【摘要】目的：探讨胃蛋白酶原 I (PqDsinogen I ,PG I )、胃蛋白酶原 II (PepsinogenD，PGII )、PG I /PGII (PG I /PGH ratio, PGR)水平变化结合内镜下美蓝-靛胭脂双重染色对胃癌及胃癌前病变(Precancerous lesions of gastric cancer,PLGC)诊断的价值。方法：应用酶联免疫法（Enzyme-linked immunosorbent assay,ELASA)法测定了124例胃溃瘍（Gastric carcinoma,GU)患者、130例慢性浅表性胃炎（Chronic superficia】 gastritis,CSG)患者、102例慢性萎缩性胃炎（Chronic atrophic gastritis,CAG)患者、90例胃癌(Gastric carcinoma,GC)患者、93例正常人的血清PG I、PGII含量及PGR的变化。将446例患者随机分为两组(双重染色组和对照组），每组各223例，双重染色组内镜下双重染色后在可疑病灶处活检，对照组不作染色按肉眼判断常规活检。结果:与正常组相比较,CSG、GU组血清PG I、PGII、PGR水平显著升高(P<0.01)，CAG及GC组血清PG I、PGR水平著降低(P<0.01)。染色组中检出阳性率72.20%;对照组中检出率53.36%。两组检出率差异有统计学意义(P<0.05)。结论:血清PG I、PGII、 PGR可作为早期GC筛查的一项血清学指标，对PLGC及早期GC的诊断有一定的临床意义。内镜下美蓝-靛胭脂双重染色可显著提高早期GC及PLGC的检出率。两项技术联合应用,可进一步提高GC及PLGC的检出率，有助于早期GC筛查。
【关键词】胃蛋白酶原;癌前病变;酶联免疫;双重染色
【中国图书分类法分类号】R446.1    【文献标志码】A    【收稿日期】2011-04-11

【Abstract】Objective: To evaluate the clinical value of measuring the serum levels of pepsinogen I (PG I ), pepsinogen H (PG D ) and double staining in 446 patients with gastric precancerous lesions or gastric carcinoma. Methods ：PG I ,PGII and PG I/PG II ratio(PGR) were measured with the two-site“sandwich”technique of enzyme-linked immunosorbent assay(ELISA) in these 446 pa¬tients. After that, these patients were randomized into two groups,223 patients were double stained with indigo carmine-methylene blue, while another 223 patients were not stained.At last, all of them were confirmed with pathology. Results：The serum PG I，PGR level of chronic atrophic gastritis (CAG) patients and gastric carcinoma(GC) patients were significantly lower than that of chronic su¬perficial gastritis(CSG) patients,gastric ulcer(GU) patients and healthy group(P<0.01).The PG I level of gastric ulcer patients was significantly higher than that of the healthy group and the other groups (P<0.01).The PGR in CAG and GC patients was significantly lower than that in the other groups (P<0.01).In double stained group,the prevalence rate was 72.20%.In nonstained group,the preva¬lence rate was 53.36%. Conclusion： Feasibility and the necessity of combined determination were evaluated.Compared with solo de¬termination, for patients with gastric lesions,it was more sensitive to determine and analyze the serum levels of PG I ,PG H and double staining.So it is recommended to popularize the combined determination of serum PG I ,PG II and double staining in clinical distinctive diagnosis of gastric precancerous lesions.
【Key words】pepsinogen ;precancerous lesions;radioimmunoassay;double staining