Diagnostic value of pepsinogen determination in children peptic ulcer
Objective To investigate the value of pepsinogen(PG)in diagnosing children peptic ulcer.Methods A total of 855 children patients completing gastroscopic examination in this hospital due to nausea,vomiting,abdominal pain,gastrointestinal bleeding and other gastrointestinal symptoms from July 2019 to January 2024 were selected as the study subjects.According to the gastroscopic examination results,they were divided into the healthy physical examination group(n=223),chronic gastritis group(n=418),chronic gas-tritis combined with duodenal bulbar inflammation(n=168)and gastric ulcer and duodenal bulbous ulcer group(peptic ulcer group,n=46).A total of 503 study subjects perfected the 13C breath test and divided into Helicobacter pylori(Hp)positive and Hp negative according to the test results.Serum PGⅠ,PGⅡ and PGⅠ/PGⅡ levels in all study subjects were measured by latex immunoturbidimetry.The differences of this indi-cator among different ages and different gastric diseases and its diagnostic value in peptic ulcer were analyzed.Results The proportion of female children patients in the peptic ulcer group was significantly lower than that in the other 3 group,and the difference was statistically significant(P<0.05).The PGⅠ level of children pa-tients<7 years old in the chronic gastritis group was lower than that of the children patients>12 years old group,and the difference was statistically significant(P<0.05).The PG level of the children patients<7 years old in chronic gastritis combined with duodenal bulbar inflammation group was lower than that in the children patients>12 years old group,the PGⅡ level in the children patients<7 years old,7-12 years was lower than that in the children patients>12 year old,and the difference was statistically significant(P<0.05).Compared with the healthy physical examination group,the PGⅠ level in the chronic gastritis group was increased,the PGⅠ and PGⅡ levels in the chronic gastritis combined with duodenal bulbar inflammation group were increased,the PGⅠ/PGⅡ ratio was decreased,the PGⅠ and PGⅡ levels in the peptic ulcer group were increased and the PGⅠ/PGⅡ ratio was decreased,and the differences were statistically significant(P<0.05).Compared with the chronic gastritis group,the PGⅠ/PGⅡ ratio in the chronic gastritis combined with duodenal bulbar inflammation group was decreased,the PGⅠ and PGⅡ levels in the peptic ulcer group were increased,the PGⅠ/PGⅡ ratio was decreased,and the differences were statistically significant(P<0.05).Compared with chronic gastritis combined with duodenal bulbar inflammation group,the PGⅠ and PGⅡ lev-els in the peptic ulcer group were increased,the PGⅠ/PGⅡ ratio was decreased,and the differences were sta-tistically significant(P<0.05).The area under the curve(AUC)of PGⅠ and PGⅡ for predicting peptic ul-cer was 0.689 and 0.785 respectively,the maximal Youden index served as the optimal diagnostic cutoff val-ue,when PGⅠ was 69.25 μg/L,its Youden index reached the maximal value,the sensitivity for diagnosing peptic ulcer was 67.4%,the specificity was 72.3%;when PGⅡ was 12.25 μg/L,its Youden index reached the maximal value,the sensitivity for diagnosing peptic ulcer was 71.7%,the specificity was 76.1%.Compared with the Hp negative,Hp positive PGⅠ and PGⅡ in the chronic gastritis combined with duodenal bulbar in-flammation group were increased,the PGⅠ/PGⅡ ratio was decreased,the Hp positive PGⅠ/PGⅡ ratio in the peptic ulcer group was decreased,and the differences were statistically significant(P<0.05).Conclusion PG could be used to diagnose children peptic ulcer.
gastric function determinationpepsinogenserological examinationchildrenpeptic ulcerHelicobacter pylori