中文摘要：

目的观察外周血胃蛋白酶原Ⅰ（PGⅠ）、胃泌素-17（G-17）、可溶性人白细胞抗原-G（s HLA-G）检测对胃癌的诊断价值。方法 94例初诊胃癌患者作为试验组Ⅰ,按照TNM分期标准分为Ⅰ-Ⅱ期组31例和Ⅲ-Ⅳ期组63例;另选择37例慢性萎缩性胃炎患者作为试验组Ⅱ,44例胃上皮内瘤变患者作为试验组Ⅲ,同期在医院体检的健康人群50例作为对照组,抽取各组患者肘静脉血5 m L,用化学发光免疫分析检测血清PGⅠ表达水平,用酶联免疫吸附试验检测血清G-17和血浆s HLA-G表达水平,根据PGⅠ、G-17、s HLA-G表达水平绘制受试者工作特征（ROC）曲线,对各指标ROC曲线进行分析。结果试验组Ⅰ、Ⅱ、Ⅲ组和对照组PGⅠ分别为（52.78±8.14）,（65.79±9.07）,（66.34±9.15）,（76.69±10.31）mg·L^-1,G-17分别为（9.87±0.76）,（4.69±0.40）（4.69±0.40）,（3.43±0.21）pmol·L^-1,s HLA-G分别为（83.63±13.29）,（56.83±8.58）,（54.95±8.37）,（37.24±5.91）U·m L^-1,与对照组相比,差异均有统计学意义（均P〈0.05）。Ⅰ-Ⅱ期组外周血PGⅠ为（58.71±7.49）mg·L^-1,G-17为（8.97±0.67）pmol·L^-1,s HLA-G为（74.29±8.94）U·m L^-1,Ⅲ-Ⅳ期组的PGⅠ为（49.55±6.42）mg·L^-1,G-17为（10.33±0.84）pmol·L^-1,s HLA-G为（88.39±10.38）U·m L^-1,差异有统计学意义（P〈0.05）。PGⅠ诊断胃癌的AUC为0.792,G-17为0.692,s HLA-G为0.853,s HLA-G的AUC显著高于PGⅠ和G-17（P〈0.05）,PGⅠ的AUC显著高于G-17（P〈0.05）;s HLA-G的特异性（92.5%）、阳性预测值（88.9%）最高,PGⅠ敏感性（84.7%）、阴性预测值（81.8%）最高。结论胃癌患者外周血PGⅠ显著降低,G-17、s HLA-G显著升高,PGⅠ、G-17、s HLA-G能够作为胃癌诊断的有效补充。

英文摘要：

Objective To observe the diagnosis value of serum pepsino-gen I （ PG I ）, gastrin - 17 （ G - 17 ）, soluble human leukocyte antigen （sHLA- G） detection in gastric cancer. Methods Ninety- four cases of newly diagnosed patients with gastric cancer were selected as treatment group I , 31 patients were divided into stage Ⅰ-Ⅱ and 63 patients with stage Ⅲ-Ⅳ according to TNM stage, another 37 cases of chronic atrophic gastritis patients as treatment group II, 44 cases of gastric intraepithelial neoplasia patients as treatment group Ⅲ, 50 cases of healthy people as control group. The expression levels of serum PG I were detected by chemiluminescence immunoassay, serum G - 17 and plasma sHLA - G levels were detected by enzyme - linked immunosorbent assay, accorded to the PG I , G - 17, sHLA - G expression level to draw the receiver operating characteristic （ROC） curve, and the ROC curve of each index were analyzed. Results The peripheral blood PG I of treatment Ⅰ、Ⅱ、Ⅲ groups and control group were （52. 78 ± 8. 14）, （ 65.79 ± 9.07 ）, （ 66. 34 ± 9. 15 ）, （76.69± 10.31） mg·L^-1, G- 17 were （9.87 ±0.76）, （4,69 ±0.40）, （4.69 ±0.40）, （3.43±0.21） pmol·L^-1, sHLA-Gwere （83.63±13.29）, （56.83±8.58）, （54.95±8.37）, （37.24±5.91）U·mL^-1, had significant difference compared with control group （P 〈 0. 05 ）. The peripheral blood of PG I in Ⅰ-Ⅱ group [（58.71 ±7.49）mg·L^-1] was significantly higher than Ⅲ-Ⅳ group[（49.55 ± 6.42） mg·L^-1]. G - 17 [ （8.97 ± 0. 67 ） pmol·L^-1] and sHLA - G [ （74. 29 ± 8.94 ） U·mL^-1] in Ⅰ-Ⅱ group were significantly lower than Ⅲ-Ⅳ group [ （ 10. 33 ± 0. 84） pmol·L^-1, （88.39 ± 10. 38） U·mL^-1 ] （P 〈0. 05）. Diagnosis of gastric cancer AUC in PG I , G - 17, sHLA - G were 0. 792, 0. 692, 0. 853, AUC of sHLA - G significantly higher than PG I and G - 17 （P 〈0. 05）, PG I AUC significantly higher than G - 17 （P 〈0. 05）. The specificity（92. 5% ）