SERUM PEPSINOGEN-I AND PEPSINOGEN-II AND STOMACH-CANCER
SERUM PEPSINOGEN-I AND PEPSINOGEN-II AND STOMACH-CANCER
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DOI：
10.1016/0009-8981(87)90022-2
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发表时间：
1987-03-16
影响因子：
5
通讯作者：
HEILBRUN, LK
中科院分区：
文献类型：
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作者：
STEMMERMANN, GN;SAMLOFF, IM;HEILBRUN, LK
夏威夷日本男性的前瞻性流行病学研究表明，血清胃蛋白酶原I(PG I)水平低于20 ng/ml对胃广泛肠化生和肠型胃癌具有高度特异性。然而，这项测试显示，作为肠型胃癌的预测指标，敏感性很低。由于A型萎缩性胃炎和晚期B型胃炎的胃体窦化导致PG II相对PG I的升高，我们研究了PG I/PG II比值作为预测胃癌的敏感性和特异性。使用2.0的比率截断点来区分胃癌的高风险和低风险受试者，我们发现敏感度水平略有提高，特异度略有下降。异常低的PG I水平和PG I/PG II比值主要与肠型癌症的晚期有关，因此不是识别早期胃癌的有用的筛查试验。PG I/PG II比值的使用导致敏感性水平略有提高，而特异性略有下降。
Prospective epidemiologic studies among Hawaiian Japanese men have shown that a serum pepsinogen I (PG I) level below 20 ng/ml is highly specific for extensive intestinal metaplasia of the stomach and for the intestinal type of stomach cancer. The test, however, shows a low level of sensitivity as a predictor of the intestinal type stomach cancer. Since antralization of the corpus, as encountered in Type A atrophic gastritis and late stage Type B gastritis, results in an increase of PG II relative to PG I, we examined the sensitivity and specificity of the PG I/PG II ratio as a predictor of gastric cancer. Using a cut-off point of 2.0 in the ratio to separate subjects at high and low risk for stomach cancer, we found a modest improvement in the level of sensitivity with a small decrease in specificity. Abnormally low PG I levels and PG I/PG II ratios were associated mainly with advanced stages of the intestinal type of cancer and therefore, are not useful screening tests to identify early cases of gastric cancer. The use of the PG I/PG II ratio resulted in a modest improvement in the level of sensitivity with a small decrease in specificity.