Value of serum gastrin and pepsinogen examination combined with narrow-band imaging endoscopy in the diagnosis of early gastric cancer / 中国基层医药

ABSTRACT

Objective:To investigate the value of serum gastrin-17 (G-17), pepsinogen (PG) I and II, and narrow-band imaging endoscopy in combination for identifying early gastric cancer.Methods:A total of 86 patients with suspected gastric cancer admitted to Zhoushan Hospital from January to September 2021 were included in this study. These patients underwent serum G-17, PG I, and PG II examination and narrow-band imaging endoscopy. PG I/PG II ratio (PGR) was calculated. Taking pathological results as a gold standard, the sensitivity, specificity, and accuracy of serum G-17, PG I, PG II, and narrow-band imaging endoscopy in combination for identifying early gastric cancer were calculated.Results:Serum G-17 level and PGR in the gastric cancer group were (20.14 ± 4.59) pmol/L and (20.21 ± 4.50) μg/L, respectively, which were significantly higher than (17.06 ± 4.05) pmol/L and (17.15 ± 4.08) μg/L in the atrophic gastritis group ( q = 4.12, 3.77, both P < 0.05) and (12.35 ± 3.31) pmol/L and (10.82 ± 5.26) μg/L in the non-atrophic gastritis group ( q = 9.34, 10.39, both P < 0.05). PG I and PGR in the gastric cancer group were (63.90 ± 14.41) μg/L and (3.17 ± 2.08), respectively, which were significantly lower than (79.34 ± 16.25) μg/L and (5.04 ± 3.61) in the atrophic gastritis group ( q = 5.33, 3.44, both P < 0.05) and (106.42 ± 20.18) μg/L and (9.22 ± 4.06) in the non-atrophic gastritis group ( q = 13.16, 9.97, both P < 0.05). Among the 86 patients included, gastric cancer was determined by biopsy in 43 patients. Pathological results showed that 37 patients had early gastric cancer and 6 patients had gastric cancer involving the muscle layer or serous layer. Narrow-band imaging endoscopy results showed that 83.78% (31/37) of patients had early gastric cancer. Serum G-17, PG, and narrow-band imaging endoscopy in combination showed that 91.89% (34/37) of patients had early gastric cancer. Taking pathological results as a gold standard, the sensitivity, specificity, positive predictive value, and negative predictive value of serum G-17 combined with PG for screening early gastric cancer were 72.97% (27/37), 77.55% (38/49), 71.05% (27/38), and 79.17% (38/48), respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of narrow-band imaging endoscopy for screening early gastric cancer were 83.78% (31/37), 85.71% (42/49), 83.10% (31/38), and 87.50% (42/48). The sensitivity and specificity of serum G-17, PG, and narrow-band imaging endoscopy in combination for screening early gastric cancer were 91.89% (34/37) and 91.84% (45/49), respectively. Conclusion:Serum G-17, pepsinogen, and narrow-band imaging endoscopy in combination can improve the diagnostic accuracy of early gastric cancer and is an effective method for screening early gastric cancer.