Study On Relationship Between Atrophic Gastritis And Pepsinogen Subtypes

BackgroundIncidence of gastric cancer ranks fourth in malignant cancer, mortality second in worldwide. Each year the number of patients who died in gastric cancer were about 227,000, it accounted for 23% in malignant cancer, and early diagnosis were less than 20% in china. Early gastric cancer has good Prognosis, 5-year survival rate was 90%. Unfortunately, operation rate of early gastric cancer were less than 5% to 10%, while the 5-year survival rate of advanced gastric cancer is about 40%,at present.Therefore, early diagnosis and early treatment of gastric cancer is very important significance for improving survival rates. gastric precancerous lesions Which accounts for about 70% of atrophic gastritis, include atrophic gastritis and intestinal metaplasia glands and os on, therefore, early diagnosis and intervention of atrophic gastritis which will reduce the incidence of gastric cancer, had a major significance. Currently study on relevance of pepsinogen (pepsinogen, PG) and atrophic gastritis had been a hot point in cancer prevention. Pepsin is an important enzymes in gastric digestive function,pepsin which had not biological activity were secreted just and known as PG. PG which had been activated by the action of hydrochloric acid in the stomach and pepsin, can be transformed into the active pepsin, pepsin was for the hydrolysis of proteins and peptides. PG Of mammals which were based on different biochemical and immunological characteristics were divided two types, namely, PGâ… , PGâ…¡. PGâ… was mainly secreted by chief and neck mucous cells, and PGâ…¡by all gastric and proximal duodenal Brunner. 1% of pepsinogen was into the blood circulation through the gastric mucosa, So it can be detected in the serum.ObjectiveTo study serum pepsinogen subgroups (PGâ… , PGâ…¡) content in atrophic gastritis, gastric ulcer, gastric cancer patients and healthy persons, and investgate the significant of serum pepsinogen subgroups (PGâ… , PGâ…¡) content for diagnosis of atrophic gastritis.MethodsOutpatients and inpatients were in gastroenterology,general surgery and medical examination center of The Military General Hospital of Beijing PLA from March 2010 to December 2010, they had received endoscopy and biopsy or surgery,we would make them as research objects. Research objects are divided into four groups by endoscopic biopsy and surgical pathology. The normal control (NC), gastric ulcers (GU), atrophic gastritis (AG), gastric cancer (GC). Enrolled persons were all the Han nationality, and no significant liver, kidney disease, they also had not have special medication history (including proton pump inhibitors and H2 receptor antagonists), and all C¹³ breath tests were negative. The values of PGâ… , PGâ…¡and the ratio of PGâ… / PGâ…¡were measured in healthy persons, gastric ulcer, atrophic gastritis and gastric cancer patients by radioimmunoassay (RIA). The normal control group and every disease group were statistically compared, measurement dataes were expressed by mean±standard deviation (x±s),and tested by normality,and homogeneity of variance, homogeneity of variance and normal distribution dataes were used by analysis of variance, p﹤0.05 (bilateral) was statistically significant.Results(1) Eligible research subjects were 113 cases, including male 65 cases and female 48 cases. They Included NC 35 cases, GU 18 cases, AG 30 cases and GC 30 cases.(2) Compared with the normal control group, the content of serum PGâ… in atrophic gastritis and gastric cancer patients were decreasing, and the ratio of PGâ… / PGâ…¡was also decreasing, but the content of serum PGâ…¡did not change significantly.(3) Compared with the peptic ulcer patients, the content of serum PGâ… , PGâ…¡and the ratio of PGâ… / PGâ…¡in atrophic gastritis and gastric patients cancer decreased significantly.(4)Compared with the atrophic gastritis patients, the content of PGâ… , PGâ…¡and the ratio of PGâ… / PGâ…¡in gastric cancer patients was slightly lower, but the difference was not statistically significant.(5)When PGⅠ≤80μg/L and the PGâ… / PGⅡ≤6, the sensitivity and specificity for diagnosis of atrophic gastritis were 53.3% and 94.3%.Conclusions(1)serum PGâ… and ratio of PGâ… / PGâ…¡were related with atrophic gastritis and gastric cancer.(2)Serum PGⅠ≤80μg/L and the PGâ… / PGⅡ≤6 for the detection of atrophic gastritis has better sensitivity and specificity.(3)Detecting PGâ… and ratio of PGâ… / PGâ…¡Has a guiding role in screening high-risk groups who may have gastric cancer.