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。 Objective To observe the diagnostic value of PGI, G-17 and soluble HLA-G in gastric cancer. Methods 94 cases of newly diagnosed gastric cancer patients as experimental group Ⅰ, according to TNM staging criteria were divided into Ⅰ ~ Ⅱ group of 31 cases and Ⅲ ~ Ⅳ group of 63 cases; another 37 cases of chronic atrophic gastritis patients as experimental group Ⅱ, 44 cases of stomach Intraepithelial neoplasia patients as the experimental group Ⅲ, 50 healthy subjects in the same period in the hospital physical examination as a control group, the elbow venous blood of each group were drawn 5 m L, the level of serum PG Ⅰ expression was detected by chemiluminescence immunoassay, enzyme-linked immunosorbent assay The serum levels of G-17 and s-G in serum were measured and the ROC curve was drawn according to the expression of HLA-G of PGⅠ, G-17 and s-R, and the ROC curve of each index was analyzed. Results The PG Ⅰ in group Ⅰ, Ⅱ, Ⅲ and control group were (52.78 ± 8.14), (65.79 ± 9.07), (66.34 ± 9.15) and (76.69 ± 10.31) mg · L -1, respectively Respectively, (9.87 ± 0.76), (4.69 ± 0.40) (4.69 ± 0.40) and (3.43 ± 0.21) pmol·L -1, respectively. The HLA-G allele frequencies were 83.63 ± 13.29 and 56.83 ± 8.58, , (54.95 ± 8.37) and (37.24 ± 5.91) U · m L ~ (-1), respectively, which were significantly different from the control group (all P <0.05). The levels of PG Ⅰ in peripheral blood of Ⅰ ~ Ⅱ group were (58.71 ± 7.49) mg · L -1, (8.97 ± 0.67) pmol·L -1 and 74.29 ± 8.94 ) PGI was (49.55 ± 6.42) mg · L -1, and G-17 was (10.33 ± 0.84) pmol·L -1 in U · m L ~ (-1) , s HLA-G was (88.39 ± 10.38) U · m L -1, the difference was statistically significant (P <0.05). The AUC of PG Ⅰ for gastric cancer was 0.792, 0.692 for G-17 and 0.853 for HLA-G, the AUC of s HLA-G was significantly higher than that of PGⅠ and G-17 (P <0.05) (P <0.05). The specificity of HLA-G was 92.5%, the positive predictive value was 88.9%, the highest PGI sensitivity was 84.7% and the negative predictive value was 81.8%. Conclusion PGI in peripheral blood of patients with gastric cancer is significantly lower, G-17, s HLA-G is significantly increased, PGI, G-17, s HLA-G can be used as an effective supplement for the diagnosis of gastric cancer.