testing methods for early gastric cancer,Most of the patients with primary gastric cancer are in the late stage and have poor prognosis.Therefore,early detection and timely treatment are the key to improve the prognosis of gastric cancer.Serological test may be helpful for the diagnosis of precancerous diseases and gastric cancer.With its advantages of simplicity,economy and non-invasive,it has attracted more and more attention of clinicians.However,the pathogenesis of gastric cancer is still unclear,and the molecular markers of gastric cancer need to be further confirmed to further improve the detection rate of early gastric cancer.So at present,the biggest challenge is to find an appropriate and cost-effective screening program to detect the disease early.In recent years,the combined detection of serum pepsinogen(PG),gastrin 17(G-17)and Helicobacter pylori(HP)has been gradually applied to the diagnosis of gastric mucosa related diseases,such as atrophic gastritis,intestinal metaplasia and dysplasia,but the sensitivity and specificity are relatively low,and the detection rate of early gastric cancer is still less than 10%.Interleukin-8(IL-8)is an inflammatory chemokine.Many studies have shown that IL-8 is important for the occurrence,development and prognosis of gastric cancer.In the past,one method was used to detect IL-8.In this study,two methods of histology and serology were used to detect IL-8.The consistency of the two methods and the combination of PG,G-17,IL-8 and HP were discussed The application value of precancerous disease and gastric cancer diagnosis.Objective:The purpose of this study was to explore the consistency of two methods of detecting IL-8 in histology and serology,and the value of combined detection of serum PG,G-17,IL-8 and HP in the diagnosis of precancerous diseases and gastric cancer.Methods:1.Study object:136 patients who received gastroscopy and histopathological biopsy in our hospital from January 1,2018 to December 31,2019 were selected as study objects;2.Grouping:according to the results of gastroscopy and histopathological biopsy,the study objects were divided into healthy control group,atrophic gastritis group(with or without intestinal metaplasia)and gastric cancer group.Among them,56 cases were in the control group,38 cases in the atrophic gastritis group and 42 cases in the gastric cancer group;3.Detection method:the serum concentrations of PG(PGI,PGII,PGR),G-17 and IL-8 were measured by ELISA,the expression of IL-8 in three tissues was detected by immunohistochemistry,and the HP infection status was detected by 13C breath test and rapid urease test;4.The serum indexes and HP infection rate were compared in each group They were divided into HP positive group and HP negative group,and compared the levels of HP positive patients and HP negative serological indicators in each group;5.Compared the consistency of IL-8 detection by histological and serological methods;6.Compared the sensitivity and specificity of combined detection of various indicators in the diagnosis of precancerous diseases and gastric cancer.Results:1.Comparison of general data of patients in each group:control group:male 27,female 29,average age 59.2±9.0;atrophic gastritis group:male 18,female 20,average age 59.1±7.6;gastric cancer group:male 20,female 22,average age 62.1±7.0.There was no significant difference in gender and age among the three groups(P>0.05).2.Comparison of HP infection rate in each group:the HP infection rate in the control group was 5.8%,that in the atrophic gastritis group was 47.4%,and that in the gastric cancer group was 73.8%.There was statistically significant difference between the three groups(x2=6.91,P=0.032).There was no significant difference between the control group and the atrophic gastritis group(x2=0.18,P=0.674).The difference between the gastric cancer group and the control group was statistically significant The difference between gastric cancer group and atrophic gastritis group was statistically significant(x2=5.88,P=0.015).3.The comparison of serological indexes in each group:PGI:the control group,atrophic gastritis group and gastric cancer group decreased gradually,and the differences between the three groups and any two groups were statistically significant(P<0.05);PGII:the differences between the three groups were not statistically significant(P=0.126);PGR:decreased gradually in the control group,atrophic gastritis group and gastric cancer group,and there were statistically significant differences between the three groups and any two groups(P<0.05);G17:there were statistically significant differences between the three groups(P<0.05),gastric cancer group was higher than the control group and atrophic gastritis group,and the difference was statistically significant(P<0.05),and atrophic gastritis group was lower than the control group,and the difference was statistically significant(P<0.05);IL-8:the control group,atrophic gastritis group and gastric cancer group gradually increase,and the differences between the three groups and any two groups were statistically significant(P<0.05).4.PGI,PGII,G-17 and IL-8 of HP positive patients in each group were higher than those of HP negative patients,and the difference was statistically significant(P<0.05);PGR of HP positive patients in each group was not statistically significant compared with HP negative patients(P>0.05).5.The results showed that there was consistency between the two methods of serum and histology in screening atrophic gastritis and gastric cancer;6.The sensitivity and specificity of the combined detection of serum PG,G-17 and HP for gastric cancer were 81.0%and 75.0%,90.5%and 66.1%respectively,and 95.2%and 73.2%respectively.The sensitivity and specificity of PG,G-17 and IL-8 were 89.5%,55.4%and 84.2%,85.7%respectively.Conclusion:1.HP infection,PGI,PGR,G-17,IL-8 may be closely related to the occurrence and development of gastric cancer;2.PGI,PGII,G-17 and IL-8 may be involved in HP induced gastric mucosal inflammation;3.Two methods of IL-8 detection,histology and serology,were used to screen atrophic gastritis and gastric cancer are consistent;4.The sensitivity of combined detection of serum PG,G-17,IL-8 and HP for gastric cancer was higher;the specificity of combined detection of serum PG,G-17 and IL-8 for precancerous diseases was higher.