Estimation of Serum Pepsinogens as a New Marker of Gastric Cancer in Young Men

对88例年龄在40岁以下的住院胃癌患者按性别、年龄(4年内)进行调查，其中临终关怀对照组50例，筛查对照组87例。他们被要求回答一份问卷，并提供1毫升血清。对这些受试者的所有血清进行了胃蛋白酶I、II和铁蛋白的测定。采用病例对照研究的方法对问卷调查和血清学检查资料进行分析，得到以下结果。结论：1.早婚、过敏反应弱、有胃癌家族史的人群患胃癌的风险较高。胃癌组胃蛋白酶原II水平显著高于对照组，胃蛋白酶原I/胃蛋白酶原II比值和铁蛋白水平显著低于对照组。在这三个标记物中，与对照相比，胃蛋白酶原I和胃蛋白酶原II的比率差异最大。这些标记物应在胃癌筛查中得到实际应用。虽然还需解决胃蛋白酶原I/II比值为3.0时的假阳性率高(假阴性率为31%，假阳性率为16-20%)等问题，但基于本研究的结果，认为这些标记值得进一步研究。

88 hospital patient with gastric cancer under 40 years of age were metched for sex and age (within 4 years) with 50 hosptal controls and 87 screening controls. They were asked to answer a questionaire and offer 1 ml serum. Pepsiongen I, II and ferritin were measured with respect to all sera from these subjects. Data of the questionaire and the serological examinations were analyzed by the methodology of case-control study and results below were obtained.1. Those who had been married early, those who had weak allergic reactions and those who had family history of gastric cancer had high risk of gastric cancer.2. Among gastic cancer patients, pepsinogen II level was significantly higher and the pepsinogen I to pepsinogen II ratio and ferritin level were significantly lower than among controls. Among these three markers the difference regarding the pepsinogen I to pepsinogen II ratio was the largest in comparison to cantrols. These markers should be put to practical use in screening for gastric cancer. Although several problems such as high false-positive rate (false-negative rate was 31% and false-positive rate was 16-20% when the pepsinogen I to pepsinogen II ratio < 3.0) must be solved, these markers were thought to be worth studying further based on the results on this study.