Detection of serum pepsinogen,gastrin-17 and Helicobacter pylori for differential diagnosis of gastric lesions
Objective To explore the value of serum pepsinogen(PG)Ⅰ,PG Ⅱ,PG Ⅰ/PG Ⅱ(PGR),Gastrin-17 levels and helicobacter pylori(Hp)detection for differential diagnosis of gastric lesions.Methods A total of 321 patients with various gastric lesions who underwent gastroscopy and histopathological examination in the Affiliated Hospital of Hangzhou Normal University between June 2021 and June 2023 were enrolled,including 148 cases of chronic superficial gastritis,80 cases of chronic atrophic gastritis,57 cases of gastric ulcers and 36 cases of gastric cancer.Hp infection was detected by hematoxylin-eosin staining and/or 14C breath test,serum levels of PG Ⅰ,PG Ⅱ,PGR and Gastrin-17 were measured and compared among 4 groups of patients.The value of serum markers,Hp infection and in combination for the differential diagnosis of gastric cancer and chronic atrophic gastritis was examined by ROC curve.Results The Hp infection rate was the highest in the gastric ulcer group compared to other three groups;the serum levels of PG Ⅰ,PG Ⅱ and Gastrin-17 were significantly higher in the gastric cancer group than those in the chronic superficial gastritis and chronic atrophic gastritis groups(all P＜0.05);the level of PGR in the gastric cancer group was significantly lower than chronic superficial gastritis group(P＜0.05).The AUC of the combination of PG Ⅰ+PG Ⅱ+PGR+Gastrin-17+Hp+age+sex(7MP)was 0.875 in differentiating gastric cancer from chronic atrophic gastritis,with a sensitivity and specificity of 0.778 and 0.875,respectively.Conclusion The levels of serum PG Ⅰ,PG Ⅱ,PGR,Gastrin-17 and the Hp detection are different among patients with chronic superficial gastritis,chronic atrophic gastritis,gastric ulcers or gastric cancer,and the above serum markers in combination of Hp plus age and sex(7MP)is valuable for the differential diagnosis of gastric cancer and chronic atrophic gastritis.
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