Clinical Study Of Pepsinogen And Gastrin-17 In Gastric Precancerous Disease

[Objective] :The purpose of this study was to detect the levels of pepsinogen-Ⅰ（PG-Ⅰ）,pepsinogen-Ⅱ（PG-Ⅱ）,PG-Ⅰ/PG-Ⅱ ratio（PGR）and gastrin-17（G-17）in different stages of gastric precancerous diseases,and to explore the value of PG-Ⅰ,PG-Ⅱ,PGR and G-17 in screening precancerous diseases.Better identify high-risk groups of gastric cancer before gastroscopy and establish a preliminary screening method for non-invasive screening of precancerous diseases of gastric cancer.[Methods] :A total of 472 patients with digestive diseases who underwent gastroscopy in the Department of Gastroenterology of Jiaxing First Hospital from December 2017 to July2019 were selected as the research subjects.According to the results of gastroscopy and pathological examination,the levels of PG-Ⅰ,PG-Ⅱ,PGR and gastrin-17 in different pathological groups（superficial gastritis group,atrophic gastritis group,dysplasia group）and atrophic gastritis patients in different atrophic sites（antrum atrophy,gastric body atrophy and gastric body + antrum atrophy group）were analyzed and compared.Receiver operating characteristic（ROC）curve was used to calculate the optimal cut-off values of serum PG and gastrin-17 for the diagnosis of atrophic gastritis.[Results] :1.Compared with superficial gastritis group,the levels of PG-Ⅰ and PGR in atrophic gastritis group and dysplasia group were significantly decreased（P<0.05）.There was no significant difference in PG-Ⅰ and PGR between atrophic gastritis group and dysplasia group（P> 0.05）.2.Compared with gastric body atrophy group,the level of serum gastrin-17 was decreased in antrum atrophy group and gastric body + antrum atrophy group（P <0.05）.Compared with antrum atrophy group,the levels of serum PG-Ⅰ and PGR in gastric body atrophy group were decreased（P< 0.05）.3.According to ROC curve,the diagnostic efficiency of combined detection of PGR ≤ 10.95 and gastrin-17 ≥ 9.95pmol/L was higher,and the detection rate of PGR combined with gastrin-17 in precancerous state group was higher than that in superficial gastritis group（P< 0.05）.[Conclusion] :The decrease of PG-Ⅰ and PGR suggested a higher risk of gastric precancerous disease.The decrease of PG-Ⅰ、PGR and G-17 levels can be used to indicate different gastric mucosa atrophy sites.The combined detection of PG and G-17 is of greater reference significance.In view of the non-invasive and low risk of serological testing,a multi-index prediction model based on serum PG-Ⅰ、PGR and G-17 was developed to identify high-risk groups of gastric cancer in Chinese population before gastroscopy to reduce the incidence and mortality of gastric cancer.