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目的探讨常见因素对血清胃泌素水平的影响,揭示血清胃泌素在胃癌及其癌前疾病诊断中的价值。方法利用ELISA方法检测2002年6月至2004年7月收集的3906份血清样品的血清胃泌素水平。结果≥60岁组的血清胃泌素水平显著高于其他年龄组。患有胃窦疾病患者的血清胃泌素水平显著高于患有胃体疾病患者。HP阳性组的血清胃泌素水平显著高于HP阴性组。由正常者经浅表性胃炎至胃糜烂或溃疡,血清胃泌素水平进行性升高,由胃糜烂或溃疡至萎缩性胃炎有所下降;由萎缩性胃炎至不典型增生,血清胃泌素水平明显升高;由不典型增生至胃癌,血清胃泌素水平明显降低。胃癌的血清胃泌素水平显著低于其他胃疾病组。结论60岁以后,老年人的血清胃泌素水平已开始倾向于升高。胃部疾病的发生部位是影响血清胃泌素水平的一个重要因素。HP可使感染者的血清胃泌素水平升高。在胃癌前期,血清胃泌素水平可随疾病的发展而呈波动性递增,至胃癌形成时明显降低;血清胃泌素是鉴别胃良恶性疾病的一个较好的标志物。
Objective To investigate the influence of common factors on serum gastrin levels and to reveal the value of serum gastrin in the diagnosis of gastric cancer and its precancerous lesions. Methods Serum gastrin levels of 3906 serum samples collected from June 2002 to July 2004 were detected by ELISA. Results Serum gastrin levels of ≥60 years old group were significantly higher than those of other age groups. Serum gastrin levels were significantly higher in patients with gastric antrum than in those with gastropathy. The level of serum gastrin in HP positive group was significantly higher than that in HP negative group. From normal to superficial gastritis to gastric erosion or ulcer, serum gastrin levels increased from gastric erosion or ulcer to atrophic gastritis decreased; from atrophic gastritis to dysplasia, serum gastrin The level was significantly increased from atypical hyperplasia to gastric cancer, serum gastrin levels were significantly lower. Serum gastrin levels in gastric cancer were significantly lower than those in other gastric diseases. Conclusion After 60 years of age, serum gastrin levels in the elderly have tended to rise. The site of stomach disease is an important factor affecting serum gastrin levels. HP can make people with elevated serum gastrin levels. In the early stage of gastric cancer, the level of serum gastrin may fluctuate with the development of the disease and decrease obviously when the gastric cancer is formed. Serum gastrin is a good marker to identify benign and malignant gastric diseases.