Kuipers Ernst J
Department of Gastroenterology and Hepatology, Erasmus MC University Medical Centre, Rotterdam, the Netherlands.
Eur J Gastroenterol Hepatol. 2003 Aug;15(8):877-9. doi: 10.1097/00042737-200308000-00007.
Gastric cancer remains the second biggest cause of cancer death worldwide. The most common type of gastric cancer, the intestinal type, is usually preceded by chronic atrophic gastritis. Gastritis serology is therefore of crucial importance for population-based screening and prevention studies. Helicobacter pylori serum antibodies can adequately diagnose inflammation of the gastric mucosa, but the serological diagnosis of atrophic gastritis is more hazardous. Many tests have been used for this purpose, either alone or in various combinations. Depending on the population, pepsinogens and gastrin often have a high specificity but low sensitivity for the diagnosis of atrophic gastritis, whereas antibodies against H. pylori or CagA have a high sensitivity but low specificity. A combination of two tests, e.g. H. pylori antibodies and pepsinogen I, may balance this issue and provide adequate screening tools, although there is a clear need for further improvement and simplification of serological testing for atrophic gastritis.
胃癌仍然是全球癌症死亡的第二大原因。最常见的胃癌类型即肠型胃癌，通常之前会有慢性萎缩性胃炎。因此，胃炎血清学对于基于人群的筛查和预防研究至关重要。幽门螺杆菌血清抗体能够充分诊断胃黏膜炎症，但萎缩性胃炎的血清学诊断则更具挑战性。为此已采用了许多检测方法，单独使用或多种组合使用。根据不同人群，胃蛋白酶原和胃泌素对萎缩性胃炎的诊断通常具有高特异性但低敏感性，而抗幽门螺杆菌或抗CagA抗体则具有高敏感性但低特异性。两项检测的组合，例如幽门螺杆菌抗体和胃蛋白酶原I，可能会平衡这一问题并提供足够的筛查工具，不过显然仍需要进一步改进和简化萎缩性胃炎的血清学检测。
