关键词: 胃癌, 胃泌素类, 胃蛋白酶原类, 幽门螺杆菌, 筛查, 健康体检

Abstract: Objective　To evaluate the effect of a combination test of gastrin-17（GAS-17） and pepsinogen measurement and 14C-UBT for gastric cancer screening in physical examination，providing a theoretical basis for the enaction of physical examination items.Methods　The enrolled 1 186 participants were employees aged 40 or over from Fourth Hospital of Hebei Medical University.They underwent a physical examination from July to October，2017.The number of participants undergoing GAS-17 measurement，pepsinogen measurement，14C-UBT，combination test（GAS-17 and pepsinogen measurement combined with 14C-UBT） and painless gastroscopy for gastric cancer screening was 471，471，440，380，130，respectively.Results　The overall positive prevalence detected by GAS-17 measurement，pepsinogen measurement，14C-UBT，combination test was 46.5%（219 cases），42.0%（198 cases），46.8%（206 cases），63.7%（242 cases），respectively，demonstrating that the combination test had higher positive rate than the other 3 methods（P<0.008 3）．Moreover，the prevalence of gastric ulcer or gastric polyps detected by combination test was still higher compared with the other 3 methods（P<0.008 3）．However，these 4 methods showed similar positive predictive value for atrophic gastritis，gastric ulcer，gastric polyps or gastric precancerous lesions（P>0.05）．By painless gastrosopy，5 were found with atrophic gastritis，30 with gastric ulcer，29 with gastric polyps，and 4 with gastric precancerous lesions.Conclusion　The combination test demonstrated higher detection rate of gastric diseases than each of its components alone，so it can be used as a screening item for high risk population for gastric cancer.

Key words: Gastric cancer, Gastrins, Pepsinogens, Helicobacter pylori, Screening, Physical examination