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幽门螺杆菌相关性萎缩性胃炎的侵入性与非侵入性诊断:一项对比研究。

Invasive and non-invasive diagnosis of Helicobacter pylori-associated atrophic gastritis: a comparative study.

作者信息

Pasechnikov Victor D, Chukov Sergey Z, Kotelevets Sergey M, Mostovov Alexander N, Mernova Varvara P, Polyakova Maria B

机构信息

Department of Therapy, Stavropol Medical Academy, Stavropol, Russia.

出版信息

Scand J Gastroenterol. 2005 Mar;40(3):297-301. doi: 10.1080/00365520410010607.

Abstract

OBJECTIVE

Helicobacter pylori-associated atrophic gastritis is known to be a significant risk factor for gastric cancer. Among the well-known parameters of atrophic gastritis are the levels of serum gastrin-17 (G-17) and pepsinogen I (PG1), which are biomarkers of gastric antral and corpus mucosal activity, respectively. The aim of study was to compare the production of G-17 and PG1 in patients with or without stomach mucosal atrophy and to investigate the utility of serum PG1 and/or G-17 concentrations for the objective evaluation of atrophic gastritis.

MATERIAL AND METHODS

A total of 178 dyspeptic Helicobacter pylori-positive patients underwent diagnostic upper gastrointestinal endoscopy with biopsy. The degree of histologic gastric mucosal atrophy was compared with the fasting levels of PG1, and to the postprandial levels of G-17 detected by enzyme immunoassay.

RESULTS

A decrease in serum G-17 levels along with worsening of the antral atrophy was observed; the serum levels of PG1 were reduced during progression of the corpus atrophy. In the multifocal atrophic gastritis, values for PG1 and G-17 serum concentrations were significantly lower than the respective cut-off values. Statistical analysis revealed statistically significant differences between the serum levels of PG1 and G-17 measured at different stages of stomach mucosal atrophy.

CONCLUSIONS

A strong reverse correlation was found between histologic/ endoscopic antral atrophy and serum G-17 levels, and between corpus atrophy and serum PG1 levels.

摘要

目的

幽门螺杆菌相关性萎缩性胃炎是胃癌的一个重要危险因素。萎缩性胃炎的一些知名参数包括血清胃泌素-17(G-17)和胃蛋白酶原I(PG1)水平,它们分别是胃窦和胃体黏膜活性的生物标志物。本研究的目的是比较有无胃黏膜萎缩患者的G-17和PG1产生情况,并探讨血清PG1和/或G-17浓度在客观评估萎缩性胃炎中的作用。

材料与方法

共178例幽门螺杆菌阳性的消化不良患者接受了诊断性上消化道内镜检查及活检。将组织学胃黏膜萎缩程度与PG1的空腹水平以及通过酶免疫测定法检测的餐后G-17水平进行比较。

结果

观察到随着胃窦萎缩加重,血清G-17水平下降;在胃体萎缩进展过程中,PG1血清水平降低。在多灶性萎缩性胃炎中,PG1和G-17血清浓度值显著低于各自的临界值。统计分析显示,在胃黏膜萎缩不同阶段测量的PG1和G-17血清水平之间存在统计学显著差异。

结论

发现组织学/内镜下胃窦萎缩与血清G-17水平之间以及胃体萎缩与血清PG1水平之间存在强烈的负相关。

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