RESUMEN
The aim of the study was to estimate the value of detecting pepsinogen (PG) I, PGII, and gastrin-17 (G-17) levels in serum for chronic atrophic gastritis (CAG) screening and to determine the clinical applicability of combined measurement of serum G-17, pepsinogens (PGI, PGII) and PGI/PGII ratio (PGR) as a screening test for CAG. The PGI, PGII, and G-17 levels were detected by ELISA in 68 patients with CAG and 86 healthy volunteers who underwent gastroscopy for gastroduodenal diseases at Taizhou Municipal Hospital between January 2016 and December 2016. Concentrations of all measured serum markers were lower in patients with CAG in comparison to healthy volunteers and achieved statistical significance (P<0.01) in PGI (93.25 vs 126.98) and PGR (12.67 vs 17.09). Receiver operating characteristic (ROC) curve analysis revealed the optimal cut-off values for PGI, PGII, PGR, and G-17 at 98.10 µg/l, 6.92 ng/l, 15.77 and 1.94 pmol/l, with sensitivities of 72.10%, 58.10%, 61.60%, and 59.30% and specificities of 61.8%, 51.50%, 77.90%, and 55.90%, respectively. The areas under the curve (AUCs) of PGI, PGR, and G-17 were 0.728, 0.726, and 0.556, respectively. The increase of AUC was observed only in PGR and G-17 combination (0.741) with increased sensitivity (69.10% vs 61.60%) of screening for CAG, whereas the specificity was reduced (72.10% vs 77.90%) in comparison to PGR alone. Combination of serum indicators can raise the diagnosis accuracy of CAG in some respects. However, further research including a larger sample size is necessary in order to accurately determine the sensitivity and specificity of combined detection of serum indicators.
Asunto(s)
Gastrinas/sangre , Pepsinógeno A/sangre , Pepsinógeno C/sangre , Neoplasias Gástricas/diagnóstico , Estudios de Casos y Controles , Detección Precoz del Cáncer , Humanos , Neoplasias Gástricas/sangreRESUMEN
OBJECTIVE: To investigate the changes in the levels of human blood nutritious metabolites and its major regulating factors after exposure to abnormal acceleration of sea state, and to provide clues for further investigating the mechanism of fatigue due to maritime operations. METHODS: Using randomly sampling method, 60 healthy male adults from one troop were selected as the subjects on April 20, 2010. All subjects were exposed to six degrees of freedom motion simulator ship for 15 min. Their blood samples were collected before and after exposure to abnormal acceleration immediately. The metabolomic technology was used to measure the levels of nutritious metabolites in the serum. Enzyme - linked immunosorbent assay or radioimmunoassay was used to measure the levels of glucocorticoids, adrenaline, insulin, glucagon, ghrelin, resistin, leptin, and gastric inhibitory peptide. RESULTS: After exposure to abnormal acceleration, the subjects showed significant decreases in the levels of serum essential amino acids, such as L-lysine[(23.63±8.24)×10(6) vs(32.83±13.58)×10(6), P<0.05], L-methionine[(4.16±1.12)×10(6) vs(5.80±1.69)×10(6), P<0.05], and L-tryptophan[(29.38±8.56)×10(6) vs (35.93±11.82)×10(6), P<0.05], and the levels of some non-essential amino acids, such as L-histidine[(1.69±0.55)×10(6) vs(2.16±0.92)×10(6), P<0.05] and 4-hydroxy- L-proline[(3.21±1.50)× 10(6) vs (7.92±4.79)×10(6), P<0.05]. After exposure to abnormal acceleration, the subjects had significant increases in the levels of serum carbohydrate metabolites, such as glucose[(2412.40±700.36)×10(6) vs(1939.30±554.33)×10(6), P< 0.05] and pyruvic acid[(9.97±5.96)×10(6) vs(2.43±1.34)×10(6), P<0.05], and the levels of fat metabolites, such as ß-hydroxybutyric acid[(37.47±60.21)×10(6) vs(10.29±20.64)×10(6), P<0.05], oleic acid[(31.94±30.39)×10(6) vs (15.94±10.37)×10(6), P<0.05], and linoleic acid[(26.19±19.16)× 10(6) vs (13.58±6.29)× 10(6), P<0.05]. After exposure to abnormal acceleration, the subjects had significant increases in the levels of serum glucocorticoids [(743.63±129.06)nmol/L vs (539.66±155.58)nmol/L, P<0.05], adrenaline[(725.04±367.08)pmol/L vs (482.58±194.97)pmol/L, P<0.05], glucagon[(5.85±1.57)pmol/L vs(5.18±1.64)pmol/L, P<0.05], and ghrelin[(62.55±32.34)pmol/L vs (40.47±22.18)pmol/L, P<0.05], and decreases in the levels of serum insulin[(107.41±21.09)pmol/L vs(150.89±48.65)pmol/L, P<0.05], gastric inhibitory peptide[(41.05±17.91)pmol/L vs(170.34±82.64) pmol/L, P<0.05], leptin[(25.62±21.75)nmol/L vs (46.50±27.40)nmol/L, P<0.05], and resistin[(209.24±107.65)nmol/L vs (535.04±263.13)nmol/L, P<0.05]. CONCLUSION: After exposure to abnormal acceleration of sea state, the levels of serum nutritious metabolites show significant changes and the levels of fatigue-associated products, such as serum pyruvic acid, increase significantly, which may be related to induced stress response and changes in the levels of metabolic regulators.