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Objective:To investigate the application value of pepsinogen, Helicobacter pylori combined with endoscopic Kimura-Takemoto classification in the diagnosis of early gastric cancer. Methods:Sixty patients with gastric cancer who received treatment in the Department of Gastroenterology, the First People's Hospital of Huzhou from January to June 2022 were included in the gastric cancer group. An additional 60 patients with benign gastric lesions (benign gastric lesion group) and 60 patients with precancerous lesions of the stomach (precancerous lesion group) were also included in this study. Serologic testing for pepsinogen and Helicobacter pylori antibody combined with endoscopic Kimura-Takemoto classification was performed to evaluate their application value in the diagnosis of early gastric cancer. Results:Compared with the benign gastric lesion and precancerous lesion groups, the pepsinogen I/pepsinogen II ratio was significantly lower, and the pepsinogen II level and Helicobacter pylori infection rate [71.67% (43/60)] were significantly higher in the gastric cancer group ( F = 108.14, 71.75, 38.43, χ2 = 6.89, all P < 0.05). Compared with the benign gastric lesion and precancerous lesion groups, the Kimura-Takenmoto classification in the gastric cancer group was significantly higher ( H = 38.91, P < 0.05). In the gastric cancer group, pepsinogen I level and pepsinogen I/pepsinogen II ratio decreased and pepsinogen II level increased with the increase of pathological stage ( F = 65.79, 5.66, 53.32, all P < 0.01). There was no significant difference in Helicobacter pylori infection rate between different stages of gastric cancer ( P < 0.05) in the gastric cancer group. There was no significant difference in Kimura-Takenmoto classification between different stages of gastric cancer (all P > 0.05) in the gastric cancer group. The area under the receiver operating characteristic curve plotted for evaluating pepsinogen I, pepsinogen II, and pepsinogen I/pepsinogen II ratio for diagnosis of gastric cancer was 0.865, 0.664, and 0.881, respectively. Conclusion:Serum pepsinogen, Helicobacter pylori combined with endoscopic Kimura-Takemoto classification can increase the diagnostic rate of early gastric cancer. The Kimura Takemoto classification is helpful for risk stratification in the endoscopic screening of gastric cancer, and its results are consistent with pepsinogen levels. The combined application is of a high application value.
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Objective:To evaluate the clinical efficacy of Wanfu-Qutong Decoction combined with esomeprazole in the treatment of chronic atrophic gastritis (CAG). Methods:A total of 106 CAG patients who met the inclusion criteria from June 2017 to June 2019 were randomly divided into two groups with 53 in each group. The control group took esomeprazole magnesium enteric coated tablets, and the observation group took Wanfu-Qutong Decoction on the basis of the control group. Both groups were treated continuously for 3 months. TCM syndrome score was performed before and after treatment, and the new Sydney system intuitive simulation score method was used to score the histopathology of gastric mucosa. The levels of gastrin 17 (G-17), pepsinogen (PGⅠ , PGⅡ) and the PG Ⅰ/Ⅱ were measured by ELISA. Results:The total effective rate was 96.2% (51/53) in the observation group and 79.2% (42/53) in the control group. There was significant difference between the two groups ( χ2=7.414, P<0.01). After treatment, the scores of epigastric pain, fullness, liking temperature and pressing, vomiting clear water, eating less and staying foolish, and limb burnout in the observation group were significantly lower than those in the control group ( t values were 2.788, 3.632, 3.816, 1.590, 2.183, 2.103, respectively, all Ps<0.05), and the scores of chronic inflammatory reaction, inflammatory activity, atrophy degree, dysplasia and intestinal metaplasia in the mucosa were significantly lower than those in the control group ( t values were 2.983, 2.106, 2.106, 3.773, 1.922, 3.095, respectively, all Ps<0.05). After treatment, the serum G-17 [(14.47 ± 3.06) pmol/L vs. (10.67 ± 2.47) pmol/L, t=10.510] and PG Ⅰ [(130.31 ± 14.79) μg/L vs. (102.36 ± 12.63) μg/L, t=8.178] and PG Ⅰ/Ⅱ [(10.45 ± 0.48) vs. (9.17 ± 0.72), t=2.104] in the observation group were significantly higher than those in the control group ( P<0.01 or P<0.05). Conclusion:Wanfu-Qutong Decoction combined with esomeprazole tablets can effectively improve the clinical symptoms of CAG patients, regulate the levels of G-17, PG Ⅰ , PG Ⅱ and PGⅠ/Ⅱ, and promote the repair of gastric mucosa.
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Objective To explore the relationship between the serum PGⅠ,PGⅡ,PGⅠ/PGⅡ ratio(PGR),IgG anti-HP and gastric cancer and the diagnostic value.Methods The levels of serum PGⅠ,PGⅡ,PGⅠ/PGⅡ ratio(PGR) and IgG anti-HP were detected by emulsio immunoturbidimetry and ELISA in 30 patients with gastric cancer and 30 healthy subjects as controls.Then, the best cut-off value was established to screen gastric cancer.Results The levels of serum PGⅠ,PGⅡ,PGR and IgG anti-HP in the gastric cancer group were (33.72±6.49)ng/L, (8.36±1.26)ng/L, (3.67±0.72), (69.74±15.86)IU,respectively,which in the control group were (111.36±15.86)ng/L, (10.57±1.71)ng/L, (10.53±1.34), (34.62±8.94)IU,respectively.The levels of serum PGⅠ,PGⅡ and PGR in the gastric cancer group were significantly lower than those in the control group(t=25.58,5.60,24.67,all P<0.01),while the level of serum IgG anti-HP was significantly higher than that in the control group(t=10.55,P<0.01).Compare the serum PGⅠ, PGR between IgG anti-HP positive group and IgG anti-HP negative group, there was statistically significant differences(t=5.77,4.02,3.76,all P<0.01).According to the ROC curves, the best cut-off points of PGⅠ, PGⅡ, PGR, IgG anti-HP were 32.54 ng/L[sensitivity 80.7%,specificity 75.0%,area under curve (0.775±0.075)], 7.73 ng/L[sensitivity 75.4%,specificity 70.5%,area under curve (0.742±0.071)],3.48[sensitivity 86.4%,specificity 72.5%,area under curve (0.859±0.067)] and 69.11 IU[sensitivity 59.1%,specificity 75.0%,area under curve (0.667±0.089)].Conclusion Detection of serum PGⅠ, PGR, and IgG anti-HP levels can be useful as a way to screen gastric cancer, the PGR may the best single measure to diagnosis of gastric cancer.
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Objective To investigate the impact and clinical significance of helicobacter pylori (Hp) elimination on ghrelin. Methods Forty patients with chronic superficial gastritis (CSG), 42 patients with chronic atrophic gastritis (CAG), 41 patients with peptic ulcer (PU) and 17 patients with gastric adenocarcinoma (CA) were included in this study. All of pa-tients in four groups were Hp-positive. Forty patients with Hp-negative were used as control. The Hp elimination were only performed in CAG,CSG and PU groups. The serum ghrelin and pepsinogen (PG) levels before and after Hp elimination were detected with ELISA assay in CSG, CAG and PU groups. The correlation between PG and glrelin was also detected. The ex-pression of ghrelin in gastric mucosa was detected by RT-PCR. Results Comparing with control group (30.41 ± 8.97), the ghrelin level was increased in PU group (35.42±9.87), but which were decreased in CAG group (18.59±8.19) and CA group (18.33±6.88). There was no significant difference in ghrelin level between CSG group (26.08±9.14) and control group. After Hp elimination, the serum and gastric mucosa ghrelin levels were significantly increased in CSG group (P＜0.01), but both serum and gastric mucosa ghrelin levels were significantly decreased in PU group (P＜0.01). And no significant difference in the level of ghrelin after Hp elimination in CAG group (P>0.05). A positive correlation was found between serum PGⅠ/PGⅡand serum ghrelin level in CSG, CAG and CA groups (r=0.668,P＜0.01). Conclusion Hp elimination has an impact on ghrelin level in patients with upper gastrointestinal diseases. The changes of ghrelin level related to PGⅠ/PGⅡ. Ghrelin can be used as one of the indexes of diagnostic and prognostic evaluation in Hp related upper gastrointestinal diseases.